GERD and Stress

[This entry is about a health condition which causes some distasteful and potentially disturbing effects. Apologies in advance for the details!]

Been suffering from GERD (“gastroesophageal reflux disease” or “acid reflux”) for about ten years at this point. Heartburns are a fairly big part of it but there are other symptoms, especially after a lot of reflux episodes. GERD is very common. But it's not frequently discussed. Perhaps because its symptoms are so repelling and are unlikely to be mentioned in polite company.
GERD is easily treated, including by surgery. Haven't had surgery myself. At one point, my condition was bad enough that we feared it might lead to cancer. Things have gotten a lot better since then.
Overall, my condition has been quite stable for a long while (thanks to some well-known medication). There are days however, like today, during which things aren't as good. Not because of pain. It can be quite painful at times (like when you get a horizontal bar of pain in your back). But it's also causing a generally displeasing overall state. Had a rather acute episode today. Woke up with almost a mouthful of acidic bile. And there wasn't anything special from the past day which might have led me to expect this episode (like eating before going to bed or sleeping in too horizontal a position). But it hurt and the effects are still with me, ten hours after waking up.
One thing about GERD, for me, is that it stresses me out. And vice-versa: stress is likely to cause a reflux episode in me. It's quite annoying but it's also potentially damaging. A seemingly simple situation may become a big problem under GERD symptoms and too high a level of stress and acid reflux is likely to change my mood. It's not at all like hypochondria, AFAIK, but it's a psychosomatic connection between mental state and physical condition. It's no less real than any other physical condition or mental state, but there's a clear connection between the two.
The upshot is that stress has become a known state to me. In my experience, and it really does seem to make sense, it has little to do with having a lot to do or even with being in a hurry. But it does have to do with situations of “double-bind” in which you feel trapped. Those types of “darned if you do, darned if you don't” situations we all know on occasion. For me, it's difficult to think straight during GERD episodes. And stress caused by double-bind situations will likely generate an acid reflux episode in me. Kind of a vicious circle. It's easier if the source is physical (if the GERD starts the pattern) as it's then possible for me to convince myself that things are fine and it's best to just wait for the GERD symptoms to pass. But it's still very inconvenient.
Another aspect of GERD, which can be especially “gross,” is that it's often associated with IBS or “irritable bowel syndrome.” Not that they're intimately linked but with GERD, IBS symptoms are frequent. Haven't had IBS diagnosed in my case but it does sound as if it were the same symptoms. In such situations where IBS is apparently caused by my GERD, it's an overall uneasy feeling which is tolerable but quite annoying. Ah, well…

Life is still good.

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About enkerli

French-speaking ethnographer, homeroaster, anthropologist, musician, coffee enthusiast. View all posts by enkerli

42 responses to “GERD and Stress

  • pip ex acid reflux

    GERD is often caused by a collection of bad lifestyle habits that just don’t work well for you.
    Others can do all the wrong things and get away without problems, smoke, drink alchohol, eat spicy or junk fat food etc.
    GERD and acid reflux can be cured naturaly if you take the time to find the cause, which means a cool look at your lifestyle.
    If you need help and directions to get there and get of drugs have a look at heartburnand acid reflux.com
    It worked for me and many many others.
    Good luck and good health quickly.

    • enkerli

      I like the fact that you specifically point to individual differences. Some people put it as if there were a single cause and a single cure for GERD, which seems to me very unlikely. In my case, it’s very clear that stress is the main factor. I feel it’s been caused by secondhand smoke, that it’s aggravated by some acidic foods, and that it can be controlled by proton pump inhibitors. But stress remains the key thing, for me. No remedy needed (natural,lifestyle, or pharmaceutical) when I manage to eliminate stress in my life. Stress-reduction has other positive effects in my life anyway.

      Thanks for dropping by.

