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    Does stress cause stomach problems?

    On this page
    1. Effects of stress and anxiety on your stomach 
    2. Why does stress or anxiety impact your gut?
    3. Tips to manage stress/anxiety related stomach problems
    4. How to improve your gut health

    Reviewed by our clinical team

    Lady bent over with stomach cramp

    We all experience stress from time to time. When we feel overwhelmed by work commitments, money worries, or a big event looming or a deadline, our bodies can react in ways that cause unpleasant symptoms.

    Most of the time, these symptoms are psychological – we might feel irritable, lack focus, and feel very worried. However, stress symptoms can be physical as well.

    In this article we’ll look at the potential links between stress and anxiety and problems like irritable bowel syndrome (IBS), other gut conditions and ways you might be able to relieve your symptoms.  

    Effects of stress and anxiety on your stomach 

    Stress and anxiety can trigger lots of different symptoms, in your mind and also on the rest of your body. Stress, for example can cause headaches, chest pain and problems concentrating. And anxiety can cause things like feeling nervous, sweating and problems sleeping.  

    But both stress and anxiety can also impact your gut. Experiencing a stressful situation can cause short-term problems in the digestive system, including: 

    • Indigestion 
    • Heartburn 
    • Constipation 
    • Diarrhoea
    • Bloating

    In addition, you might find that stress affects your appetite, causing you to eat more or less than you would normally.

    Can anxiety or stress cause IBS?

    Stress and anxiety are also known to be a trigger for long-term conditions affecting the digestive system, IBS is often caused by stress, and flare ups of inflammatory bowel disease, like Crohn’s or Colitis, can be triggered by stress.

    If you have IBS, you’ll probably know that feeling stressed and anxious can cause a flare-up of symptoms. Before a big event or on a day where you have to meet lots of work deadlines, you might experience cramps, bloating, diarrhoea or constipation.

    Causes of IBS

    The causes of IBS are not 100% clear, it’s thought to be caused by a number of different things – for example an episode of severe gastro-enteritis, stress or emotional trauma in your early life, your nervous system makeup, changes to gut microbes and in some cases an intolerance to certain foods - but this is thought to be rare. 

    IBS flare ups and stress

    We know that stress can trigger a flare up of IBS. And when you're feeling stressed your body might not be able to cope well with certain foods that you can usually eat without any problems. Some of these 'trigger foods' are wheat, dairy, or 'gassy' foods such as beans, cabbage, broccoli or fizzy drinks. 

    By keeping a good and detailed food, symptom and stress diary you should be able to identify foods to stay clear of when stressed.

    If you’re expecting a flare-up of IBS due to stress, might be a good idea to stock up on medicines to treat your symptoms in the short term. Loperamide is a good treatment for diarrhoea, while laxatives can help with constipation. For bloating and cramps, you could try Buscopan

    In the long term, The IBS Network has some good resources for coping with stress.

    Why does stress or anxiety impact your gut?

    There’s increasing evidence showing that there’s an important relationship between the brain and the digestive system. This is sometimes called the “brain-gut” or “gut-brain” axis.

    Communication between the two can affect activity in the brain and in the digestive system. This is why stress can cause symptoms in the stomach and the gut, and why the reverse is also true – having digestive problems can make us feel very stressed and anxious.

    When we’re in a stressful situation, our bodies tend to have a “fight or flight” reaction. Hormones are released which prepare us to act, by keeping us alert and energised.

    The theory is that when these stress hormones are released, digestion slows down or even stops altogether so that the body can divert its energy to managing the perceived threat. This slowing down of the digestive process causes the symptoms of bloating, constipation, and pain.

    We also know that in some people, stress can cause the opposite problem, speeding up the digestive process and causing diarrhoea.

    Tips to manage stress/anxiety related stomach problems

    There’s no easy way to prevent stress or anxiety from causing problems in your stomach and gut, but there are some things you could try. And looking at both your physical and mental symptoms might help. 

    Short-term solutions

    Depending on your symptoms you could try laxatives (to help with constipation), antidiarrhoea tablets such as Imodium or Buscopan if cramping/pain is an issue. If you are having frequent or severe symptoms you should have a chat with your doctor.

    Also if you have something important coming up (a wedding, exam or interview for example), it might be worth avoiding any foods that you know can trigger your symptoms. This just helps reduce the chances of your IBS flaring up for another reason.  

