From the Guidelines
Yes, GERD can cause palpitations in some people, as the irritation from acid reflux can stimulate the vagus nerve, potentially leading to heart palpitations or a feeling of irregular heartbeat. When stomach acid flows back into the esophagus, it can trigger the vagus nerve, which helps regulate heart rhythm, potentially leading to heart palpitations or a feeling of irregular heartbeat 1. This connection occurs because the esophagus and heart are located close to each other, and the irritation from acid reflux can stimulate the vagus nerve. Additionally, the discomfort from GERD symptoms like chest pain or burning can cause anxiety, which itself may trigger palpitations.
Possible Extraesophageal Manifestations of GERD
Some possible extraesophageal manifestations of GERD include:
- Cough
- Laryngeal hoarseness
- Dysphonia
- Pulmonary fibrosis
- Asthma
- Dental erosions/caries
- Sinus disease
- Ear disease
- Post-nasal drip
- Throat clearing However, palpitations are not explicitly listed as a possible extraesophageal manifestation of GERD in the provided evidence 1, 2.
Treatment and Lifestyle Changes
If you're experiencing both GERD symptoms and palpitations, treating the underlying reflux with medications like proton pump inhibitors (such as omeprazole 20-40mg daily or pantoprazole 40mg daily), H2 blockers (like famotidine 20mg twice daily), or antacids may help reduce the palpitations 2. Lifestyle changes are also important, including:
- Avoiding trigger foods (spicy, fatty, acidic foods)
- Eating smaller meals
- Not lying down for 2-3 hours after eating
- Elevating the head of your bed
- Maintaining a healthy weight. However, it's essential to consult with a healthcare provider to rule out other cardiac causes of palpitations, as heart palpitations can sometimes indicate more serious conditions.
From the Research
Gastroesophageal Reflux Disease (GERD) and Palpitations
- GERD has been linked to an increased risk of atrial arrhythmias, including palpitations, in several studies 3, 4.
- A study published in the Journal of Clinical Gastroenterology found that patients with symptoms of both palpitations and reflux reported a reduction in arrhythmia symptoms after treatment with proton pump inhibitor therapy 3.
- Another study published in the World Journal of Gastroenterology found that the presence of atrial fibrillation in patients with GERD was reported to be between 0.62%-14%, higher compared to those without GERD 4.
- The mechanisms of atrial fibrillation as a consequence of GERD remain largely unknown, but inflammation and vagal stimulation may play a possible role in the development of these disorders 4.
Treatment and Management
- Treatment with proton pump inhibitors may improve symptoms related to palpitations and facilitate conversion to sinus rhythm 3, 4.
- Lifestyle changes, medication, and surgery are the main treatment options for GERD, with proton pump inhibitors being the most common treatment 5, 6.
- The American College of Gastroenterology recommends updated, evidence-based recommendations and practical guidance for the evaluation and management of GERD, including pharmacologic, lifestyle, surgical, and endoscopic management 6.
Evidence and Recommendations
- The current evidence suggests a potential relationship between GERD and atrial arrhythmias, including palpitations, but larger prospective studies are needed to confirm this relationship 3, 4.
- Patients with documentation of both atrial arrhythmias and reflux should have a trial of aggressive acid suppressive therapy 3.
- The Grading of Recommendations, Assessment, Development, and Evaluation system can be used to evaluate the evidence and the strength of recommendations for the management of GERD 6.