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Anxiety and GI Issues: What's the Connection?

Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.

• Anxiety-Related GI Symptoms
• When to Seek Emergency Care

GI Conditions Linked to Anxiety

What to do about anxiety and stomach pain, frequently asked questions.

Anxiety and stomach issues often seem to occur together. A queasy stomach is a common experience for people experiencing anxiety, but anxiety may also contribute to other GI issues as well.

Gastrointestinal (GI) disturbances commonly include symptoms of stomach pain, heartburn, diarrhea, constipation, nausea, and vomiting. While there are plenty of possible causes of GI issues, when no medical explanation is found, they are often termed “functional GI symptoms.”

Many studies have shown a correlation between anxiety, depression, and functional GI symptoms. Generally, study results have demonstrated that people who have at least one GI symptom are more likely to have an anxiety disorder or depression than those without any GI symptoms.

Unexplained physical complaints as a whole—including fatigue, headache, stomach upset, nausea, diarrhea, constipation, dizziness, and musculoskeletal pains—are more commonly reported in individuals with an anxiety disorder and/or depression.

Common Anxiety-Related GI Issues

GI symptoms may be associated with generalized anxiety disorder (GAD), social anxiety disorder (SAD) , panic disorder , and phobias . Common GI symptoms that have been associated with anxiety disorders include:

• Constipation
• Increased hunger
• Indigestion
• Loss of appetite
• Stomach cramps

Dangerous GI Symptoms

Whether or not you believe your GI symptoms are anxiety-related, you should consult your doctor as soon as possible if your symptoms occur with any of the following:

• Blood in the stool
• Feeling bloated or full after eating very little
• Having a bowel movement that is black, tarry, and foul-smelling
• Persistent, low-grade fever
• Unexplained weight loss

These symptoms could mean you have another condition that requires treatment, like hemorrhoids, an infection, intestinal bleeding, or inflammatory bowel disease (IBD). While it can be concerning to know that these symptoms could indicate a serious condition, seeking medical help sooner rather than later will ensure that you receive the right treatment.

Seek Immediate Care

Seek immediate medical care if you have:

• Chest, neck, shoulder, or jaw pain
• Disorientation or confusion
• Inability to have a bowel movement
• Moderate to severe rectal bleeding
• Rapid or significantly decreased heart rate
• Severe abdominal pain
• Severe diarrhea lasting more than one day
• Vomiting blood (if the vomited matter looks like ground coffee, this may indicate blood)

Some GI conditions—such as irritable bowel syndrome (IBS) and gastroesophageal reflux disease (GERD)—have also been linked to anxiety disorders.

IBS is a GI disorder that causes symptoms like pain, bloating, cramping, flatulence (gas), whitish mucus in the stool, diarrhea, and constipation. While the condition is not life-threatening, it is chronic and can have a serious impact on a person's quality of life.

People who have IBS are also often diagnosed with mood and anxiety disorders.

IBS is a treatable condition. Making dietary changes can often help, as can managing your stress using strategies like yoga.

GERD is a digestive condition that causes acid reflux, which is when stomach acid enters the esophagus and leads to sensations like heartburn and trouble swallowing.

Common symptoms of GERD include:

• Difficulty swallowing
• Hoarseness of the voice, especially upon waking
• Mild pain or stuck-in-throat type sensations
• Persistent dry cough

Some research suggests that people who have GERD are also more likely to experience anxiety. While the exact reasons for this connection are not entirely understood, researchers suggest that high anxiety and stress levels may increase stomach acid and muscle tension that can contribute to symptoms of GERD.

GERD is treatable with medication, diet, and lifestyle changes.

You should consult with your healthcare provider if you are experiencing unexplained mild to moderate GI disturbances for more than a few days, or if your symptoms stop and then return. They may order tests or refer you to a specialist to rule out any serious medical problem that may be causing your symptoms.

If your doctor determines that you have functional GI symptoms related to anxiety, there are many effective treatments available—both for your GI concerns and the underlying anxiety. Prescribed medications and psychotherapy can help you to reduce your feelings of anxiety and develop healthy ways to cope with stress.

Coping With Anxiety and GI Issues

Learning to manage your anxiety while treating your GI symptoms can be the most beneficial approach for helping you deal with both issues. To help cope with symptoms of anxiety and related GI problems, try:

• Avoiding excessive caffeine : Not only can caffeine increase feelings of anxiety, but many caffeine-containing products can also lead to GI upset.
• Changing your diet : Focusing on a gut-friendly diet may help calm symptoms of GI upset. Make sure that you are eating fiber-rich foods, and try adding foods containing probiotics to your diet (such as yogurt, sauerkraut, and kombucha). Some animal studies have suggested that probiotics may have anxiety-reducing effects, though more research is needed to understand their impact on human mental health.
• Practicing stress management techniques : Stress is a normal part of life, so developing good coping skills is important. Relaxation techniques that can help include deep breathing, progressive muscle relaxation, and meditation.

If you or a loved one are struggling with anxiety, contact the  Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline  at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our  National Helpline Database .

Yes, anxiety can cause a variety of GI problems, including consipation, nausea, diarrhea, indigestion, and stomach pain. You should talk to your doctor for advice on treatment and to rule out other potential causes.

The hormones and chemicals that are released by your body in times of stress can have an impact on the digestive system. They enter the digestive tract and affect the balance of bacteria in the gut. Anxiety can slow down digestion, which can lead to stomach and intestinal issues.

Hartono JL, Mahadeva S, Goh KL. Anxiety and depression in various functional gastrointestinal disorders: Do differences exist? J Dig Dis . 2012;13(5):252-7. doi:10.1111/j.1751-2980.2012.00581.x

De Heer EW, Gerrits MM, Beekman AT, et al. The association of depression and anxiety with pain: A study from NESDA . PLOS ONE . 2014;9(10):e106907. doi:10.1371/journal.pone.0106907

Lee C, Doo E, Choi JM, et al. The increased level of depression and anxiety in irritable bowel syndrome patients compared with healthy controls: Systematic review and meta-analysis . J Neurogastroenterol Motil . 2017;23(3):349-362. doi:10.5056/jnm16220

Bharucha AE, Chakraborty S, Sletten CD. Common functional gastroenterological disorders associated with abdominal pain . Mayo Clin Proc . 2016;91(8):1118-32. doi:10.1016/j.mayocp.2016.06.003

Popa SL, Dumitrascu DL.  Anxiety and IBS revisited: Ten years later .  Clujul Med . 2015;88(3):253–257. doi:10.15386/cjmed-495

Sanna L, Stuart AL, Berk M, Pasco JA, Girardi P, Williams LJ.  Gastro oesophageal reflux disease (GORD)-related symptoms and its association with mood and anxiety disorders and psychological symptomology: A population-based study in women .  BMC Psychiatry . 2013;13:194. doi:10.1186/1471-244X-13-194

Choi JM, Yang JI, Kang SJ, et al. Association between anxiety and depression and gastroesophageal reflux disease: Results from a large cross-sectional study .  J Neurogastroenterol Motil . 2018;24(4):593-602. doi:10.5056/jnm18069

Reis DJ, Ilardi SS, Punt SEW. The anxiolytic effect of probiotics: A systematic review and meta-analysis of the clinical and preclinical literature .  PLOS ONE . 2018;13(6):e0199041. doi:10.1371/journal.pone.0199041

By Sheryl Ankrom, MS, LCPC Sheryl Ankrom is a clinical professional counselor and nationally certified clinical mental health counselor specializing in anxiety disorders. 

How To Calm an Anxious Stomach From Anxiety and Stress

You’ve probably experienced this before: You’re about to make a big public speech, go on a first date, or interview for a new job. You’re feeling understandably nervous about it. But, not only are you feeling emotionally anxious – there’s an uncomfortable sensation in your stomach as well.

You might describe it as “butterflies.” Or, the sensation might be less pleasant, like a knot or a sinking feeling in your stomach. Whatever you call it, that bodily sensation is connected to your thoughts and emotions.

In this article, we’ll review how your gut and mind are connected, why anxiety can sometimes cause stomach problems, and what you can do about it.

Can anxiety and stress cause stomach problems?

