The Link Between Stress and Acid Reflux

By Terez Malka, MD
Medically reviewed checkmarkMedically reviewed
January 18, 2022

Feeling overwhelmed by work or dealing with financial stress?

Having troubles in your interpersonal relationships? All these scenarios can induce stress that may bring on a case of acid reflux. 

According to The American Psychological Association (APA), 77% of Americans regularly experience physical symptoms caused by stress, 73% regularly experience psychological symptoms caused by stress, and 48% said stress had a negative impact on both their personal and professional lives.

Gastrointestinal reflux disease (GERD) is a physical symptom that has been researched as being brought on by stress.

It can occur at the most inopportune times such as when you are at a job interview or right before you have an important speech to make — a burning sensation in your throat caused by stomach acid creeping up your esophagus. 

What is Acid Reflux?

Acid reflux is a condition that many of us will experience at least once in our lives.

It is brought on by digestive issues and specifically occurs when stomach acid or bile enters the lower esophageal sphincter and irritates the pipe lining.

It is an extremely unpleasant experience that can make your chest burn and cause discomfort when speaking.

Symptoms

You may be struggling with a case of acid reflux if you are experiencing any or all of the following symptoms:

  • Heartburn: a burning pain that can travel from your stomach to your lower abdomen and up to your chest. You may also experience this burning pain in your throat.
  • Dyspepsia (indigestion): this is a stomach upset that can be categorized by burping, belching, bloating, nausea after eating, and heartburn.
  • Regurgitation: a sour or bitter taste in your mouth or throat that may feel like you are heaving. You may experience this as wet burps. You may also experience dry-heaving
  • Dysphagia: the feeling of food being stuck in your throat.

Causes

Hiatal hernia is a common cause of acid reflux disease.

This is when the upper part of the stomach bulges through your diaphragm, the muscle that separates your stomach from your chest.

Your diaphragm typically works to help keep acid in your stomach but if you have a hiatal hernia, acid can move into your esophagus.

This causes acid reflux. 

If you are pregnant, you are also more likely to get acid reflux from the pressure put on your stomach. Unfortunately, there’s no way to prevent this but you can manage your symptoms with home remedies and over-the-counter medications.

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Does Stress Cause Acid Reflux?

While there have been numerous studies that have correlated stress to acid reflux, there is no concrete scientific evidence.

Many scientists believe that stress can cause a person to become more sensitive to small amounts of acid in the esophagus.

This is based on research from the American Journal of Gastroenterology which found that those who had acid reflux and anxiety or stress experienced more painful symptoms but showed no increase in the amount of gastric acid in their esophagus.

Studies have revealed that anxiety and depression levels were significantly higher in subjects with GERD than in controls, and stress is often a psychological symptom of anxiety and depression.

Treating Stress

When it comes to treating stress, there are several approaches you can take.

Discuss with your health care provider which avenue may be best for you. If your stress is caused by other health issues, medication may be the appropriate route.

You may also want to consider lifestyle changes and therapy to help you cope.

Medications

Speak to your doctor if you are suffering from stress and they will be able to determine if medication is the right choice for you.

There are no medications specifically for stress, however, several types of medications that treat other conditions can help you manage and reduce stress. 

  • Sleeping pills: your doctor may prescribe you sleeping pills or mild tranquilizers if you are having difficulty sleeping.
  • Antidepressants: these can help you be less reactionary to stress, and are a first-line anxiety treatment.

Lifestyle Changes

  • Exercise: exercise can help you release natural feel-good hormones, maintain a healthy weight, boost your mood, and get your mind away from the issues causing you stress.
  • Get enough sleep: getting a good night’s sleep is a natural stress reducer. Try to create a healthy sleep routine.
  • Relaxation techniques: incorporating meditation and mindfulness practices can significantly reduce your response to stress. Consider tai chi, yoga, and guided meditations which can balance the mind and body.
  • Spend time with your pet: pets can be a major stress reliever. Cuddling on the couch or taking your dog for a walk as part of your daily routine can help manage stress.
  • Set healthy boundaries: when you are feeling overwhelmed, delegate your work and learn to say no when you are too busy or too stressed.
  • Avoid food triggers: Stress can increase your sensitivity to certain foods. These include spicy foods, fatty foods, chocolate, caffeine, citrus juices, and tomatoes. 
  • Write things down: write down a list of things you are grateful for. Consider writing down your feelings to help you cope.

Therapy

Having someone to speak to about your stress can be extremely beneficial in helping you cope.