      > New comment on your post “GERD and Stress” > Author : pip ex acid reflux (IP: 92.11.251.4 , host-92-11-251-4.as43234.net) > E-mail : pip@heartburnandacidreflux.com > URL : http://heartburnandacidreflux.com > Whois : http://ws.arin.net/cgi-bin/whois.pl?queryinput=92.11.251.4

  • Barbara Thomson

    Great post. I especially found it useful where you stated that stress can also be a factor in the occurence of GERD, having a stress-free life is very helpful and healthy too… thanks, Barbara.

    • enkerli

      Glad you enjoyed it. Since I posted this, my condition has improved somewhat due to decreased stress. Still haven’t managed to decrease stress to a mere trickle, but I often feel that I’m getting there, which has all sorts of other benefits, as you point out.
      Another thing I’ve noticed, which does appear in comments to this post, is that different people experience GERD in different ways. Not only in terms of degree of acuteness or in frequency. But in actual experience. My symptoms are probably different from that of somebody else and what helps me is probably different from what would help somebody else.
      What’s probably the most striking thing is caffeine. Coffee drinking is one of the very first thing anyone would say you should stop, when you have GERD. And I did stop drinking coffee for months at a time. Some of these months were among the worst I’ve gone through, in terms of GERD. And some of the times I was closest to GERD-free was when I was drinking quite a bit of coffee. Of course, I’m not saying that coffee alleviates symptoms of my condition. But I haven’t seen a direct correlation between my coffee drinking and my GERD symptoms. I know how counterintuitive this may sound but that’s how it is for me. After all, it’s my body and though I don’t know much about it, symptoms are still things I feel.
      On the other hand, cigarettes are clearly a direct “excitant” of my œsophagous. And I mean indirect smoke, I’ve never been a smoker myself. The connection is so bad that I now have an automatic reaction, as if smoke went directly in my œsophagous. I know that part is psychological, but I’m convinced that it comes from a physiological issue.

      Thanks again for your comment!

  • raja

    gerd is totally curable.
    pls follow the steps by K.KODANDAPANI
    i had gerd for 1 year 4 years back.
    now i have it 2 to 3 times a month only.
    this happens when i skip meals and do not exercise in the morning and night.
    pls do not drink coke alchohol or smoke.
    maintain this throughout your life.
    u will not get anything.
    medicines are only temporary relief.

  • raja

    K.KODANDAPANI,what is your condition now? do u have gerd any more?are u symptom free? pls give me ur mobile no.mail me at freemanit2005@yahoo.com

  • enkerli

    @Paul
    Hé? Tu viens t’immiscer dans ces discussions de santé, maintenant?😉
    En fait, comme ça fait douze ans que j’ai des reflux gastrique, j’ai tout essayé ce que tu m’indiques (à part la comédie italienne, quoique…). Ce que j’ai tendance à dire, c’est que ça change vraiment, d’une personne à l’autre. Dans mon cas, le café n’a aucun effet (j’ai souvent arrêté pendant de longs mois). Le poids non plus (j’ai perdu 25 kg au Mali et j’avais encore plus de symptôme). Par contre, ce qui fait une réelle différence, c’est le stress. Au point que, comme j’essaie de le dire dans ce billet, je peux jauger assez précisément mon niveau de stress, le moment de déclenchement d’une sensation de stress, le type de stress, etc. Je somatise mais d’une façon très précise. C’est même plus exact que le rhumatisme comme baromètre (quoique, j’ai jamais eu de rhumatismes). Et lorsque j’ai des reflux (par exemple, si j’ai beaucoup trop mangé), je me mets à stresser très directement.

    La douleur que Monica ressent au bras, j’ai aucune idée d’où elle provient. J’imagine qu’il peut y avoir un lien avec les reflux mais, dans le fond, j’en ai aucune idée.