We have all experienced stomach issues and nervousness at the same time. But are the two really linked?

The short answer is yes. Anxiety and stress can, and do, cause stomach problems.

Think about it: when you’re worried about an upcoming deadline or traveling to an unfamiliar location – and feel your pulse racing, palms sweating, and your heartbeat pounding in your ears (often a sign of an increase in blood pressure) – you are not consciously causing these things to happen. Your body is responding to a release of epinephrine, otherwise known as adrenaline [1] , that kickstarts those processes.

Similarly, anxiety and stress can trigger the release of hormones in the stomach, causing gastrointestinal (GI) issues [2] . Some of the GI symptoms that can be caused by anxiety and stress are:

• Indigestion
• Loss of appetite
• Gastritis (inflammation in the lining of the stomach)
• Irritable Bowel Syndrome (IBS)
• Peptic ulcers

And while many of the stomach issues listed above are only mildly concerning, conditions like gastritis and peptic ulcers, when left untreated, may pose a serious threat to a person’s health [3] .

The mind-gut connection

You may have heard that scientists have found, and continue to research, a connection between the brain and the “gut” or gastrointestinal tract. The ‘gut-brain axis’ is a communication network between the central nervous system-your brain and spinal cord-and enteric nervous system [4] .

The enteric nervous system, sometimes called the “brain of the gut,” operates separately from the central nervous system and is a vast network of nerve cells controlling everything from digestion to the “butterflies” you feel when you’re anxious.

You might think of the gut-brain axis like two tennis players in a match. Both sides are involved and make moves according to what the other does. For example, the mere thought of eating a food can stimulate your stomach to begin ramping up the digestive process [5] . In the opposite direction, if you haven’t eaten for hours, your stomach triggers the release of ghrelin, a hormone that increases appetite.

On top of that, both sides are affected by the enteric microbiome, or the collection of all the microorganisms living in the gut. We might think of the gut microbiome as the weather conditions during the tennis match. Certain weather just makes for better playing environments than others.

For example, scientists have discovered similar patterns in the microbiomes of animal models used to study anxiety and major depression.

In one study, researchers transferred the microbiomes from rats who showed signs of major depression into healthy rats who showed no signs of depression [6] . What they discovered is the previously healthy rats began to show signs of depression. These findings, and studies like them, suggest the gut microbiome may have a significant influence, through the mind-gut connection, on mental health.

Overcoming Anxiety and Phobias

Is anxiety or phobia taking hold of your life? Dr. Jantz explains why you feel anxiety in today’s world. He also shares why phobias make you react in certain ways. For Gen Z, there is a newer term called foreshortened future, which describes those who don’t see any hope for the future and are struggling to sense their place in society.

What settles a stressed stomach?

Dealing with the GI issues associated with stress and anxiety can be tough. On top of whatever you’re worried about taking up energy and brain space, your body is joining in on the action. It can be tough to manage.

Here, we’ll go over seven tips that might help you if you’re dealing with an upset stomach from stress or anxiety.

Practice breathing

When someone is in an anxious or agitated state, there’s a reason people usually say things like, “Calm down. Take a deep breath.”

Remember, when we are stressed, the body’s natural tendency to initiate a stress response – fight, flight, or freeze. It begins releasing adrenaline causing rapid heartbeat, increased blood pressure, body temperature, and short, shallow breathing. Your brain is alerting you to the ‘danger’ ahead so that you can do something about it.

Deep breathing, especially abdominal or “belly” breathing, stimulates your vagus nerve [7] . The vagus nerve sends a signal from the belly to the brain, letting your brain know that everything is okay. Your brain, receiving word that you are not in immediate danger, signals the body to stop producing adrenaline, slow your heart rate down and lower your blood pressure and body temperature.

You can practice belly breathing while sitting, standing, or lying down. Try to make yourself as comfortable as possible and begin breathing deeply through your nose. Some people find it helpful to slowly count from 1 to 5 while breathing in. Exhale slowly and gently while counting from 1 to 5. Repeat the inhale/exhale cycles as many times as you need or for at least 5 minutes.

Progressive Muscle Relaxation

Progressive Muscle Relaxation (PMR) is another exercise designed to help counter the physical sensations that often accompany stress and anxiety [8] . Like the name suggests, this exercise involves tensing and relaxing your muscles, focusing on one muscle at a time and progressing from head-to-toe or toe-to-head.

The idea behind PMR is that you cannot focus on relaxation while also focusing on the symptoms of stress or anxiety, and it has been proven to be an effective tool in decreasing stress, creating a more relaxed state, and improving overall wellbeing.

Try herbal remedies

When you have an anxious stomach, tea can be just the thing that helps tame your tummy. Whether you drink it purely for relaxation or to ease the GI distress that sometimes comes with stress and anxiety, there are tons of tea options.

Chamomile tea is perhaps the most widely known for its natural relaxing properties, but it can also help reduce acid production in the stomach and relieve pain associated with stomach cramps.

Ginger has long been used as a cure for nausea and digestive issues like gas and bloating. Gingerol, a natural compound in ginger, has antioxidant and anti inflammatory properties, making it a good option to help potentially heal damage to the stomach lining.

Peppermint tea is a refreshing and soothing option for calming an anxious stomach that has been around for centuries. It has the ability to regulate pain receptors and reduce stomach pain.

Take OTC medication

Over-the-counter medication is another option for helping calm an anxious stomach. Stress and anxiety can increase acid production in the stomach, causing heartburn, indigestion, and creating an environment where ulcers can form. Antacids and acid reducers can help combat those symptoms.

Find a quiet place

Sometimes a busy, noisy environment can add to the feelings of stress or anxiety you might be having. Finding a quiet place to practice relaxation techniques could be just what you need to feel calmer and more grounded.

Avoid caffeine

Caffeine does not directly cause anxiety, but it’s stimulant effects can make symptoms worse. Especially in large amounts, caffeine consumption can look similar to anxiety [9] . You might:

• Feel restless or on edge
• Have a rapid heart beat, palpitations
• Have trouble concentrating
• Feel irritable or easily agitated
• Have trouble sleeping or struggle to get quality sleep

To help reduce feelings of stress and anxiety, consider reducing or even eliminating your caffeine intake.

Get anxiety treatment

While it is common to feel anxious in certain situations, constantly feeling anxious, worried, or stressed might be a sign that something more is going on.

If you suspect your worrying is negatively impacting your daily life, it may be time to seek anxiety treatment and work with a professional. A professional counselor, psychologist, or psychiatrist has access to resources like therapeutic tools and medication to help treat anxiety.

When to see a doctor

We know from the gut-brain connection that stress and anxiety can have an impact on your GI system. Taking steps to reduce your stress or consuming foods that help alleviate the symptoms can be helpful.

However, the gut-brain connection is not a one-way street. Issues in the stomach might be a result of stress or anxiety and treating underlying anxiety is a great step. Still, there are a number of other issues that can cause similar symptoms; it is important to see a doctor to rule out other GI issues.

Whole Person Care at The Center • A Place of HOPE

At The Center, we’ve always understood the profound connection between mind and body. That’s why we use a unique Whole Person Care approach, which was created by our founder. Dr. Jantz, in the 1980s.

Using this approach, we address every aspect of your holistic health – mental, physical, spiritual, nutritional, intellectual, relational, and spiritual. When you participate in our treatment programs, we help you take a look at every one of these aspects and how they may be contributing to your condition. Healing happens at every level.

For more information about admissions, get in touch with us or schedule a call .

[1] https://my.clevelandclinic.org/health/body/23038-adrenaline [2] https://www.ncbi.nlm.nih.gov/books/NBK499926/ [3] https://www.mayoclinic.org/diseases-conditions/gastritis/symptoms-causes/syc-20355807 [4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4367209/ [5] https://pubmed.ncbi.nlm.nih.gov/3940915/ [6]https://pure.rug.nl/ws/portalfiles/portal/34658674/Transferring_the_blues_Depression_associated_gut_microbiota_induces_neurobehavioural_changes_in_the_rat..pdf#page=10&zoom=100,0,0 [7] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5859128/ [8] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8272667/ [9] https://psychcentral.com/anxiety/can-caffeine-cause-anxiety#symptoms

Dr. Gregory Jantz

Pioneering Whole Person Care over thirty years ago, Dr. Gregory Jantz is an innovator in the treatment of mental health. He is a best-selling author of over 45 books, and a go-to media authority on behavioral health afflictions, appearing on CBS, ABC, NBC, Fox, and CNN. Dr. Jantz leads a team of world-class, licensed, and...

