Stress can increase the amount of acid in the stomach, worsening symptoms of acid reflux. But there are ways to manage both.

Acid reflux is a common condition that you may experience occasionally. For example, after eating spicy food or laying down immediately after eating.

But if you’re experiencing acid reflux more often and it seems to coincide with anxiety or excess worry, there could be a connection.

You may wonder if your anxiety is causing your acid reflux or if your acid reflux is causing your anxiety. Both can be true, creating a cycle that can get out of control if left unmanaged.

A better understanding of the connection between how your thought processes affect your body’s systems is a good step toward reducing physical and emotional discomfort.

With the right support, you can learn to manage your anxiety and reduce your acid reflux.

Acid reflux occurs when the acid in your gut moves backward into your esophagus. It can cause symptoms such as cough, sore throat, and a burning feeling in the chest.

Several studies have investigated the connection between the brain and the gut. The two are linked by the gut-brain axis. Trillions of microbes (microorganisms) live in the gut and can affect many things, including your immune system, gut function, and chemicals that affect the brain.

These chemicals, or neurotransmitters, also play a role in mood, memory, concentration, behavior, and thinking. They can also contribute to mental health conditions, such as anxiety.

A 2015 study highlighted the connection between anxiety and various gut disorders, including acid reflux. It also found that increased stress levels were associated with irritation in the esophagus, a primary indicator of acid reflux.

Similarly, research from 2016 looked at the social, psychological, and physical connection between gastrointestinal disorders such as acid reflux and other common illnesses — both physical and psychological.

Researchers noted that anxiety disorders are the most common condition linked to other physical and mental health conditions, including acid reflux.

The researchers suggest that anxiety disorders and gastrointestinal disorders may share brain pathways because the two tend to go hand in hand. Consequently, anxiety could act as a trigger for acid reflux, among other changes in the body.

A 2018 study points out that anxiety may change the pressure in the esophageal sphincter, which keeps acid in the stomach.

If you have both, treating anxiety and acid reflux at the same time can help you navigate the intertwined systems of your body and improve your quality of life.

Stress can make acid reflux worse in several ways.

A 2017 study found that symptoms of stress were reported more often among people with acid reflux. Additionally, people with acid reflux perceived more pain from their symptoms, reducing their quality of life and increasing their stress.

Frequency and severity of acid reflux increase as stress increases. Whether stress triggers acid reflux or not, it can fuel digestive discomfort until it becomes chronic.

Gastroesophageal reflux disease (GERD) occurs when acid reflux becomes chronic (long term) and severe, which can lead to complications, such as damage to the esophagus.

It’s not uncommon to experience gastroesophageal reflux, acid reflux, or heartburn from time to time. In fact, a 2020 review estimates that nearly 1.03 billion people worldwide experience GERD.

But when the symptoms are frequent and bothersome and begin to interfere with your daily life, you may have GERD.

GERD may also be referred to as:

  • reflux
  • acid reflux
  • acid regurgitation
  • heartburn
  • acid indigestion

Common symptoms of GERD include:

  • belching
  • nausea and vomiting
  • difficulty swallowing (dysphagia)
  • stomach pain
  • tooth erosion and bad breath

The symptoms of anxiety are different from GERD but are important to recognize to identify a connection between GERD and anxiety. The symptoms include:

  • excessive worry
  • restlessness
  • sleep problems
  • muscle tension
  • fatigue
  • uncontrollable fearful or worrisome thoughts

If you’re experiencing both sets of symptoms, you may have acid reflux (potentially GERD if it’s persistent) and anxiety. And this is not uncommon.

GERD and anxiety often co-occur together. A 2022 review discusses this and how both conditions can affect each other.

Anticipation of reflux and experiencing chronic acid reflux can increase anxiety.

A 2017 study suggests that anxiety (and depression since the two are so closely linked) sometimes develop after reflux, potentially as a result of it.

For example, if you’ve had heartburn before, you may worry about experiencing again — whether you’re worried about the discomfort or how it will affect your sleep. And as time goes on, you may grow more and more anxious.

The longer this continues, the greater your chance of experiencing symptoms of acid reflux while increasing your symptoms of anxiety at the same time.

There are many at-home and medical treatment options you can try for both anxiety and acid reflux. For acid reflux, you can begin with daily habits before moving to more aggressive prescription treatments.

Consider these options for managing acid reflux.

  • Avoid spicy and fatty foods late at night: Try to eat your evening meal 2 to 3 hours before bed. Foods such as chocolate, drinks with caffeine, and acidic foods such as tomatoes may worsen reflux.
  • Eat smaller meals: Overeating can put more pressure on the esophageal sphincter and contribute to acid reflux. Try eating smaller, more frequent meals instead.
  • Stay upright after eating: Gravity helps keep the stomach’s contents where they belong, especially when you’ve got a full stomach.
  • Consider weight loss: Excess weight can sometimes put more pressure on the esophageal sphincter, according to a 2016 review. But weight loss may not make a difference in all cases. If a doctor recommends shedding a few pounds to help, try to eat a balanced diet and exercise daily.
  • Avoid cigarettes and alcohol: Research from 2017 suggests that alcohol and cigarette use may increase your chances of developing acid reflux.
  • Sleep with your head elevated: Even if you eat smaller, more frequent meals, acid reflux can kick in at bedtime. Gravity works in your favor when you sleep on an incline. Consider using extra pillows or buying a bolster to keep your head above your stomach.

If home remedies don’t help, you can talk with a healthcare professional about medications such as proton pump inhibitors (PPIs) such as Prilosec or H2 blockers such as Pepcid AC.

You can manage anxiety by making big and small changes in your daily life. Anxiety treatment can include:

  • Help from a mental health professional: A mental health professional trained in cognitive behavioral therapy (CBT) and other therapeutic techniques can help you learn to manage your thoughts and fears.
  • Medication: You might be prescribed medication, such as selective serotonin reuptake inhibitors (SSRIs), which block serotonin absorption so that there’s more of it in your brain to help regulate your mood.
  • Regular exercise: Exercise releases endorphins that help you feel good. It can also help you get rid of nervous tension.
  • Eat a balanced diet: A 2020 study suggests that low vitamin D levels may contribute to anxiety symptoms. Giving your body adequate nutrition can make sure you have the vitamins and nutrients you need to keep anxiety from getting out of control.

For many people, acid reflux and anxiety go hand in hand. Anxiety can lead to acid reflux, and acid reflux can lead to anxiety.

But this cycle isn’t inevitable. You can treat anxiety and acid reflux with home remedies or help from a healthcare or mental health professional.

Treatment for acid reflux may include changing your daily habits, eating a balanced diet, changing your meal timing, and exercising regularly.

If you have an anxiety disorder, medication, therapy, or a combination of both may be recommended. Self-care strategies may also help calm anxiety at the moment.

A healthcare or mental health professional can help you manage both conditions. If you’re unsure where to start looking for support, you can check out Psych Central’s hub on finding mental health support.