    Je sais bien que ça t’a fait rire que j’aie rajouté que ce billet était pas la meilleure source. Mais un truc qu’on remarque souvent, en-ligne, c’est que la confiance dépend de plusieurs facteurs. Comme tu peux peut-être le remarquer par certains commentaires ici, certains parmi nous avons parfois eu à mettre la parole de certains professionnels de la santé en question. Mais nous cherchons surtout à communiquer avec des gens qui vivent la même chose que nous. C’est un peu comme un micro-groupe de support, ad hoc.

  • paul2canada

    > but it’s probably not the best source of info about GERD!

    it’s certainly not the best source.

    > 5) Avoid spicy food, hotel food and junk food

    +1😀
    pour l’hôtel ça dépend du nombre d’étoile et du pays.

    Alexandre, je répond en français vu que mon anglais n’est pas très bon.

    Pour la douleur d’irradiation au bras, plusieurs causes possibles : le cœur, une crise d’anxiété ou un problème de cervicale (cou).

    Ah les problèmes de santé qui nous gâchent notre qualité de vie.
    Des médecins québécois m’ont prescris des anti-inflammatoires pour un mal au dos et après 6 semaines je me suis gagné en prime une gastrite vu qu’ils m’avaient rien donné pour l’estomac comme j’avais pas beaucoup de reflux d’acidité gastrique.
    Avec une médication adaptée prise en France, j’ai aussi suivi qq conseils de diète lu dans un livre (“Et si ça venait du ventre” pierre pallardy un ostéopathe et naturopathe français): évitez l’épicé, l’ail, le Café, le chocolat, le jus d’orange, le trop gras ou trop sucré et tout ce qui peut irriter un estomac. Au bout d’un mois, les choses sont +/- rentrés dans l’ordre. L’auteur parlait aussi de manger lentement et au calme à heure régulière, d’auto-massage, de respiration et de méditation du ventre.
    Essaye et vois si ça un impact positif sur tes propres symptômes. Ensuite c’est une sorte d’hygiène à suivre à vie.

    Et j’ajoute une prescription quotidienne ou quasi-quotidienne de comédie italienne. C’est très efficace chez moi.
    Dr Paul😉

  • enkerli

    @Monica Phew! You had me worried there, for a minute. The left arm thing is better known for heart than GERD, but we’re all different.
    Yes, sore throat, sure. My voice has changed quite a bit since I started having GERD (12 years ago).
    BTW, you mentioned “other people on this site.” This is actually a personal blog. This specific post got a number of comments but it’s probably not the best source of info about GERD!

  • Monica

    It happens on occassion. Not all the time. I had an EKG today and that came back clear. Just trying to see if anyone has had any problems. What about sore throat?

  • enkerli

    @Monica
    Chestpains, yes. Left arm, no. Is this something you regularly have?

  • Monica

    Hello to all,

    I have enjoyed reading your comments. I suffer from GERD as well. I had my first episode in 2006 and it healed up within 6 mos. after being on Carafate and Protonix. But it has come back again in late 2007 and just recently. I have had a scope done and was told that I have a hitial hernia, bile reflux and gastritis. I am now on Carafate and Nexium. I am having the PH test on August 25. The doctor’s want to do this before they offer surgery. I have one question to anyone on this site…has anyone had pains in their chest as well as left arm associated with GERD?

  • enkerli

    @Krishna
    So glad to hear this!
    Yes, GERD is very painful and we wish it could just go away. But medication is quite effective.

  • krishna

    HI Alex,
    I am doing better now. I did PH test of esophagus and the PH level is normal after taking medicine, so doctor says to reduce my medicine from 2 to one Nexium.

  • enkerli

    @gastromama Thanks for this. It does seem that stress is an important factor, for most people.

  • GastroMama

    I found your site very interesting. It helps to read about the experiences others have had regarding GERD. I have a daughter who has GERD, IBS, slow emptying stomach. She also is lactose intolerant. I find watching her diet and keeping stress down really helps. I do find that if she eats a low fat diet, low citrus diet, low acid diet. GastroMama@sensitivetummies.com

  • enkerli

    @MF Thanks for sharing. Again, to each their own. During fieldwork in Mali, I lost 50 lbs and rarely ate bread. I had more acid reflux episodes than I do now.
    As for surgery, there surely are risks to take into account. And there are some excesses in terms of treating everything with surgery. But this is a case in which I would tend to trust doctors.