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Anxiety-Related Stomach Pain and its Causes

Reviewed by Heather Cashell, LCSW · November 27, 2020 ·

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Have you ever experienced stomach pain when you’re starting to get anxious about something? Some people get very nervous about certain issues and wind up having stomach pains as a response to what is going on. This is sometimes referred to as anxiety stomach pain, but others just call it having a nervous stomach or gut. Those “butterflies” that you get in your stomach before you have to speak in public can sometimes turn into nervous stomach pain. Why does this happen so suddenly to some people, though? Is there a logical reason why anxiety and stomach pain are related?

Yes, and it comes down to your body experiencing a stress response. When you get anxious or nervous about a situation, your body is going to produce stress hormones. These hormones can wind up entering your digestive tract and causing numerous issues for you. Your digestion can wind up being negatively impacted by the stress hormones, and this can even throw off the bacterial balance in your gut. You might even have antibody production get reduced due to the problems that you’re experiencing.

Potential Anxiety-Related Stomach Issues

What does anxiety and stomach pain feel like? Well, that’s a tough question to answer because many different stomach issues can occur as a result of your stress hormones being overactive. Some people might experience significant stomach cramps, while others will feel like they have indigestion. It isn’t unusual for people with anxiety to report feeling like they have acid reflux. Acid reflux and anxiety (or GERD and anxiety if you prefer that term) are commonly associated with each other. The potential stomach issues don’t end there, though, since many people experience diarrhea, constipation, nausea, ulcers, and even conditions such as Irritable Bowel Syndrome (IBS).

You can wind up experiencing several different types of stomach pain and gut issues due to being anxious. It isn’t uncommon for this to happen, but that doesn’t mean that it isn’t problematic. Being put in a stressful situation and then suddenly experiencing stomach pain can make things that much tougher. How can you get through a presentation or a business meeting when you’re having such pronounced gut problems? Lots of people struggle with this, and you could indeed consider it to be normal. This isn’t an obscure thing that only happens to people rarely, and you might be surprised by how many people you know will have anxiety and stomach issues.

Now that you know that having an anxious stomach ache isn’t unusual, you’ll likely want to know more about what can be done to stop it. Thankfully, there are lots of treatment options that can help you to get by. Some people are able to reduce anxiety-related stomach symptoms by taking normal over the counter medications. Anti-diarrhea medications might help you out, and so will antacids if you feel like you have acid reflux. You really just need to take the appropriate medicine based on the type of stomach issues that you’re experiencing.

If you know that you’re likely to have anxiety issues during certain situations, then it might be wise to keep stomach medications on hand. It can potentially help you to get through your workday, schoolday, or whatever else you’re trying to do. This is still going to be a bit of an inconvenience, though, and you might want to take care of the anxiety problem itself. There are lots of ways to deal with anxiety so that you can feel better. The first step is to talk to your doctor about things, and once that is done, you’re going to be able to use other methods to reduce stress levels.

Doctors Can Help

Doctors can help those who are going through anxiety struggles. You should take a bit of time out of your day to take this anxiety test if you’re unsure about whether you’re dealing with significant anxiety issues. Although this isn’t a method for diagnosing anxiety, it is a good way to see how substantial your problems are ahead of going to your doctor. Once you’ve done the test, you should make an appointment to discuss your anxiety issues. Your doctor will be happy to help you to figure things out.

One way that doctors will help you out is by prescribing you with anti-anxiety medications. Many patients report feeling significantly less anxious in many situations when they’re taking prescription medications like this. It might help you to avoid anxiety stomach pain, but it’s not a guarantee that it will. The results that you get from anti-anxiety medications will depend on many factors, and it’s worth working with your doctor to see what medications will help you out the best.

It’s also worth noting that many people find success by going to therapy. Therapy helps people to work through anxiety issues while developing strong coping mechanisms. If you get better at controlling your emotions and dealing with anxiety, then your anxiety-related stomach issues might become far less severe. Consider talking to a therapist if you and your doctor believe that it would help. It’s very common for patients with anxiety to seek out cognitive behavioral therapy so that they can make important life changes. It could be the biggest thing that will help you to turn things around.

Reducing Stress Sources

You likely have certain things that cause you more stress than usual. It could be that you aren’t doing a good job of keeping your stress levels down, and this could be making your anxiety and gut health worse than usual. Gut health and anxiety can be improved a lot when you aren’t so stressed about things. Try to determine what the most significant sources of stress in your life are. Once you have this information, it’ll be possible to see if you can avoid certain stressors in your life.

Of course, it isn’t possible to completely avoid stress in life, and you might not even want to try to change certain things. If your stress is related to your job, then you might just have to try to get better at handling stressful situations. Even so, eliminating sources of stress at home, such as arguing with people, doing stressful activities, or watching television shows that cause you anxiety, can make a difference. If you have fewer sources of stress in your life, then your stress hormones will be less likely to cause you various gut problems. This is well worth doing if you can determine some ways to cut down on stress.

Lowering your stress levels by doing things that are relaxing will help you out as well. For instance, lots of people like to do calming things such as gardening, reading books, and listening to soothing music. These are all ways that you can lower your stress levels when you’ve been going through a tough time. If you had a stressful day at work, then lowering your stress levels at home by doing relaxing things will be helpful. It might make it more likely that you’ll feel better and won’t have significant gut issues. At the very least, it’s going to put you in a better mood and make you feel more ready to face the next day’s challenges.

Start Exercising

Starting an exercise routine is another strong idea that can help you to keep your stress levels in check. Many people who experience anxiety and depression note that exercising is a good way to make themselves feel better. It can make you feel happier than usual to get some physical activity, and this can alleviate anxiety more than you might think. A regular exercise routine might be one of the best tools at your disposal when it comes to coping with anxiety.

Meditation And Breathing Exercises

When you start to feel those butterflies in your stomach, you might be concerned that your stomach problems are going to flare up again. Lots of successful people get nervous before they need to do important things, and many of them deal with their feelings using meditation and breathing techniques. If you have the time to do so, then you can find a quiet space where you can relax and meditate for a while. This really just involves sitting down quietly, closing your eyes, and trying to clear your mind of all thoughts.

Eliminating your negative thoughts like this should help you to feel a lot less anxious. Breathing exercises work very well in tandem with meditation, but they can help when you aren’t able to meditate, too. Taking deep and slow breaths can help you to calm yourself down if you’re beginning to feel panicked. People who suffer from panic disorders often use breathing techniques to help themselves regain their sense of calm when they feel a panic attack coming on. The same thing might help you to avoid getting too anxious so that your stomach issues won’t get worse.

If you can get good at using these simple coping mechanisms, then you’ll have an easier time getting through your day. It might feel like a pain to have to experience stomach problems and anxiety, but you can get through this issue. Work with your doctor to treat your anxiety and consider what you can do personally to lower your stress levels. You aren’t helpless when it comes to living with anxiety, and you also never have to try to deal with things alone. There will always be professionals ready to assist you if you feel like you’re having a tough time.

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Physical Symptoms

How to stop anxiety stomach pain & cramps.

• The stress that anxiety puts on your body can lead to stomach pains
• Anxiety can cause stomach pain in a way that leads to indigestion and physical pain
• Stress tends to cause a great deal of tension in the abdomen. That tension can tire out abdominal muscles and cause an internal feeling of discomfort
• Stress affects hormone levels, and hormones are used to aid digestion
• Anxiety has been linked as one of the most likely causes of irritable bowel syndrome, or IBS
• Consider sipping cool (but not too cold) water. Antacids may also be beneficial in some cases, but if you have stomach pain often you may not want to depend on antacid treatments

Fact Checked

Micah Abraham, BSc

Last updated November 26, 2022

Anxiety is a complex disorder and one that can have a profound effect on one’s body, mind, and daily life. The stress that anxiety puts on your body can lead to various different issues, including those relating to the digestive system. One of the more common symptoms is stomach pain.