Consider speaking to a licensed therapist who can discuss ways to manage stress and develop healthy coping mechanisms for when you feel overwhelmed. 

There are now online options for therapy with video, phone, email, and text-based options.

Treating Acid Reflux

You can treat acid reflux with diet changes and medications available through prescription and over-the-counter.

Diet Changes

  • Maintain a healthy weight: being obese or overweight can place pressure on your abdomen.
  • Eat smaller meals: avoid eating large meals that can cause acid reflux. Eat smaller meals sporadically throughout the day.
  • Avoid lying down after a meal or eating before bed: lying down can cause the acid to sit uncomfortably in your esophagus. If you do eat before bedtime, consider propping your head up with a pillow. In general, wait about 3 hours after a meal before lying down.
  • Avoid spicy, acidic, and greasy foods: these can aggravate your stomach acid and burn your esophagus.
  • Reduce citrus fruits: citrus fruits including tomatoes and tomato-based sauces can bring on acid reflux.
  • Reduce caffeine: caffeine can dramatically increase your stress so consider switching out your coffee for a relaxing tea.

Medications

  • Antacids: Mylanta, Rolaids, Maalox, and Tums are Antacids that work quickly and efficiently to neutralize stomach acid. If you find you are needing this multiple times per day or for longer than two weeks, speak with your primary care provider.
  • Proton pump inhibitors (PPIs): PPIs such as Prevacid, Nexium, and Prilosec block acid production and are best taken before a meal. These take some time to start working but are more effective than antacids over time. These can have some side effects, so speak with your health care provider if you have symptoms that last longer than two weeks.
  • H-2-receptor blockers: H-2-receptor blockers such as Zantac 360, Pepcid, Tagamet, and Axid can reduce stomach acid for up to 12 hours. They do not work as quickly as antacids but they last longer. 

Preventing Stress

Aside from therapy and medications, you can prevent stress in many ways by making lifestyle changes.

Develop a healthy daily routine with a balance of activities that bring you joy and calm.

Manage your time and make a plan so you are not rushing throughout the day.

Spend some time with loved ones when you are feeling stressed.

This can release the hormone oxytocin, a natural stress reliever.

If you are feeling lonely, try to keep a strong social network by visiting friends, chatting, or calling them as loneliness can lead to stress. 

Find a creative outlet or physical outlet for your stress.

This can also help release oxytocin.

Going for a run can be a huge boost to your mood and a great way to clear your head from the thoughts that are bothering you. 

Risks of Stress

Chronic stress can have a detrimental effect on our overall health causing disturbances in the immune, digestive, cardiovascular, reproductive, and sleep systems.

If you are suffering from stress constantly, your body never gets the chance to return to its regular functioning.

Over time, this can lead to major health concerns including high blood pressure (hypertension), heart disease, diabetes, anxiety, and depression. 

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When to See a Doctor

Struggling with ongoing symptoms of acid reflux that is not going away with medication, over-the-counter treatments, and home remedies?

Experiencing heartburn more severely and frequently?

These are signs that it’s time to see a doctor or your primary care provider. Another tell-tale that you should see a doctor is when you have difficulty swallowing.

Your health care provider will examine you to determine if you have a more serious condition and then diagnose the right treatment plan for you.

Most acid reflux can be diagnosed with a physical exam and thorough history alone.

Your doctor may also conduct a blood, breath, or stool test to determine if you have a bacterial infection that will need antibiotic treatment.

In severe or prolonged cases, they may refer you to a gastroenterologist who can perform more advanced testing such as endoscopies or esophageal pH measurements, if indicated.

If you experience severe chest pain, pressure, difficulty swallowing, pain in the neck, jaw, or arm, and you are vomiting blood, you should seek medical advice immediately.

Mild cases of acid reflux can be cured with over-the-counter medicine, but recurring symptoms or strong symptoms could indicate a more serious health condition and you should see a doctor. 

How K Health Can Help

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Frequently Asked Questions

Can stress cause acid reflux?
Stress, paired with exhaustion, can create even more body changes that lead to increased cases of acid reflux. Many scientists believe stress can cause a person to become more sensitive to small amounts of acid in the esophagus.
What is the most common trigger for acid reflux?
Acidic and fatty foods are the two most common triggers for acid reflux.
Is stress harmful in the long term?
Yes, chronic stress can lead to high blood pressure (hypertension), heart disease, diabetes, anxiety, and depression.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Terez Malka, MD

Dr. Terez Malka is a board-certified pediatrician and emergency medicine physician.