  • Maximilian Forte

    Interesting that this should catch my eye. I have suffered with these symptoms since 1995. What I discovered in the last year is that two things made it virtually disappear, becoming extremely rare: (1) losing weight, which causes less discomfort and pressure when sleeping; (2) never eating bread or potatoes–I eat no bread that has yeast in it. With these two things alone, and the occasional milk-based drink, I am fine.

    I would avoid surgery at all costs–unless you have been in a car accident, or something like that. You risk coming out of the hospital with much graver problems, such as a flesh eating disease.

  • enkerli

    If they determine surgery is the best option, it can be a good way to solve the problem. People I heard talk about this surgical procedure described it as something pretty straightforward and which has good results.
    If they determine there are other options besides surgery or if they advise you to wait, as much as it may hurt, it’s probably a good idea to heed their advice.
    In other words, trust your doctors. This is an area in which expertise is well-established and they won’t make harsh decisions on a whim. One problem we often have is that, because it hurts, we want the fastest treatment possible.

  • krishna

    Thanks a lot! I will have my PH study on 18th June and after that they will decide whether i need surgery or not…..I want to do surgery.

  • enkerli

    @Krishna Well, your doctor should be able to tell you about what this means. My guess is that these are straightforward symptoms that you’re having chronic reflux but that other tests are needed to determine what should be done.
    Of course, I’m not a doctor.

  • krishna

    Hi
    I have been suffering from GERD for more than 10 years. Now in my esophagus biopsy it says that ” Gastric type mucosa with acuta and cronic inflamation” Does Gastric mucosa generally present in esophagus? Please let me know, if anyone know.
    Thanks
    krishna

  • enkerli

    @ K. Kodannapani
    Thanks for the advice. Glad it worked for you.
    To each their own.

  • K.KODANDAPANI

    Dear Friends,

    You are aware that prevention is better than cure. I too suffered from GERD a lot in the past. If you take following precautions you will not suffer from GERD in future.

    1) Have Dinner atleast 3 hours before going to bed.
    2) Consume plenty of water everyday ( Minimum 6 Ltrs.)
    3) Take atleast 1 ltr of water before 3.00 A.M. every day.
    4) Wake up before 5.30 in the morning and go to bed before 10’O Clock in the night
    5) Avoid spicy food, hotel food and junk food
    6) Exercise in the morning before taking bath and having breakfast.
    7) Take only curd rice and fruits in the night as Dinner.

    If you follow the above you will not face problem of GERD even you are under stress. However, practise YOGA to avoid stress.

    Wish you best of luck.

    K.KODANDAPANI

  • enkerli

    @Krishna,
    Yes, I was already taking medication and I kept taking medication afterwards. I’m not exactly sure in terms of timing but it’s possible that the switch from Prevacid to Nexium happened at the same time as when my oesophagus got better.
    One way to put it is that the combination of the Nexium, a stricter diet, avoidance of second-hand smoke, and the other things I described were apparently successful at healing my oesophageal ulcers but I’m not sure these ulcers are completely cured or that the Nexium was the only factor. It did take a couple of years for those ulcers to disappear.
    Not sure coke is that bad for you but I’m quite convinced that cigarettes are. Even if I’m wrong and cigarettes aren’t that much part of your problem, I’m sure you can improve your general health if you quit smoking. And if you avoid stress as much as possible.
    I do occasionally get the chestpains you describe. They’re even scary, the first few times. Those chestpains are part of the symptoms which tell me I’m having an episode. They’re among the strongest effects of my GERD and many episodes are much more benign than this. Just thinking about these, I feel the pain.
    So, my feeling is that there’s hope your condition will improve. Especially if you stop smoking and you do at least some of the other things which are recommended in order to avoid reflux episodes. You might still need surgery but chances are that you can get better in some way.