Upset stomach, stomach cramping, and intestinal discomfort that are hard to describe can all result from persistent anxiety - you may be experiencing nervous stomach symptoms.

What Is Anxiety and How Can It Cause Stomach Pain?

Anxiety is a natural response to stressful situations. When you perceive a scenario as stressful or dangerous, your body goes into ‘fight or flight’ mode.

‘Fight or flight’ mode involves activation of the sympathetic nervous system, the branch of your nervous system that plays a crucial role in the stress response. This triggers a whole host of physiological symptoms that prepare your body to fight the threat or flee from it. These bodily changes include:

• Release of Stress Hormones: The body secretes stress hormones such as adrenaline and cortisol. This increases your blood pressure.
• Racing Thoughts: Your thinking speed quickens, helping you to make quick-fire decisions to keep yourself safe.
• Breathing Rate Increases : Your breathing becomes quicker and shallower; you breathe into your chest rather than your lungs, which helps increase the oxygen concentrations in your muscles.
• Heart Beat Quickens : Your heart beats quicker when under threat, which helps pump blood around the body.
• Muscle Tension: Muscles begin to tense all over the body, preparing you to run away or fight.
• Hyperawareness: Activation of the stress response causes your vision to become more acute, fine-tuning your senses to pay attention to the dangers around you.

Alongside other symptoms, the fight or flight response also causes stomach symptoms. It may make you feel nauseous or experience ‘butterflies’ as the blood shifts away from the digestive system towards the arm and leg muscles. However, this isn’t the only way stress and anxiety can impact the stomach.

The Gut-Brain Axis

The brain shares an intimate connection with the stomach through the gut-brain axis. It’s a two-way connection linking nerves, hormones, and gut flora. The enteric nervous system (ENS), a key component of the brain-gut connection, is often referred to as the ‘second brain.’ Within the ENS, you have millions of nerve connections that regulate digestion.

The ENS is connected to the nervous system, which is, of course, connected to the brain. Therefore, when a change occurs in the brain, it affects the gut and vice versa.

When you experience stress, your body releases hormones and neurotransmitters, which travel to the gut and affect how your stomach and intestines transfer waste through the body, known as gut motility. Stress levels can also influence gut bacteria, causing imbalances that can lead to gastrointestinal discomfort if you experience too much stress.

As you can see, it’s very plausible that your anxiety may be causing your digestive problems.

Examples of Anxiety-Related Stomach Issues

Numerous health concerns are caused by anxiety. These can lead to various types of digestive system symptoms. Some examples are:

• Abdominal Tension: Stress tends to cause a great deal of abdominal tension. That tension can tire out abdominal muscles and cause an internal feeling of discomfort.
• Indigestion: Stress affects hormone levels, and hormones are used to aid digestion. Stress can lead to hormonal imbalance, resulting in indigestion that may lead to bloating, intestinal pain, and more.
• Irritable Bowel Syndrome: Anxiety is one of the most likely causes of Irritable Bowel Syndrome (or IBS). IBS occurs when your body’s digestive system functions poorly without a definitive underlying cause. Health conditions like IBS can cause altered bowel movements and abdominal discomfort.

Anxiety also triggers the release of the stress hormone cortisol. This causes the body to produce extra levels of stomach acid. This acidity irritates the esophagus lining, leading to belly pain, nausea, vomiting, and in severe cases, stress-induced ulcers.

These are just a few ways that anxiety can cause pain or adverse symptoms in the digestive system.

Can Stress Cause Stomach Pain?

You may be asking: what about stress? While anxiety and stress are closely related, they’re different phenomena.

Stress vs. Anxiety: What’s the Difference?

Anxiety and stress are part of the fight or flight response - they help your body react to danger. However, there are some key differences between the two:

• Stress is short-term, whereas anxiety can linger, even when you’re no longer under threat.
• Stress always occurs in response to an actual threat, whereas anxiety can happen because you have perceived or ‘imagined’ a threat. Therefore, on occasion, you may not even be able to identify the danger that’s causing your anxiety.
• While symptoms of stress are dizziness, loneliness, nausea, anxious thoughts, unhappiness, overwhelm, and irritability, symptoms of anxiety include restlessness, tension, sweating, a sense of dread, and nervousness.

Stress and anxiety also have some overlapping symptoms:

• Fast heart rate
• Rapid breathing
• Constipation or diarrhea

It’s possible to experience a significant amount of stress without experiencing anxiety. Yet the causes of belly pain from stress are similar.

How Do I Know if It’s Anxiety and Not an Ulcer?

You may worry that your stomach pain has a more severe underlying cause, not a result of anxiety or stress. It’s common for those with stomach pain to fear that there’s something more serious going on, such as a stomach ulcer.

Only a doctor can offer advice, diagnosis, or treatment - while Healthline media websites may provide you with some guidance, your best bet is to speak to your doctor. They can tell you, for definite, why you are experiencing stomach problems. However, some clues will help you figure this out for yourself:

• Blood in Your Stool

If you’re seeing blood in your stool, this may be due to bleeding in the stomach. This might indicate stomach ulcers. You’re unlikely to experience this symptom as a result of anxiety or stress.

• Acid Reflux

Indigestion is a classic sign of stomach ulcers. This may be what’s causing the pain in your stomach region. You may also experience heartburn, so it can be challenging to decipher between this and stomach ulcers. However, the symptoms of a stomach ulcer also tend to cause dull pain in the abdomen, similar to the sensation of being hungry.

• Pain After Eating

Pain or discomfort after eating may be a sign of a stomach ulcer. However, it can also indicate other health conditions, such as GERD (heartburn/acid reflux), so you’ll need to check this with your doctor.

Stomach Pain and Long-Term Health

It’s essential to remember that chronic stress can also lead to stomach ulcers because of the extra stomach acid.

Because of the extra acid in your stomach and the changes in how your body processes nutrients, stomach pain from stress or anxiety can be a problem if left untreated. Ulcers are just one example. Some people experience heartburn from anxiety, and others eat less often, giving their bodies fewer nutrients.

The stomach pain from anxiety and stress is rarely dangerous, but it is still important to treat it because the effects on your long-term health, when left untreated, may be harder to manage.

When Is Stomach Pain Most Likely to Occur?

If you have anxiety, stomach pain can occur anytime – even when no anxiety is present. However, many people experience stomach pain during panic attacks.

The exact link between an anxiety attack and stomach pain is not clear, other than the fact that during a panic attack, your body is under a considerable amount of stress, and your hormones are often on overdrive. Also, those with anxiety attacks are prone to hyperventilation, which may lead to symptoms that create stomach pain.

How to Relieve Stomach Pain Symptoms

There isn’t necessarily a cure for the stomach pain symptoms themselves. When your body is under stress, your stomach tends to hurt based on the acids in your stomach and the foods you’ve already eaten. If you have stomach pain due to an anxiety attack, you may need to wait it out.

Water can help a little, however. So consider sipping cool (but not too cold) water. Antacids may also be beneficial in some cases, but if you have stomach pain often, you may not want to depend on antacid treatments.

Method #1 See a Doctor

Stomach pain caused by anxiety is difficult for doctors to diagnose because the pain and indigestion are still real physical responses – the same type of responses that would occur if you had any other physical health issue.

If the stomach pain is severe or accompanied by fever or other symptoms, it’s certainly a good idea to seek the medical expertise of a doctor.

Method #2 Natural Remedies

Some herbal remedies can help to ease the symptoms of a nervous stomach. Ginger root is an excellent natural remedy for nausea or when you’re feeling a little queasy. There are several ways you can make use of the remedial effects of ginger:

• Chew a small piece of root ginger
• Eat ginger candy
• Drink ginger ale (the real ginger ones!)
• Try ginger tea

Other effective antispasmodics that people often already have in their homes are peppermint, lemon balm, lavender, and spearmint.

These can help to ease stomach tension and spasms from anxiety, thus helping to reduce the likelihood of stomach upset, cramps, anxiety butterflies, and flatulence.

