Why Anxiety May Be Causing Your Acid Reflux/GERD
Do you ever notice that your acid reflux symptoms worsen during times of increased stress? If your answer is yes - you are not alone.
As a Registered Dietitian who has helped hundreds of individuals overcome chronic acid reflux symptoms, I can tell you that there is a correlation between GERD and anxiety. While the main causes of GERD may be related to functional digestive issues (such as the lower esophageal sphincter), recent research suggests that anxiety and stress can make GERD symptoms worse. In this blog post, we'll explore the interesting connection between anxiety and GERD, and how psychological factors can affect physical well-being.
Understanding GERD:
GERD occurs when stomach acid and partially digested food flow back into the esophagus, irritating its lining. The LES, which is a muscular valve between the esophagus and stomach, is responsible for preventing this backward flow. When the LES doesn't close properly or weakens, stomach acid refluxes into the esophagus, causing GERD symptoms. Malfunction of the LES is a very common root cause of acid reflux, especially if symptoms are more severe at night.
The Link Between Anxiety and GERD:
Anxiety is a psychological condition characterized by excessive worry, fear, and apprehension. People with anxiety disorders often experience physical symptoms like heart palpitations, sweating, and problems with their digestion. There are several theories that provide some insight into the relationship between anxiety and acid reflux:
Increased Acid Production: The brain-gut axis, a communication system between the brain and the gut, plays a role in how stress affects the digestive system. Stress activates the hypothalamic-pituitary-adrenal (HPA) axis, which releases stress hormones like cortisol. These hormones can directly affect gut function, increase stomach acid production, and impact immune responses and inflammation in the gut. This increase in acid caused by anxiety can raise the chances of acid reflux, potentially worsening GERD symptoms.
Hypochlorhydria or Decreased Acid Production: In some individuals, anxiety may result in decreased acid production. When our body is under stress, digestion is deprioritized. Blood flows to our limbs, away from our digestion. Our body prioritizes bodily functions such as the brain, heart, and kidneys, instead of digestion. As a result, the production of stomach acid and digestive enzymes can be compromised. (Note: We also see decreased production of stomach acid/enzymes in individuals who are undereating or deficient in protein, zinc, and iron) Working with a Registered Dietitian who specializes in acid reflux/GERD can help you determine if low vs high stomach acid may be causing your acid reflux.
Altered Esophageal Function: Anxiety can affect the muscles in the esophagus, including the LES. Studies suggest that stress and anxiety may cause the LES to relax, making it easier for acid to reflux into the esophagus. Anxiety-induced changes in esophageal motility can also make it harder for the esophagus to clear acid, making GERD symptoms worse.
Hypervigilance and Sensitization: Anxiety can make people more aware of bodily sensations. Those with anxiety may pay close attention to normal physical processes and interpret them as signs of a more severe condition. For example, minor instances of acid reflux that would usually go unnoticed might be seen as significant symptoms in an anxious person, causing more distress.
Breaking the Anxiety-Gastrointestinal Cycle:
To manage both anxiety and GERD symptoms together, there are several strategies you can try:
Stress Reduction Techniques: Practices like deep breathing exercises, meditation, yoga, or mindfulness have been shown to help reduce anxiety and digestive symptoms. By lowering overall stress levels, these techniques may indirectly help manage GERD symptoms. If you feel that stress or anxiety may be contributing to your acid reflux symptoms, explore the healing tools of the FLORA™ Integrative Gut Health app. Start healing acid reflux, improving your relationship with food, and decreasing anxiety today with FLORA’s 7-day risk-free trial.
Cognitive Behavioral Therapy (CBT): CBT is a therapy that can effectively address anxiety disorders. By challenging negative thought patterns and developing healthier coping mechanisms, individuals can reduce the impact of anxiety on physical symptoms.
Lifestyle Modifications: Making certain lifestyle changes can significantly improve GERD symptoms. These include finding foods you enjoy outside of the common reflux triggers, creating a meal schedule to eat smaller, more frequent meals, and avoiding lying down immediately after eating.
Seeking Professional Help: If anxiety and GERD symptoms persist or greatly affect your quality of life, it's important to seek professional help. Consult a healthcare provider who can assess your symptoms, provide an accurate diagnosis, and recommend appropriate treatment options tailored to your specific needs.
GERD is a complex condition influenced by various factors, including anxiety and stress. Understanding the connection between anxiety and GERD symptoms can help individuals better manage their condition. By addressing anxiety through stress reduction techniques, cognitive-behavioral therapy, and lifestyle modifications, individuals may experience relief from both anxiety and GERD symptoms. Remember, seeking professional guidance is crucial for an accurate diagnosis and personalized treatment plan.
Written by Molly Pelletier, MS, RD, LDN
Molly Pelletier is a Registered Dietitian specializing in digestive health, IBS, and Acid Reflux. Her work, across multiple disciplines, centers around developing a healthy relationship with food and the importance of gut health. Molly's personal struggles with acid reflux and digestive dysfunction were the catalysts that led her to complete her BS and MS degrees in Nutrition Science at Boston University. Molly's background in nutrition science and personal health journey culminated in the curation of the community platform FLORA, where she shares evidence-based tools and strategies to help others heal their gut and optimize their overall well-being.
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References
Mohammad S, Chandio B, Soomro AA, et al. Depression and Anxiety in Patients with Gastroesophageal Reflux Disorder With and Without Chest Pain. Cureus. Published online November 8, 2019. doi: https://doi.org/10.7759/cureus.6103
Yang XJ. Anxiety and depression in patients with gastroesophageal reflux disease and their effect on quality of life. World Journal of Gastroenterology. 2015;21(14):4302. doi: https://doi.org/10.3748/wjg.v21.i14.4302