  • krishna

    I have a question for you. You said that your esophagus had ulcer. Did you take medication when it happend. I mean you are taking medicine for 10 years, but still esophagus ulcer happened, right? Does it mean that Nexium cured your ulcer? For my case, i smoke and drink coke, might be that is a reason that Nexium could not cure me. Recently after taking two Nexium daily, i am having pain in cheast when i take a deep breadth.

  • enkerli

    @Krishna,
    In my case, they stopped talking about surgery a few years ago. I’m not exactly sure why but it might have to do with the fact that my condition is pretty stable. At the time they were thinking about surgery, my oesophagus was lacerated with ulcers. These resorbed a few years ago and I now rarely have episodes. One Nexium is enough for me, these days. When I get an episode despite the Nexium (usually, because of a stressful situation, second-hand smoke, or something I ate), I take one Pepcid Complete and I feel good within an hour or so. When I get episodes, I go into “reflux-prevention mode.” These are the times for me to avoid a number of things like acidic or spicy foods (oranges, tomatoes, hot pepper) and second-hand smoke. I also try to wear loose clothes, incline my bed a few degrees (so my stomach is lower than my oesophagus), eat bananas (for some reason, they seem to help), eat small portions more regularly, make sure I don’t eat before going to bed, etc. These are all well-known strategies and they really do help. Still, I often don’t need them because my condition is pretty stable overall and my oesophagus is now “clean.”
    Surgery can be a good option, for some people. The procedure is well-known so risks should be minimal.

  • krishna

    Hi
    Recently I did endoscopy and they found inflamation in my stomach and esophagus after taking two nnexium for 1 year. It sounds like my stomach can not handle acid too. Recently i am having some pain in my chest when i take deep breath. I am thinking to do GERD surgery, i have to do PH study on 18th June and then i will talk with a surgeon. I do not know whether surgery will help me or not, but that is the only hope for me at this moment.

  • enkerli

    @Krishna,
    Just moved back to Montreal from Texas (3300km). Hence the delay. Sorry!
    I do still take 1 Nexium every day. It’s usually enough, when I’m not too stressed out. I’ve been under a lot of stress recently so it wasn’t enough. I don’t tend to take two Nexiums, though.
    One thing I do when I get an episode is take 1 Pepcid Complete. It usually calms my oesophagus fairly quickly. Also, when I get more episodes, I go back to “reflux prevention mode” and avoid foods that may induce episodes, such as oranges and tomatoes. I also eat bananas, elevate the head of my bed, wear looser clothes, etc. I’m guessing you’ve received all those pieces of advice, over the years. I tend to gauge my oesophagus as time goes on and it works fairly well.

  • krishna

    Hi Guys,
    I am from India, my name is krishna. I am 27 years old. I have been suffering from severe GERD for 20 years. In my momory there is no single day, when i did not take GERD medicine. I started with antacid, then Zantac, then Prilosec, now Nexium…..
    I take two nexium with 4 reglan per day. Still i am having symtopms. I did endoscopy few days before, they found inflamation in esophagus and stomach…..I am thinking for sergery. If you guys have any suggestions, please let me know by my email.

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  • enkerli

    KK Pani,
    Thanks for the testimonial.
    To each their own. I tried things like walking and taking water. It didn’t help me much. I also don’t take antacids frequently.
    Maybe there’s a difference between occasional GERD (from which a large proportion of the population suffers) and chronic GERD (from which I have been suffering for over ten years).

  • K.K.PANI

    The best way to get relief from GERD is to go for a morning walk/Jogging and by consuming water early in the morning before taking breakfast rather tha taking antacids.