Essential oils also supposedly work wonders on anxiety. A 2019 systematic review and meta-analysis demonstrates that oral consumption of lavender essential oil can effectively reduce anxiety symptoms. This study also suggests that massage with lavender oil and inhalation may reduce anxiety symptoms.

Chamomile, catnip, and fennel are also natural remedies, alongside various other plants for mild anxiety symptoms.

Method #3 Foods That Reduce Stomach Pain

An upset stomach from anxiety is not usually the result of your diet (although a poor diet and sedentary lifestyle may increase the risk of anxiety), there aren’t necessarily any dietary changes that can help reduce stomach pain.

However, those with panic attacks are more prone to experiencing more severe stomach pains, even when no anxiety is present. In other words, when you have panic attacks, it’s possible to have stomach pain even without a panic attack.

Also, those with anxiety attacks and acute anxiety are prone to what’s known as “over-sensitization.” That means that they are more likely to notice and feel smaller, normal body changes, which can trigger an anxiety attack. So if your diet contains foods that cause you gas, stomach discomfort, or mild indigestion, it may be best to avoid them because the slight discomfort could feel worse than it should and may trigger a panic attack.

That’s why healthy eating is important for those that get stomach pain from anxiety. Make sure you’re getting:

• Water/Hydration
• Wholegrain carbohydrates

In addition, if possible, try to avoid eating until you’re too full. Those with severe anxiety sometimes interpret the “full” feeling as pain, which could trigger a panic attack and further pain.

Furthermore, diets containing more alcohol and caffeine can worsen or even cause stomach symptoms. Stay away from these if you want to improve your gut health and digestive problems.

Method #4 Alternative Techniques

You can also try reducing stress to treat your anxiety. If anxiety is the cause of your stomach pain, reducing your anxiety will target both symptoms at once - it’s a win-win!

Relaxation techniques such as mindfulness , yoga, and visualization will help you to manage stress. Deep breathing practices also work wonders for relieving the body of stress and anxiety.

If you are experiencing an anxiety disorder, another treatment method worth trying is seeing a mental health professional such as a counselor . They may be able to support you emotionally, helping you to identify the root cause of your anxiety so that you can combat the problem at the source. This can have multiple benefits, including improving your mental health.

Finally, physical activity can benefit your brain and gut - regular exercise can reduce your anxiety symptoms and improve gut bacteria, making it an excellent treatment method for stress-related stomach pain.

SUMMARY: Stomach pain from anxiety can be caused by several stress-related issues, including abdominal tension, digestion issues, and irritable bowel. Although the stomach pain may be caused by anxiety, the acids in the stomach are still very real. There are ways to treat both your stomach discomfort and anxiety.

Questions? Comments?

Do you have a specific question that this article didn’t answered? Send us a message and we’ll answer it for you!

Where can I go to learn more about Jacobson’s relaxation technique and other similar methods? – Anonymous patient

You can ask your doctor for a referral to a psychologist or other mental health professional who uses relaxation techniques to help patients. Not all psychologists or other mental health professionals are knowledgeable about these techniques, though. Therapists often add their own “twist” to the technqiues. Training varies by the type of technique that they use. Some people also buy CDs and DVDs on progressive muscle relaxation and allow the audio to guide them through the process. – Timothy J. Legg, PhD, CRNP

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Nervous Stomach: How to Calm Stomach Pain, Causes & Symptoms

Nervous stomach? You're not alone. Pain in the stomach and abdominal area is a common symptom for a range of issues, and anxiety and stress may be responsible for this pain if no other biological cause (e.g., stomach ulcers) can be found.

People with anxiety disorders develop gut symptoms such as cramping, bloating, and abdominal pain more frequently than healthy individuals. And, people with gut symptoms are much more likely to suffer mental health problems.

This two-way link between anxiety and abdominal pain is shown in ‘functional gastrointestinal disorders’. The most common functional disorder is irritable bowel syndrome (IBS), affecting 1 in 7 people worldwide. ( 1 )

Functional Gastrointestinal Disorders

Functional gastrointestinal disorders such as irritable bowel syndrome (IBS) differ from conditions such as inflammatory bowel disease (IBD) or coeliac disease that have a physical basis. In these ‘functional’ disorders, the digestive tract is healthy, yet symptoms are still experienced.

Multiple factors – environmental, psychological, and social – contribute to the development of functional gastrointestinal disorders. Stress, in particular, may be an initial trigger for symptoms. However, gut bacteria imbalances and psychological conditions such as depression may also contribute. ­( 2 , 3 )

• Irritable bowel syndrome

Irritable bowel syndrome (IBS) is the most common functional gastrointestinal disorder. It is defined by persistent abdominal pain and one or more additional symptoms, such as a change in stool frequency.

The most common symptoms of IBS are:

• Abdominal pain
• Constipation or diarrhea ( 4 )

IBS and mental health

IBS is more common in individuals who suffer mental health issues. It has been shown that over 50% of people with IBS also experience mental health conditions, such as:

• Generalized anxiety disorder
• Panic disorder
• Post-traumatic stress disorder
• Depression ( 5 )

Although the cause of IBS is not known, the enteric nervous system and gut-brain connection are thought to be involved. These help to explain how psychological ill-health may be linked with gastrointestinal symptoms.

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• The enteric nervous system

The enteric nervous system refers to the neurons controlling the digestive system. This ‘second brain’ is connected to the central nervous system – the brain and spinal cord. This system relies on neurotransmitters to communicate with the central nervous system and may affect mood. ( 6 )

After sensing food, the nerves of the enteric nervous system communicate with muscle cells to initiate contraction, moving food along the intestines.

In response to stress and in disorders such as IBS, the enteric nervous system may function abnormally. For instance, levels of neurotransmitters such as serotonin may be altered, or nerves may become hypersensitive. This may lead to gut symptoms such as abdominal pain, cramping, or constipation.

The gut-brain axis

The ‘gut-brain axis’ refers to the two-way communication between the brain and gut. It helps explain how stress can contribute to gastrointestinal symptoms, and is made up of several components:

• The Vagus nerve
• Levels of gut bacteria in the intestines
• Neurotransmitters, such as serotonin ( 6 , 7 )

The gut-brain axis is being investigated in the new field of ‘neurogasterenterology’. Modern research has allowed researchers to measure pain perception in the gut, and the effect of gut bacteria on mental wellbeing. Stress and mental illness are being uncovered as a source of GI dysfunction. ( 7 )

Stress causes IBS?

‘Stress’ is the term for the normal response to survival, and chronic levels of stress may disrupt the gut-brain axis. This may lead to gastrointestinal symptoms, including abdominal pain.

GI symptoms may arise due to the following effects of the stress response:

• Activation of the ‘fight-or-flight’ response
• Increased sensitivity to visceral (bodily) pain
• Reduced gut motility – the speed of transit through the GI tract ( 8 , 9 )

These mechanisms slow the passage of food through the intestines, leading to pain and other symptoms of IBS. Researchers have confirmed that stressful experiences, tested with complex pattern recognition tasks, make IBS patients more sensitive to non-painful stimuli. ( 10 )

However, the exact mechanism for how stress causes IBS is not known. One theory suggests that people who are predisposed to IBS – by genetics or early life trauma – develop the condition after a long period of stress, which acts as the trigger. ( 11 )

IBS causes stress?

It works the other way, too: IBS symptoms may cause stress. Normal GI activities, such as needing to go to the bathroom, may be misinterpreted by the brain of a person with IBS as a catastrophic event, triggering the ‘fight or flight’ response.

Or, they may suffer anxiety about the social situations in which symptoms occur. This misinterpretation of normal digestive processes as dangerous leads to stress.

