Anxiety and Mental Health: Can They Cause GERD/Indigestion?

Most people have experienced heartburn at some point. However, if it becomes chronic, occurring twice a week or more, there is a high likelihood that you are experiencing gastroesophageal reflux disease (GERD).

GERD is the most common disease affecting a significant portion of the population. Interestingly, there is a close relationship between GERD and anxiety. A study published in the Journal of Neurogastroenterology and Motility in 2018 reported that over 19,000 individuals with GERD had significantly higher levels of anxiety compared to those without GERD. Another study in November 2019, published in the Cureus Journal, concluded that individuals with GERD also had higher levels of anxiety and reported symptoms of heartburn.


Symptoms of GERD and Anxiety

Symptoms of GERD and anxiety often overlap and include digestive issues, heartburn, nausea, and stomach pain. Other symptoms that may arise include a globus sensation, which is the feeling of a lump in the throat or a sensation of tightness or choking without pain.

Individuals experiencing the globus sensation often have symptoms such as hoarseness, chronic cough, or a constant need to clear their throat. An indicative symptom is difficulty sleeping, as nighttime acid reflux can cause individuals to wake up due to nocturnal acid breakthrough (NAB).


What is the connection between GERD and Anxiety?

There are various factors at play in this case. However, several studies have reported interesting connections between anxiety and GERD. The Journal of Neurogastroenterology and Motility mentioned the following mechanisms: anxiety can reduce the pressure on the lower esophageal sphincter, the valve that prevents food from flowing back into the mouth. During anxiety, the valve relaxes abnormally, allowing stomach acid to flow into the esophagus. Anxiety also causes abnormal contractions of the valve, leading to heartburn. Therefore, high levels of stress and anxiety can increase stomach acid production.

Other research has shown that patients with mental health issues and anxiety have a higher sensitivity to changes in their gastrointestinal tract. This was confirmed in a study published in the Journal of Surgical Endoscopy in February 2019, which evaluated approximately 200 patients diagnosed with GERD.


Tips for Managing GERD and Anxiety

Therapies using proton pump inhibitors, antacids, and H2 blockers can help control high stomach acid levels. However, they should be combined with lifestyle modifications, such as:

  • Avoiding foods and beverages that can trigger stomach acid (fatty foods, acidic foods, chocolate, onions, mint, caffeine, and alcohol)
  • Eating small, frequent meals
  • Maintaining a healthy body weight
  • Avoiding lying down after meals
  • Avoiding tight-fitting clothing, especially around the abdomen
  • Elevating the head while sleeping
  • Gradually quitting smoking

In addition, exploring stress management methods such as yoga, meditation, relaxation techniques, and hypnosis can be beneficial.




Matt Seidholz, 2021, What’s the connection between Anxiety and Acid Reflux? Access on