  • enkerli

    Raymond,
    Too bad your physician wasn’t more specific. I haven’t had those issues, so far. I was advised to try skipping medication on occasion but it didn’t have really good effects.
    In my case, I’m still convinced that things will get better if my stress decreases. And it’s already happening.

  • raymond

    Hi,
    I like you have suffered from GERD for over ten years. I thought everything was under control until I visited my doctor last year for a repeat prescription. He told me that because I had been on the medication (omeprazole) for so long he was cutting me down from 20mg per day to 10mg because of long term side effects. This change of dose is not enough to keep acid reflux at bay and I am back to having daily bouts of heartburn and I still do not know what long term side effects acid reflux medication has?

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  • enkerli

    Well, in my case, natural medication isn’t really that much more attractive than Nexium. Besides, my condition is pretty much under control as long as I’m not too stressed out.

  • pavangoud

    I read a similar article on the GERD has on acid reflux suffers

    This natural weapon against GERD, usually taken in pill form, has come into vogue within the past few years. Like all acid reflux remedies, orange peel extract works for some people but not others, though this particular remedy has a better success rate than some. There is more about the Heart burn GERD in the rest of the article.

  • enkerli

    Gayle,
    Thanks for your input. Really sorry you have to suffer through all of this. I would say, though, that there is hope for us.
    When I first got GERD, about ten years ago, even two doses of PPI (IIRC, it was Lozec at the time) wasn’t sufficient. At one point, my oesophagus was lined with ulcers and doctors were afraid I might develop oesophageal cancer (which can be cured but wouldn’t have been a very nice thing, of course). At another point, my lower oesophageal sphincter was so weak that those who did the manometry talked about possible sclerodermia. Scary stuff, but none of the really bad stuff happened.
    Since that time, my condition became rather stable except for a few episodes, once in a while. I’m still careful about several things and make sure I always take my Nexium, but I’m not all that worried. In fact, at some point, they pretty much stopped talking about surgical intervention. Not that it’s good news in itself (surgery could possibly be better than living with GERD all my life) but in this context, my condition is stable enough that I would probably prefer not to get surgery. Getting stressful situations out of my life has certainly helped, but so did the medical attention I received.
    I strongly encourage you to go through the process of seeing a gastroenterologist, undergoing those icky tests, and making sure that what you have isn’t getting more serious. That, in itself, really helps. Once you get proper medical attention, it’s much easier to stop worrying and focus on what works for you.
    Personally, I was prescribed different medication over the years. These things change rather rapidly and you can greatly benefit from these changes.

    So, in summary: yes, you can reassure yourself that your condition might get much better. But, as much as you can, do get proper medical attention from a gastroenterologist.

  • Gayle arient

    I have fibromyagia and have been suffering greatly with GERD> My doctor, very respected, blew me off and said there was nothing he could do, that the Nexium should take care of the acid. I was in tears as he told me this; more pain I have to live with. i was thinking of going to U of Chicago for another opinion. But I notice at night my symptoms are better, as I take xanax for my pain.
    I have IBS too. I think there is a connection, too.
    My family is dysfunctional and my ma is now sick, so there is definitely stress. Hard to avoid it. Thank you for this info. I may just try to take it easy and hope for the best and forget the icky tests, like having a tube down my nose to assess the acid. God bless you for posting this.

  • enkerli

    Thanks for the thoughtful comments. Of course, what makes it more annoying is that it sometimes prevents me from enjoying beer to its fullest.
    Best of luck with your own GERD/IBS!

  • Mike Gibson

    Hello ALEx, I can associate with your GERD and IBS situation, I too suffer from these symptoms and I am going in for xrays to look into it.

    Your analysis of the double bind situations are very familiar and cause similar side effects for me also. I think part of the problem stems from a fear of not letting anyone down and trying to please everyone all the time. Catch 22.

    Good luck Alex and I hope you can come to some conclusions to help with your situation. Life is good as ong as you don’t weaken.

    Cheers,
    Gibby

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