Hence, a vicious cycle may emerge between IBS symptoms such as abdominal pain and stress. ( 12 )

The biopsychosocial model

More broadly, the ‘biopsychosocial model’ (1980) explains how stress and anxiety may link to abdominal pain. As suggested by the name, the model proposes that biological, psychological, and social factors may all contribute to disease. Looking at IBS this way helps to explain how stress – a social and psychological factor – may have a biological effect on the gut. It also explains how therapies targeting the mind, such as hypnotherapy and CBT, make sense as treatments for gut symptoms.( 13 )

Confirming the model, scientists in China recently found a link between stress and IBS. They showed that a protein called NGF appeared in higher rates following early life trauma, and led to symptoms of IBS. Hence, the biopsychosocial model appears valid in IBS. ( 14 )

How to calm a nervous stomach

Given the importance of the psychological process in IBS, it is unsurprising that psychological therapies are an effective treatment option. Several psychotherapies are effective in reducing gastrointestinal distress:

• Gut-directed hypnosis (GDH). This hypnosis involves the patient visualizing their gut as a set of slimy tubes and other gut-related imagery. This helps to restore the gut-brain communication to reduce symptoms of IBS . Smartphone-based versions such as Nerva have recently become available, and offer convenient access to hypnotherapy. ( 15 )
• Cognitive-behavioral  therapy (CBT). This skill-based therapy teaches control over negative thought patterns and modifies patterns of behavior. Relaxation techniques help to control the stress response, and cognitive     restructuring allows the patient to avoid catastrophizing. These techniques help to reduce the symptoms of IBS. ( 16 )
• Mindfulness-based therapies. This practice involves attending to the present moment and cultivating non-judgemental attitudes. Mindfulness therapies reduce levels of stress and sensitivity to pain, a key symptom of IBS. The effects have been shown to last over three months ( 17 ), although these therapies can be less effective than GDH and CBT.

These treatment options are likely to target both symptoms of anxiety, and functional symptoms such as abdominal pain. Psychological therapies, especially gut-directed hypnotherapy, have been shown as effective, if not more effective, than diets and medications for relieving IBS symptoms.

Other treatments for IBS            

The following treatments are also available for IBS. However, the effectiveness can be lower than for psychotherapies:

• Low FODMAP diet . This diet eliminates common ‘trigger compounds’ of IBS such as fructose and lactose and has been shown effective in treating IBS. ( 18 )
• Antidepressant medication. Low dose treatments of selective serotonin reuptake inhibitors (SSRIs) and tricycle antidepressants (TCAs) have been shown to relieve symptoms of IBS. ( 19 , 20 )
• Peppermint oil . It's been shown that peppermint oil is a natural anti-spasmodic which means it can relax the smooth muscles in the gut, improving some of the symptoms of IBS.

When should I see the doctor?

If gastrointestinal symptoms and pain persist for more than a few days, you should consult a doctor. You may be instructed to undertake certain tests or see a specialist if there are signs of a more life threatening medical condition. If you experience abdominal pain and the following symptoms, you should consult a doctor as soon as possible:

• Vomiting blood
• The abdomen is larger than usual and hard
• Rectal bleeding
• You stop having bowel movements

These symptoms may suggest the pain is linked with a biological disease and is not a symptom of IBS or another functional gastrointestinal disorder.

Alternative causes of abdominal pain

As well as from functional gastrointestinal disorders, there are many other sources of abdominal pain. This pain may arise from inflammation, distension, and stretching or impaired blood supply. These include:

• Heartburn (indigestion after eating)
• Gallbladder inflammation
• Ulcerative colitis
• Crohn’s disease
• Kidney stones
• Gluten intolerance (coeliac disease)
• Menstrual cramps
• Gastroenteritis (inflammation)
• Ischemic colitis
• Pregnancy ( 21 )

Diagnosis of abdominal pain

If you experience abdominal pain and other GI symptoms, your physician will likely ask you a series of questions, addressing the pattern and persistence of the pain. A range of diagnostic tests may also be used to assess for certain medical conditions, including:

• Physical examination
• Colonoscopy
• Magnetic resonance imaging (MRI)
• Computerized tomography (CT) ( 22 )

Treatments for abdominal pain

A range of treatment options are available for abdominal pain of biological origin, depending on the cause. These include:

• Antibiotics for gastroenteritis
• Antacid for gastroesophageal reflux disease (GERD).
• Surgery, for bowel obstruction
• Corticosteroids for ulcerative colitis or Crohn’s disease
• Loperamide for diarrhea-induced cramping
• Painkillers (e.g., paracetamol) ( 23 , 24 )
• Pain Hypnosis

Preventing abdominal pain

Some forms of abdominal pain require medication or surgery. However, certain behaviors may minimize the risk of many types of abdominal pain:

• Exercising correctly and making fitness-based lifestyle changes
• Eating a healthy diet, rich in vitamins and minerals
• Staying hydrated
• Taking herbal remedies such as ginger and peppermint
• Limiting alcohol consumption

A Word from Mindset Health

If you suffer anxiety and abdominal pain, and diagnostic testing finds no physical cause, you may have IBS . The gut-brain connection suggests how physical symptoms of IBS such as stomach aches may be linked to anxiety symptoms and stress levels. Seeking help from a mental health professional and receiving psychotherapies such as gut-directed hypnosis will offer the chance for your gut and mind to be healed as one.

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Constipation, cancer, and the power of calming down: Hannah’s story

Four decades ago, Hannah* sensed something was amiss in her gut, setting her on a 40-year journey to reclaim control of her digestive well-being. Finding a level of relief she could live with after years of trial and error for her IBS-C, a surprise cancer diagnosis in her 50s unraveled her hard-earned progress. With gut health no longer a priority, Hannah shifted into survival mode.

Our sources

Mindset Health only uses high-quality sources, including peer-reviewed research, to support our articles. We work with experts to ensure our content is helpful, accurate and trustworthy.

• Bommelaer G, Poynard T, Le Pen C, Gaudin AF, Maurel F, Priol G, Amouretti M, Frexinos J,Ruszniewski P, El Hasnaoui A. Prevalence of irritable bowel syndrome (IBS) and variability of diagnostic criteria. Gastroenterologie clinique et biologique. 2004 Jun 1;28(6-7):554-61. Link
• Masand PS, Kaplan DS, Gupta S, Bhandary AN, Nasra GS, Kline MD, Margo KL. Major depression and irritable bowel syndrome: is there a relationship? The Journal of clinical psychiatry. 1995 Aug. Link
• De Palma G, Collins SM, Bercik P, Verdu EF. The microbiota–gut–brain axis in gastrointestinal disorders: stressed bugs, stressed brain or both?. The Journal of physiology. 2014 Jul15;592(14):2989-97. Link
• Drossman, D.A., 2006. Rome III: the new criteria.  Chinesejournal of digestive diseases ,  7 (4), pp.181-185. Link
• Garakani, A., Win, T., Virk, S., Gupta, S., Kaplan, D. and Masand, P.S., 2003. Comorbidity of irritable bowel syndrome in psychiatric patients: a review.  American journal of therapeutics ,  10 (1),pp.61-67. Link
• Foster, J.A. and Neufeld, K.A.M., 2013. Gut–brain axis: how the microbiome influences anxiety and depression.  Trends in neurosciences ,  36 (5), pp.305-312. Link
• Cryan, J.F. and O’mahony, S.M., 2011. The microbiome‐gut‐brain axis: from bowel to behavior.  Neurogastroenterology & Motility ,  23 (3), pp.187-192. Link
• Aggarwal, A., Cutts, T.F., Abell, T.L., Cardoso, S.,Familoni, B., Bremer, J. and Karas, J., 1994. Predominant symptoms in irritable bowel syndrome correlate with specific autonomic nervous system abnormalities.  Gastroenterology ,  106 (4), pp.945-950. Link
• Mönnikes, H., Tebbe, J.J., Hildebrandt, M., Arck, P.,Osmanoglou, E., Rose, M., Klapp, B., Wiedenmann, B. and Heymann-Mönnikes, I.,2001. Role of stress in functional gastrointestinal disorders.  Digestive Diseases ,  19 (3), pp.201-211. Link
• Posserud, I., Agerforz, P., Ekman, R., Björnsson, E.S.,Abrahamsson, H. and Simrén, M., 2004. Altered visceral perceptual and neuroendocrine response in patients with irritable bowel syndrome during mental stress.  Gut ,  53 (8), pp.1102-1108. Link
• Chang L. The role of stress on physiologic responses and clinical symptoms in irritable bowel syndrome. Gastroenterology. 2011 Mar1;140(3):761-5. Link
• Moloney, R.D., O’Mahony, S.M., Dinan, T.G. and Cryan,J.F., 2015. Stress-induced visceral pain: toward animal models of irritable-bowel syndrome and associated comorbidities.  Frontiers in Psychiatry ,  6 ,p.15. Link
• George E, Engel L. The clinical application of the biopsychosocial model. American journal of Psychiatry. 1980 May5;137(5):535-44. Link
• Wong, H.L.X., Qin, H.Y., Tsang, S.W., Zuo, X., Che, S.,Chow, C.F.W., Li, X., Xiao, H.T., Zhao, L., Huang, T. and Lin, C.Y., 2019.Early life stress disrupts intestinal homeostasis via NGF-TrkA signaling.  Nature communications ,  10 (1), p.1745. Link
• Peters SL, Yao CK, Philpott H, Yelland GW, MuirJG, Gibson PR. Randomised clinical trial: the efficacy of gut‐directed hypnotherapy is similar to that of the low FODMAP diet for the treatment of irritable bowel syndrome. Alimentary pharmacology & therapeutics. 2016 Sep;44(5):447-59. Link
• Kinsinger, S.W., 2017. Cognitive-behavioral therapy for patients with irritable bowel syndrome:current insights.  Psychology research and behavior management ,  10 ,p.231. Link
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Anxious Stomach: Overview, Causes, And How To Get Rid Of It

