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GERD and Panic Disorder

Anxiety Disorders Are Associated With an Increased Risk for GERD

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Updated October 21, 2008

GERD

Gastroesophageal reflux disease (GERD), or acid reflux disease, is a common health problem that causes heartburn and acid regurgitation from the stomach. In order to digest the food you eat, your stomach is filled with gastric acid. As long as it stays in the stomach performing its job, there’s no problem. But, when this acid backs up into the esophagus, you experience symptoms of heartburn. If the acid is regurgitated, you may experience burning in your throat and a very unpleasant taste in your mouth.

What Causes GERD?

The esophagus is a muscular tube that connects the mouth to the stomach. The lower esophageal sphincter (LES) is a ring of muscle that closes the stomach off from the esophagus when you are not eating. When you eat, this muscle relaxes to allow food to pass from the esophagus to the stomach. The LES then closes again so that food in the stomach will not back up into the esophagus. It is believed that, with GERD, the LES is not functioning properly to prevent the backup of stomach acid.

Anxiety and Depression Increase the Risk of Developing GERD

In studies, both anxiety and depression are associated with a two to four-fold risk of developing acid reflux disease. Some researchers believe that a brain chemical called Cholecystokinin (CCK), which has been linked to panic and gastrointestinal disorders, may play a role in the prevalence of GERD in people with anxiety disorders. Another possibility or contributing factor may be that when people are anxious they tend to engage in behaviors that trigger or worsen acid reflux.

Common Triggers of GERD

The following are not causes of GERD, but may trigger acid reflux episodes and affect the intensity your symptoms.

  • Certain foods, especially fatty foods
  • Alcohol
  • Smoking
  • Eating too much
  • Lying down or bending over shortly after eating
  • Certain medications, including some antidepressants and anti-anxiety drugs

Complications of GERD

When gastric acid comes in contact with the esophagus, it is highly erosive. Left untreated, the reflux of gastric acid can cause inflammatory changes in the esophageal lining resulting in difficulty swallowing, chronic chest pain, and may even lead to esophageal cancer.

See Your Healthcare Provider

Given the complications that can result from GERD, it is important to see your healthcare professional for treatment if you are experiencing heartburn several times a week or more. With your doctor, you can develop a treatment plan that may include medications and lifestyle or diet modifications. If these treatments do not alleviate your symptoms, surgical intervention may also be an option.

Sources:

Haug, T.T.; Mykletun, A.; and Dahl, A.A. "Are anxiety and depression related to gastrointestinal symptoms in the general population?" Scand J Gastroenterol 2002 37(3):294-298.

Jansson, C.; Nordenstedt, H.; Wallander, M.A.; Johansson, S.; Johnsen, R.; Hveem, K.; and Lagergren, J. "Severe Gastro-oesophageal Reflux Symptoms in Relation to Anxiety, Depression and Coping in a Population-Based Study." Alimentary Pharmacology & Therapeutics. 2007 26(5):683-691.  

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