    Stress-busters

    If you speak to your GP about IBS, they might be able to offer yousome advice on stress-busting techniques, and may be able to refer you for counselling or therapy. Treatments like cognitive behavioural therapy (CBT) can be good for breaking anxious thought patterns and recognising stress triggers.

    Seeking a doctor's advice

    Your GP (or you could speak to one of our VideoGPs) will be able to assess your symptoms and work out if your digestive problems might be caused by something else. 

    Symptoms like stomach pains, changes to your bowel movements (e.g. constipation or diarrhoea), indigestion, and heartburn should be checked by a GP if they haven’t improved within a couple of weeks. You should also go to the doctor if you experience any bleeding from your bottom, difficulty swallowing, or unexpected weight loss.

    How to improve your gut health

    There are lots of different ways you can try to improve your gut health, and it’s not all about the food you eat. 
    If you're feeling stressed or anxious and it’s impacting your digestive system, this could be damaging your gut microbiome – that’s the network on trillions of microbes that live in your gut. So any steps you can take to look after that microbiome will help limit the damage caused by stress, and also might help your stress in the first place!

    Diet

    We all know that eating healthily is good for us. But there are some simple steps you could take with your diet to help keep your gut as healthy as possible. 

    1. Eat up to 30 types of plant each week – this includes fruit, veg, nuts, seeds, pulses, herbs and spices. 
    2. Keep your plate colourful – colourful plants tend to be richer in fibre and contain things called polyphenols which are great for the gut microbes.
    3. Try fermented foods - things like live yoghurt, kefir, kimchi or kombucha contain microbes called probiotics. These will then live in your gut and can help it stay diverse and healthy. Some fermented foods can trigger IBS, so you should add fermented foods slowly and in small quantities- over time though they might help improve your IBS symptoms.
    4. Reduce snacking – giving your gut a break between meals means it can rest and recuperate. 
    5. Limit lots of ‘ultra-processed’ foods – things like sausages, ready meals, shop-bought bread and crisps, won’t be rich in fibre and won’t nourish your gut, so they’re best avoided if possible. There is growing evidence that ultra processed foods are linked to obesity, diabetes and non alcoholic fatty liver disease.

    Quit smoking

    Smoking we know can increase the risk of cancer, including cancers associated with the digestive system. But it can also damage the quality of your gut microbiome. So the best idea is to quit smoking, the sooner you stop, the sooner you’ll start seeing the various health effects. 

    Alcohol

    Excessive drinking can change your gut’s makeup and can cause inflammation throughout your digestive system. So reducing your alcohol intake or cutting alcohol altogether can help you look after your gut. 

    If you’d like to speak to a GP about stress, anxiety or any digestive issues, you can book an appointment with one of our VideoGPs. Appointments are usually available 8am-8pm, seven days a week. 
    Visit our lifestyle advice hub for more guidance.

    VideoGP by LloydsPharmacy

    References

    https://www.mind.org.uk/information-support/types-of-mental-health-problems/stress/signs-of-stress/
    https://www.nhs.uk/live-well/eat-well/five-lifestyle-tips-for-a-healthy-tummy/
    https://www.nhs.uk/conditions/irritable-bowel-syndrome-ibs/symptoms/
    https://www.nhs.uk/conditions/irritable-bowel-syndrome-ibs/diet-lifestyle-and-medicines/
    https://www.health.harvard.edu/newsletter_article/stress-and-the-sensitive-gut
    https://www.mind.org.uk/information-support/types-of-mental-health-problems/stress/treatment-for-stress/
    https://www.nhs.uk/live-well/eat-well/common-digestive-problems-and-how-to-treat-them/
    https://www.nhs.uk/mental-health/feelings-symptoms-behaviours/feelings-and-symptoms/stress/
    https://www.mayoclinic.org/diseases-conditions/anxiety/symptoms-causes/syc-20350961
    https://www.mayoclinic.org/diseases-conditions/irritable-bowel-syndrome/symptoms-causes/syc-20360016
    https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/irritable-bowel-syndrome-ibs#managing-ibs
    https://joinzoe.com/learn/how-to-improve-gut-health 
    https://joinzoe.com/post/tim-spector-gut-tips
    https://joinzoe.com/learn/what-is-ultra-processed-food#common-UPFs

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