What causes the anxious feeling in your stomach, could the relationship between your anxiety and stomach issues be the other way around, how can you get rid of these symptoms, dietary changes, traditional medications, psychological approaches, herbs and spices, gut-directed hypnotherapy, the lowdown.

At some point in your life, you have likely experienced some level of anxiety about a stressful situation. You might have also noticed that sometimes, anxious symptoms appear in your stomach. 

Feeling anxious in your stomach can include having what feels like “butterflies” or “knots.” These usually subside relatively quickly once the stressful situation, such as a job interview, is removed. 

However, anxiety can also cause more unpleasant and painful symptoms in your stomach. These could include:

Indigestion

Changes to your appetite

These symptoms may be more persistent, remaining even after what’s causing your anxiety is gone. If you experience this regularly,  it is important to try and get on top of it as soon as possible, as it can lead to conditions such as irritable bowel syndrome . 

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The gut-brain connection

There is a very strong connection between our brain and our gut. The thoughts and emotions we experience mentally in our brains, such as stress and anxiety , can be related to our gut,¹ which is we experience anxiety-related symptoms in our stomach.

This happens because we have a long nerve called the vagus nerve,² connecting our brain to our gut. Our gut has over 200 million nerve cells and is controlled by its own nervous system, known as the enteric nervous system. This can respond to signals and hormones from our brain and our central nervous system. 

When our brain detects a stressful situation or a threat, it automatically reacts by going into a “fight or flight”³ mode, a response designed to help us survive. Chemical messengers and hormones, such as adrenaline and cortisol, are released. One of their roles is to send less blood to the stomach and slow down digestion. This can cause the symptoms in the stomach that we associate with anxiety. 

The release of chemicals and hormones in the body allows more blood and energy to go to organs crucial for survival, like the heart and lungs. 

However, our brain can see situations that are not life-threatening as stressful, such as an upcoming presentation or interview or even relationship issues. Since our body perceives this stressor as a threat, it still activates the fight or flight response. 

In chronically stressed or anxious people, this response can remain permanently ‘switched on,’ and cause ongoing anxiety-related stomach symptoms. 

Stress can also affect the balance of gut bacteria. 

We have about 100 trillion microbes in our digestive tract. Most are bacteria and are important for keeping our gut healthy, regulating our gut-brain connection, and breaking down substances that we cannot digest, such as dietary fiber. It is vital for there to be a healthy balance and diversity of the gut microbiome. 

Because of their importance in regulating the gut-brain connection, these microbes also contribute to anxiety-like behavior⁴ in situations where we experience real or perceived stress. 

The chemical messengers released when we are stressed or anxious can create an imbalance of our gut microbiome, even if this stress is short-term. This can also cause symptoms related to anxiety in our stomach, such as nausea . 

Just like how our brain can communicate with our gut, our gut can communicate with our brain. Evidence⁵ has shown that your stomach pain or other gastrointestinal symptoms may be contributing to your feelings of anxiety. 

It is believed that gut bacteria can impact the parts of our brain that manage stress and emotional behavior. So, an imbalance of our microbiome can influence stress-related behaviors such as anxiety. This can then begin a vicious cycle where anxiety about stomach pain causes the stomach pain to stick around as a symptom of anxiety. 

To get rid of the anxious feeling in your stomach, there are different approaches you can take. This could involve managing the stomach issues or treating anxiety as the root cause of the stomach pain. This can help improve stomach pain and even prevent it from occurring in the future. 

Although these suggestions are practical and evidence-based, it is important to understand that everyone has different experiences, so some approaches may not be effective for you. 

If you cannot manage your symptoms through these strategies, or they last for longer than a few days, you should see your doctor for an evaluation. They will be able to rule out other causes and physical conditions, provide you with mental health support or refer you to a specialist, such as a therapist, psychologist, or gastroenterologist. 

Avoid caffeine. This can be helpful for two reasons: 

Caffeine can cause gastrointestinal problems.

Caffeine can worsen anxiety-related symptoms because it increases molecules associated with the fight or flight response, such as adrenaline and cortisol, and blocks a molecule called adenosine, which aids relaxation. 

Improve your gut health

Diet is an important modifier of the microbiota-gut-brain connection. Gut health can be improved by: 

Consuming probiotics. These are microorganisms that can contribute to our gut bacteria and help to create a healthy balance. In turn, this can help promote a balance of hormones and neurotransmitters. Also, early studies in mice⁶have suggested that a probiotic effectively reduces anxiety and related gut symptoms by activating the vagus nerve. Probiotics are in foods like yogurt, kombucha, pickled vegetables, and sauerkraut.

Increasing fiber intake. We cannot digest fiber, but it acts as the “food” for probiotics and helps promote a healthy balance of gut bacteria. You can find good sources of fiber in whole grains, legumes, and many different fruits and vegetables.

Traditional medications can help treat your stomach pain directly or help manage the anxiety causing your stomach issues. 

Common medications for anxiety include selective serotonin reuptake inhibitors (SSRIs) , beta-blockers , or sedatives. 

Your doctor must prescribe these medications after a consultation to ensure they will be safe and effective for you.

You could also try over-the-counter medications for stomach issues available at your pharmacy. However, it is still a good idea to consult with a doctor. 

Usually, medications for anxiety are only prescribed as a short-term solution and used in conjunction with therapy so that you can work on treating the psychological aspect of your anxiety. 

Psychological treatments, such as therapy, reduce the anxiety responsible for your stomach issues. Even though this approach may not directly target your physical symptoms , they are effective since your gut is so directly connected to brain functioning. 

Cognitive behavioral therapy (CBT)

CBT has been shown to help reduce anxiety and associated gastrointestinal symptoms. This form of therapy teaches you how to manage the interactions between your feelings, thoughts, and behavior. It can involve deep breathing and muscle relaxation to reduce the stress response. 

Relaxation therapy

Relaxation therapy involves learning various techniques to feel more relaxed and have a less intense reaction to stressful situations. These techniques involve progressive muscle relaxation, visualizing relaxing scenes, and listening to peaceful music. It is best for treating gastrointestinal disorders associated with anxiety when used alongside CBT. 

Diaphragmatic breathing

Diaphragmatic breathing is an exercise that modulates the functioning of the nervous system and can influence the brain and gastrointestinal system. This means it can help manage stomach pain associated with anxiety. 

Decrease muscle tension, such as in the smooth muscle of the stomach.

Activate the body’s relaxation response⁷ and lower the ‘fight or flight’ response by stimulating the vagus nerve. 

Try to repeat the following process for ten to fifteen minutes. 

Find a comfortable place where you can sit or lie down. Relax your muscles. 

