Anxiety and Heartburn: (A Comprehensive Guide)

Anxiety and Heartburn

Heartburn is a condition in which some of the content of the stomach is forced back in esophagus because of the phenomenon known as anti peristalsis. This flush back of food content causes severe pain and heart burning in the lower chest is known as heartburn. In this article we will discuss heartburn and anxiety. 

Anxiety and Heartburn: (A Comprehensive Guide)

Food moves through the mouth to the stomach through the esophagus and in the stomach it is mixed with HCL and pepsin. HCL and pepsin is known as gastric juice. When food is mixed with gastric juice it forms chyme. Chyme is acidic in nature because of HCL. When chyme flushes back in esophagus it causes burning sensation in the chest.

 Heartburn is a normal condition which occurs when a person intake spicy food in large amounts or if physical activity of a person is compromised. It can be treated by an individual on its own by changing diet plans or eating routines. But if the condition persists it can affect an individual normal life routine. If a person experiences heartburn twice a week then the condition is known as gastroesophageal disease. Heartburn is a symptom of gastroesophageal disease. 

Symptoms of Heartburn:

Symptoms of heartburn are commonly known to the sufferer. Most common symptom includes a feeling of heat or burning in the chest. Other symptoms might include:

  • Burning sensation in the middle of chest 
  • Acrid or foul taste in mouth 
  • Rising pain in stomach that might reach to jaw 
  • Pain in stomach due to indigestion
  • Nausea or vomiting 
  • Difficulty eating and swallowing 

If a person experiences these symptoms twice a week, he must immediately consult his doctor and take prescribed precautions. 

Causes of heartburn:

Occasional heartburn can be usual for a person but experiencing symptoms of heartburn frequently can be problematic and might be an indicator of some underlying condition. Common causes of heartburn include:

  • Weakened muscle of esophageal sphincter
  • Higher consumption of spicy food 
  • Higher consumption of chocolate or fatty food
  • Lack of physical activity 
  • Consumption of alcohol or coffee  
  • Eating meals before bed
  • Smoking 

Anxiety:

Anxiety is a natural response of a body in reaction to stress. It is constituted by emotion of fear or apprehension for what is coming next. Anxiety is a part of natural everyday life as a person might feel anxious on the first day of school, before a job interview or because of interpersonal conflict. However, if this anxiety remains for a longer period of time or if it starts to interfere with the daily routine of a person’s life, it becomes dysfunctional. Such dysfunctional anxiety is diagnosed as anxiety disorder.

Anxiety and Heartburn: (A Comprehensive Guide)

Anxiety disorder:

Anxiety can play its role in motivating individuals to be prepared for a situation that can cause anxiety, in this way certain amount anxiety becomes functional for individuals. However, problems arise when anxiety becomes hindrance for a person in performing daily routine tasks. It remains with the person all the time, it’s intense and incapacitating. It can interfere in the menial task such as using the elevator, crossing the road or going out of the house. 

According to American psychological association, anxiety is the most common of all emotional disorders. It can affect individuals at any age. It is also more common in women than in men. 

Anxiety constitutes a wide range of mental disorder such as:

  1. Phobia: 

It is an excessive fear of certain objects, places or any activity.

  1. Obsessive-compulsive disorder:

It is a disorder characterized by obsessive recurrent thoughts which makes an individual perform certain repetitive behaviors. 

  1. Post-traumatic stress disorder:

It is a mental disorder characterized by flashbacks of traumatic events in an individual’s life which can lead to a great deal of distress and anxiety. 

  1. Social anxiety disorder:

This is characterized by extreme fear of being judged for one’s physical appearance and behaviors by others in different social situations. 

  1. Separation anxiety disorder:

It is characterized by extreme forms of anxiety either by the idea of or by actually being separated from their loved ones. It is most common in children with working mothers

  1. Illness anxiety disorder:

This is characterized by extreme fear of being physically ill, also known as hypochondriacs.

  1. Generalized anxiety disorder:

This is most common for anxiety disorder. It is characterized by long term anxiety and worries about unspecified life events, situations or objects. People suffering from GAD are not always able to identify the cause of their anxiety. 

Anxiety and Heartburn: (A Comprehensive Guide)

Symptoms of Anxiety:

Symptoms of anxiety differ from individual to individual. Symptoms can range from feeling butterflies in the stomach to irregular heart beat. People can experience anxiety in the form of panic attacks, nightmares, painful thoughts and memories that the individual has no control on. A person might feel that his mind is disconnected from his body. Common symptoms of anxiety are as follow:

  • Restlessness 
  • Rapid breathing 
  • Increased heart rate 
  • Difficulty in falling and staying asleep 
  • Trouble in concentrating 

Causes of anxiety:

There are a plethora of causes that can cause anxiety including genetic, environmental and hormonal factors. Causes of anxiety are complex as many causes occur at one time or one cause can lead to another cause. Possible causes of anxiety are as follow:

  • Environmental factors:

These factors include interpersonal difficulties, problems at work or family issues.

  • Genetic factors:

Individuals who have a family history of anxiety are more likely to experience anxiety disorder as genetics play a major role in anxiety disorder. 

  • Medical factors:

Anxiety can result from other medical conditions or can be the effect of medication. Intensive surgery or prolonged prognosis can also result in anxiety.

  • Brain chemistry:

In the brain certain neurotransmitters such as serotonin, dopamine, norepinephrine and GABA are associated with anxiety.

  • Withdrawal:

Withdrawal from any drug can result in symptoms of anxiety. This can also activate other causes of anxiety. 

