What’s up with the acid in my throat?

Dear Ulcer and Deathly Ill, 

Having stomach acid burn your throat can be quite painful and worrisome. Additionally, when paired with a lack of regular sleep and a stressful roommate situation, dealing with everything that’s on your respective plates may be a lot to manage. While stomach ulcers can indeed lead to symptoms that you’re describing, there may be several other explanations, including: 

• Gastroesophageal reflux disorder (GERD). This condition is a digestive disorder characterized by the reflux—or regurgitation—of stomach acid into the throat, leading to symptoms like heartburn. Similar to ulcers, symptoms can worsen after eating greasy or spicy foods or drinking coffee or alcohol. Additionally, researchers have found higher rates of GERD in individuals who regularly lack a sufficient night’s sleep. This is because sleep allows the digestive tract to recover and function optimally. 
• Stress-induced gastritis. Sores in the digestive tract can also develop as a result of stress. Stress triggers a decrease in regeneration of the stomach lining, which can cause the existing protective mucus lining to deteriorate. Additionally, blood flow to the stomach decreases, which makes the stomach more prone to the development of ulcers. Symptoms can include upper gastrointestinal pain, vomiting, and blood in the stool. 
• Peptic ulcers. As you mentioned, one possible cause can be open sores along the stomach walls or intestinal linings—also known as stomach ulcers. The stomach walls and intestinal linings are protectively coated with a layer of mucus, however, if the environment were to become acidic, the mucus can deteriorate, allowing sores to form. Symptoms can range from moderate (such as burning stomach pain or heartburn) to severe (such as blood in vomit or stool and internal bleeding). 

In contrast to GERD and stress-induced gastritis, ulcers are commonly caused by a bacterial infection from Helicobacter pylori (H. Pylori) or the frequent use of nonsteroidal anti-inflammatory drugs (NSAIDs). No studies have shown that either stress or caffeine can cause ulcers. However, drinking caffeine can increase stomach acidity, which may irritate an existing ulcer. So, even though your five cups of coffee may be delicious, Deathly Ill, they could be triggering worsening burning sensations in your stomach. That said, you may consider swapping out that cup of joe for another less acidic drink, alternate the days you decide to drink coffee, or balance your coffee out with water. If you’re considering limiting your caffeine intake, health care providers typically advise consuming less than 500 milligrams per day. However, you may consider speaking directly with a health care provider, as the specific amount varies from person to person depending on their metabolism and caffeine tolerance. 

In addition to advising on caffeine consumption, a health care provider may also suggest stress management strategies or tips for sleeping since caffeine, stress, sleep, and your digestive system are all interconnected. Since caffeine blocks the sleep-promoting chemical adenosine, consuming coffee can cause you to have disrupted sleep patterns, get fewer sleeping hours per night, or reduce the amount of deep, slow-wave sleep you get. Without a good night’s sleep, melatonin—a hormone that regulates sleep and gastrointestinal (GI) mobility—isn’t properly released, leading to inadequate absorption of nutrients. Lack of sleep can also cause a hormonal imbalance by releasing cortisol, which can lead to stress and the development of a leaky gut. Too much stress can make it harder to fall asleep, which can result in more coffee being consumed. Ultimately, it's a complex, interconnected cycle of caffeine consumption, digestive issues, inadequate rest, and stress, with each of these behaviors perpetuating the next. 

If you believe that you may have any of these conditions or want more information about the things you’re experiencing, you might consider meeting with a health care provider. They may be able to run additional diagnostic tests to determine your condition and can provide treatment options, if necessary. Treatment can include antibiotics, antacids, proton pump inhibitors, or medications to protect the lining of your stomach and small intestine. 

Lastly, you’ve both expressed concern over roommate situations. Although roommate troubles may not directly cause an ulcer, they can negatively impact sleep, which can worsen existing ulcers and other conditions. 

Wishing you an acid-free sleep!