Does Stress Cause Stomach Acid to Rise?

Need to learn proper stress management

Does Stress Cause Stomach Acid to Rise?
illustration of a man under stress (pexels.com/Andrea Piacquadio)

Acid reflux or gastroesophageal reflux (GERD) refers to the rise of acid or digestive juices from the stomach into the esophagus. This then causes a burning sensation in the chest and the urge to keep burping. Some people may also experience coughing or chest pain. This condition can affect anyone of any age or gender.

Some people with acid reflux have observed a flare-up of symptoms when faced with stressful situations, such as a job interview or an exam. However, is it true that stress can cause acid reflux? If so, what is the connection and how can it be overcome?

1. Many people report increased acid reflux symptoms when stressed

A health survey of 40,000 Norwegians and found that people who reported work-related stress were more at risk of GERD symptoms (Scandinavian Journal of Gastroenterology, 2009). In contrast, people who reported being satisfied with their job were less likely to experience GERD symptoms.

Another study interviewed 12,653 people with GERD and found that almost half reported stress as the biggest factor worsening symptoms. Even when they were on medication (Internal Medicine, 2015).

2. Why does stress aggravate acid reflux?

illustration of a man under stress (unsplash.com/ahmad gunnaivi)

Stress can increase acid production in the stomach, which worsens GERD, according to Harvard Health Publishing. In people with GERD, the lower esophageal sphincter muscle-which acts as a door between the stomach and esophagus-does not function properly. This then allows stomach acid to rise and enter the esophagus.

Whether stress actually increases stomach acid production or just physically worsens symptoms is debatable. A past study found that people with acid reflux who experienced anxiety and stress reported more painful symptoms (American Journal of Gastroenterology, 1993). However, no one showed an increase in stomach acid. Arguably, although people consistently reported worse acid reflux symptoms, scientists found no increase in total acid produced.

Another study also supports this idea. Researchers exposed people with GERD to stressful sounds. As a result, the researchers found that it aggravated symptoms by making participants more sensitive to acid exposure (Gastroenterology, 2008).

3. Acid reflux triggers stress and anxiety

Experts have also found that stomach acid can be a source of stress and anxiety. A study found that GERD survivors who experienced chest pain had higher levels of depression and anxiety than those who did not experience pain (Cureus, 2019).

Research has also found that people are more likely to associate symptoms such as chest pain with other more serious conditions, which increases their anxiety about these symptoms.

The combination of these factors can become a vicious cycle. GERD causes stress and anxiety, while stress and anxiety also contribute to GERD. For this reason, survivors need to find ways to treat their symptoms to break the cycle.

4. How to deal with stress

Illustration of tai chi (pixabay.com/franciscojcesar)

Adopting coping techniques to manage stress in life can help reduce the risk of acid reflux symptoms and other conditions, such as heart disease, stroke, obesity, irritable bowel syndrome and depression. The more you can cope well with stress, the better off you'll be.

Here are some ways you can manage stress as reported by Healthline:
  • Exercise: Exercise helps relax tense muscles and triggers the release of natural hormones that make you feel better.
  • Avoid trigger foods: When under stress, you tend to be more sensitive to GERD trigger foods, such as chocolate, caffeine, citrus fruits and juices, tomatoes, spicy foods, and fatty foods.
  • Get enough sleep: Sleep is a natural stress reducer. To help avoid acid reflux while sleeping, keep your head elevated.
  • Practice relaxation techniques: Yoga, taici, or meditation can help you relax.

5. First aid for acid reflux

GERD treatment aims to reduce the symptoms of acid reflux or acid damage to the lining of the esophagus. Here are some first aid measures you can take when experiencing acid reflux according to WebMD and Houston Methodist:
  • Antacids: These are used to neutralize the acid in the esophagus and stomach and stop the symptoms of acid reflux. 
  • H2 blockers: These are used to reduce acid in the stomach. Usually, they are given by doctors to people who have chronic reflux.
  • Prokinetics: These drugs work by helping the stomach empty faster so you don't have as much acid left behind. It also helps with symptoms, such as bloating, nausea, and vomiting.
  • Eat bananas: Bananas are high in potassium which makes this food quite alkaline and able to neutralize the acid that rises up the esophagus.
  • Chew sugar-free gum: Chewing increases saliva production, which neutralizes stomach acid that rises up the esophagus.
  • Loosen clothing: Tight clothing that presses on the stomach contributes to acid reflux symptoms.
Check again, do acid reflux symptoms often recur when you're under stress? If so, do stress management immediately to reduce the frequency of recurrence.

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