Can Stress Give You Diarrhea? Doctors Explain.
ALMOST EVERYONE HAS felt butterflies in their stomach before making a big decision or when something upsetting happens. And you may have needed to run to the restroom because of it. Having an upset stomach when you’re under a lot of stress or feeling anxious is actually pretty normal.
“Stress can absolutely cause an upset stomach and diarrhea,” says Ali Khan, M.D., a board-certified gastroenterologist with Gastro Health in Fairfax, Virginia.
The reason is related to the brain-gut axis, where the two parts of your body “talk to each other,” he explains. “When someone feels stressed or anxious, this can lead to gastrointestinal distress,” including diarrhea, stomach pain, and bloating.
The symptoms of an upset stomach might make you feel even more stressed and anxious. And, Dr. Khan says, that can lead to a vicious cycle of stress and diarrhea.
The brain-gut connection is also a pathway irritable bowel syndrome (IBS), a group of GI symptoms without any visible evidence of damage or disease in your digestive tract, according to the National Institute of Diabetes and Digestive and Kidney Diseases.
If stress leaves your stomach rumbling so much that you need frequent trips to the bathroom, Dr. Khan says there are some ways to reduce the impact. Usually, that involves learning to deal with your stress and anxiety. But, if your diarrhea persists and you worry about your GI symptoms, he says seeing a doctor is a good idea.
Here’s a look at the connection between stress, anxiety, and diarrhea and what you can do about it.
Can stress cause diarrhea?
Yes. Stress can affect the physiology of the gut and cause many different GI symptoms, like indigestion, bloating, and “altered bowel habits,” including diarrhea and constipation, says Kevin Beyer, D.O., an osteopathic physician specializing in gastroenterology in Kalamazoo, Michigan.
“The effects of stress on our body can be very deleterious to both our mental and physical health,” he says. “As we are all wired differently, the effects of stress can range from minor to debilitating.”
Managing stress is a major factor in improving your quality of life and overall health, including your gut health, Dr. Beyer says.
Why stress causes diarrhea?
The digestive system has been referred to as the “second brain” because it has so many nerve cells, and it’s through the nervous system that the gut and brain are connected. Scientists continue to uncover more and more about this gut-brain axis, but research suggests that the gut responds to emotions.
Part of the central nervous system, called the enteric nervous system, directly connects the brain and GI system, according to the University of Chicago Medicine. Stress and anxiety release hormones in the body, such as cortisol and adrenaline, which can impact your bowel habits. Stress can also affect the healthy bacteria in your gut, causing diarrhea. Stress can also affect how you digest foods, which might cause diarrhea.
“These nerve and hormone pathways can be triggered or stimulated by stress,” Dr. Beyer explains.
If you have IBS or inflammatory bowel disease, anxiety and stress can trigger flare-ups, which might include more diarrhea, Dr. Khan says. People with these GI conditions are also more likely to experience stress, which worsens their symptoms.
How to Treat Stress-Related Diarrhea
Addressing the root cause of your stress is the first step to treating stress-related GI problems, Dr. Khan says. “That can look different for everybody,” and might involve exercising, doing yoga, practicing meditation and mindfulness, or talking to a therapist. And, if you’re diagnosed with a mental health condition, follow through with your treatment plan, he adds.
This might be easier said than done, however, Dr. Khan admits. “Coping with stress is a valuable skill that can take years to master, so it is important to manage expectations.”
But learning to reduce stress benefits your GI and overall health, Dr. Beyer says. He adds that you can also try taking an over-the-counter medication or a probiotic supplement to help deal with stress-related diarrhea.
Immodium or Pepto Bismol can relieve diarrhea and other GI symptoms when you’re in a pinch, such as right before a flight or long drive when bathroom access might be limited, Dr. Khan says. “But, I would not recommend using anti-diarrheal medications long-term,” since they don’t actually treat the problem.
Adjusting your diet might help, too, Dr. Beyer says. For example, if certain foods, like spicy foods or dairy, irritate your stomach, it’s best to avoid them while you’re stressed.
When to See a Doctor
While you might be quick to blame your diarrhea on stress, Dr. Khan says many conditions can cause bowel movement changes, like IBS, IBD, celiac disease, an infection, or even colon cancer. Reducing stress alone won’t relieve diarrhea if you have one of these medical problems.
So, it’s usually a good idea to see a gastroenterologist about your diarrhea, especially if it’s a common occurrence in your life. Dr. Khan says doctors will discuss your family history, perform lab work, and maybe recommend a colonoscopy, depending on your symptoms. It’s recommended that adults at average risk for colon cancer get regular colonoscopies once they turn 45.
Knowing the exact cause of your diarrhea—which really only a doctor can tell you—will ensure you get the most effective treatment, Dr. Khan says.
For instance, antibiotics may be needed for an infection, and a gluten-free diet is necessary for celiac disease, he says. IBD is treated with prescription anti-inflammatory medication, whereas IBS can be managed with OTC medications, prescription, medications, and sometimes cognitive behavioral therapy.
Diarrhea accompanied by other symptoms, like fever, severe abdominal pain, bloody stool, or unintended weight loss, are definite signs to see a doctor, Dr. Beyer says.
Seeing a doctor in itself can also relieve stress if you’re worried about your GI health, he adds.
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