Anxiety and Heartburn:

There is a strong relationship between anxiety and heartburn. Anxiety would not cause gastroesophageal reflux disease (GERD) but can worsen its symptoms and increase the episodes of heartburn. Dr. Madanick says anxiety and heartburn go side by side and treating anxiety can result in decreased heartburn. 

Some researchers also have shown the link between anxiety and heartburn as anxiety worsens the symptoms of heartburn. And sensation of burning in the chest can add up to the stress and anxiety thus starting the cycle where one leads to another. 

A study was conducted in 2018 with 19,000 individuals to explore the relationship anxiety and heartburn. Results of the study indicated that those individuals who suffer from anxiety have more severe symptoms of GERD than the control group. 

Researchers have explored possible reasons for the relationship between anxiety and heartburn which can include the following:

  • Anxiety might affect sphincter muscles at the end of the esophagus which stops the chyme to flush back in the esophagus. If those muscles are weakened this would ultimately lead to heartburn. 
  • Anxiety and stress can have long lasting effects on the muscles of the body. If stomach muscles are affected by anxiety it can result in heartburn.
  • Anxiety can lead to increased production of gastric juice in the stomach which might make chyme more acidic than necessary. 

These reasons pretty much explain the link between anxiety and heartburn. Researchers have also indicated that individuals suffering from anxiety experience more severe symptoms of heartburn than individuals who do not experience anxiety. 

The link between anxiety and heartburn can be other way round too. As researchers have indicated, individuals experiencing symptoms of heartburn or GERD score higher on anxiety than control groups. This relationship between anxiety and heartburn can be explained by individuals’ tendency to link the sensation of burning in the chest to some other severe medical condition which adds up to their anxiety. 

It has also been hypothesized that a brain chemical known as choleocystokinine (CCK) is linked to both anxiety and heartburn which can be one of the factors that link anxiety and heartburn together. 

This relationship between anxiety and heartburn results in a vicious cycle where anxiety leads to increase in symptoms of heartburn and increased episodes of heartburn again add up to the anxiety. 

Treatment and prevention:

Some individual’s when faced with stress can enter into this vicious cycle of anxiety and heartburn thus it is important for a person to take precautionary measures to prevent this cycle of anxiety and heartburn or go through a treatment if symptoms get worse. It is important to take immediate steps as symptoms of anxiety and heartburn can make each other worse. 

Symptoms of heartburn can be relieved as follow:

  1. By avoiding the food which triggers the symptoms of heartburn
  2. By avoiding fatty and spicy food
  3. By taking meal 2 to 3 hours before bed 
  4. By using drugs which blocks H2 receptors such as Pepcid 
  5. By using drug which inhibits proton pump such as Nexium 
  6. By taking antacid such as Tum or Pepto Bismol 

To reduce the symptoms of anxiety following methods can be adopted:

  1. Taking regular sessions of cognitive behavioral therapy 
  2. Avoiding caffeine 
  3. Avoiding recreational drugs 
  4. Limiting alcohol use
  5. Following relaxation therapies such as yoga or meditation
  6. Taking drug which function as serotonin-norepinephrine reuptake inhibitor or benzodiazepine

Symptoms of anxiety and heartburn can be treated through home remedies but it is recommended that if symptoms get severe, a person should immediately seek medical advice as consistent heartburn can lead to scarring in tissues of esophagus and persistent anxiety can result in a number of mental complications. 

Exercise can also be effective in treating anxiety and heartburn. Exercise can worsen the symptoms of heartburn initially but in the longer run it is effective in treating the symptoms of anxiety and heartburn. It is suggested that a person should treat the underlying condition first which is causing the symptoms of anxiety and then treat heartburn. 

Conclusion:

Anxiety and heartburn are strongly associated with each other with one leading to another and giving a way to a vicious cycle. Researchers have explored many reasons for this strong association between anxiety and heartburn such as anxiety leading to increased production of gastric juice, decreasing the strength of sphincter of esophagus and many others. It should be noted that if a person starts to experience the symptoms of anxiety and heartburn, he should immediately take preventive measures to avoid a vicious cycle of anxiety and heartburn.

Anxiety and Heartburn: (A Comprehensive Guide)

FAQs about Anxiety and Heartburn

Can stress and anxiety cause heartburn?

There is a strong association between anxiety and heartburn. Anxiety can worsen the symptoms of heartburns by increasing the amount of gastric juice in the stomach, decreasing the strength of sphincter of the esophagus and by affecting stomach muscles. 

  1. What is a bad heartburn sign of?

A person can experience after a spicy meal or by eating food late at night but if it is persistent it can be a sign of underlying condition. Heartburn is most commonly associated with gastroesophageal reflux disorder.

  1. Why does stress cause heartburn?

Stress can decrease the amount of a chemical known as prostaglandin which usually protects the stomach from acidic chyme. If that chemical is reduced it can lead to enhanced perception of discomfort in the stomach. 

References:

health.com/condition/gerd/9-serious-conditions-that-can-feel-like-heartburn

medicalnewstoday.com/articles/acid-reflux-and-anxiety#when-to-see-a-doctor

verywellmind.com/gerd-and-panic-disorder-2584204

everydayhealth.com/gerd/symptoms/connection-between-anxiety-acid-reflux/

calmclinic.com/anxiety/signs/heartburn

Anxiety and Heartburn: (A Comprehensive Guide)

Juanita Agboola

Juanita Agboola is the editor in chief of HFNE and an expert in mental health online. She has been writing about online behaviour, mental health and psychology issues since 2012. All Guides are reviewed by our editorial team which constitutes various clinical psychologists, PhD and PsyD colleagues.