With your eyes closed, place one hand on your chest and your other hand on your stomach. 

Inhale through your nose for six seconds. Allow your belly to expand, but try to keep your chest as still as possible.

Hold your breath for two seconds. 

Slowly exhale through your mouth for six seconds.

Mindfulness meditation

Mindfulness meditation is a mental training practice where you learn to focus your attention on the present moment and accept your thoughts and feelings. It is believed to be effective because we often feel anxious and experience symptoms when looking to the past or the future. 

A study⁸ in people with IBS and anxiety showed that mindfulness meditation reduced their gastrointestinal symptoms and anxious thoughts , and improved their overall quality of life. 

Any type of exercise improves hormonal balance and stimulates the release of endorphins that improve mood and decrease stress — in turn reducing the anxiety that can ease your symptoms. 

In particular, yoga is beneficial for improving physical gastrointestinal symptoms and anxiety, including GI-specific anxiety.

Yoga is believed to influence the brain-gut connection, reduce the activity of the sympathetic nervous system that is associated with stress and the “fight or flight” response, and increase the relaxation response. 

These are more of a quick fix to help an anxious stomach, so they will not address your underlying anxiety. 

However, science-backed suggestions to ease stomach issues include:

Commonly used to relieve stomach aches.

Peppermint oil

This is an “antispasmodic,” which means it can relax the muscles in the gut. It can relieve IBS symptoms, abdominal pain,⁹ cramping and bloating in the stomach, and nausea.  

Iberogast is a combination of nine medicinal plants. Some studies have shown it to reduce gastrointestinal symptoms and treat irritable stomach symptoms such as nausea and cramps. 

Gut-directed hypnotherapy is a form of hypnosis, a therapeutic technique that can help manage anxiety or pain. It is a guided process where you learn how to relax, focus, and concentrate on achieving a heightened state of consciousness, which is meant to alter your state of awareness. 

When relaxed in this state, your mind is open to prompts or suggestions for imaginative experiences. Your therapist guides you with metaphors and suggestions directed towards your gut. Suggestions could be made for your stomach pain and symptoms to subside and for a healthy connection to grow between the brain and gut. This type of hypnotherapy aims to prevent you from focusing too much on the discomfort that you feel in your stomach due to your anxiety. 

Scientists don’t know exactly why, but studies have shown gut-directed hypnotherapy to be effective in reducing abdominal pain¹⁰ in adults by 70-80%, as well as having psychological benefits. It also appears to be beneficial for children, with long-term positive outcomes. ¹¹

An anxious stomach can be uncomfortable and prevent you from living your life to the fullest. Fortunately, by treating the stomach pain directly and also managing the root of your anxiety, you can take steps to reduce, get rid of, and even prevent these anxiety-related symptoms in your stomach.

Review article: Gut-directed hypnotherapy in the management of irritable bowel syndrome and inflammatory bowel disease (2015)

The gut-brain axis: Interactions between enteric microbiota, central and enteric nervous systems (2015)

Physiology, stress reaction (2022)

Stress & the gut-brain axis: Regulation by the microbiome (2017)

Pathways in gut-brain communication: Evidence for distinct gut-to-brain and brain-to-gut syndromes (2015)

The anxiolytic effect of Bifidobacterium longum NCC3001 involves vagal pathways for gut-brain communication (2011)

Effect of slow abdominal breathing combined with biofeedback on blood pressure and heart rate variability in prehypertension (2010)

Mindfulness-based stress reduction improves irritable bowel syndrome (IBS) symptoms via specific aspects of mindfulness (2020)

Herbal medicines for gastrointestinal disorders in children and adolescents: A systematic review (2017)

Gut-directed hypnotherapy for functional abdominal pain or irritable bowel syndrome in children: A systematic review (2013)

Long-term follow-up of gut-directed hypnotherapy vs. standard care in children with functional abdominal pain or irritable bowel syndrome (2012)

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How to (finally) fix your chronic stomach issues

Use these helpful tools to figure out what's really causing all that cramping, bloating and gas -- and get rid of it for good.

What you eat affects your digestion big time, but so do a lot of other factors.

Whether it's constipation, diarrhea, gas or the dreaded bloat, everyone deals with digestive discomfort at one point or another. Occasional digestive symptoms usually aren't an issue -- maybe you just ate too much in one sitting or you've got a virus that will pass -- but chronic digestive issues can indicate an underlying issue. 

The thing is, it's not always easy to tell what's going on. From food sensitivities to inflammatory diseases, any number of things could be contributing to your symptoms. You should contact a doctor if you have severe or persistent symptoms, but by knowing the basics of digestion and using the right tool, you could get to the bottom of your digestive discomfort and restore health to your gut. 

Read more: Why IBS and poop are suddenly trendy

Digestion basics

Your digestive system includes your gastrointestinal tract -- your mouth, esophagus, stomach, small intestine, large intestine and anus -- along with your liver, pancreas and gallbladder. This intricate organ system is responsible for helping your body adequately absorb nutrients from the food you eat, break food down into energy-available molecules and get rid of waste.

A bunch of things need to go right for your digestive system to operate optimally: You need healthy colonies of gut bacteria , proper amounts of digestive enzymes and timely secretions of digestive hormones, among other things.

If one tiny component goes wonky, you may experience a range of symptoms, including gas, bloating, cramping, constipation, diarrhea or acid reflux. If things are really off, you might experience nondigestive issues , such as brain fog, fatigue, mood swings, poor sleep or skin breakouts. 

What causes digestive issues?

Most of the time, no one thing triggers gastrointestinal problems, and often, GI symptoms aren't spontaneous. Many people develop digestive issues slowly, when a combination of factors worsens over time. Any of these seven elements could be affecting your digestion:

Diet: Obviously, what you eat impacts your entire GI tract. If you're allergic to or sensitive to certain foods, your body may revolt in the form of upset digestion. 

Hydration: Nothing works well when you're dehydrated. Water acts as a lubricant for all organ systems and helps your body maintain homeostasis . 

Sleep: Lack of sleep affects every part of your body, including your digestive system -- and all the hormones that dictate its functions. Studies show that short sleep duration alters the levels of important digestive hormones and that poor sleep harms the healthy bacteria in your microbiome .

Stress: You may not intuitively equate stress with an upset stomach, but research tells us that millions of neurons in your gut communicate with the billions of neurons in your brain along something called the gut-brain axis . When you're stressed, you also produce excess cortisol, which can trigger a handful of digestive reactions .

Microbiome dysfunction: Your gut contains two kinds of bacteria: friendly and unfriendly. If the bad bugs outweigh the good ones , your risk for all kinds of digestive issues increases. 

Inflammation: Inflammation is a leading cause of disease worldwide, and that also applies to digestive diseases. If your GI tract is chronically inflamed, it may lead to inflammatory bowel disease , ulcerative colitis , diverticular disease  or other conditions. 

Hormonal imbalances:  Consider your hormones the chemical messengers in your body. They tell your organs what to do and when to do it. If you have too much or not enough of any hormone that affects your digestion, such as gastrin or peptide YY , symptoms may appear.

View this post on Instagram Wise words brought to you by the microbiome. 🧠 ​. ​The gut affects mood, digestion, immunity, weight, etc. - that's why we want EVERYONE to understand how important gut health is! ​. ​What do you do to keep your gut in check? ​. ​#biohm #gut #lasvegas #gutstuff #guthealth #microbiome #biohmgut #biohmhealth #probiotics #health #wellness A post shared by BIOHM Health (@biohmhealth) on Aug 14, 2019 at 7:00am PDT

Tools to help decipher digestive symptoms

If you feel overwhelmed about digestion, GI disorders and understanding symptoms, know that there are a handful of products, apps and services available to make it all a bit easier. Here are five great ways to take control over your digestion.

Aire by FoodMarble

This pocket-size breath test identifies food intolerances in real time by analyzing the amount of hydrogen in your breath. Excess hydrogen in your breath may indicate excess fermentation in your large intestine, which can signal food intolerances. 

How that works: When you eat food, it travels to your small intestine where most of it is absorbed. What's left unabsorbed travels to the large intestine, where it begins to ferment. Too much undigested food can cause high levels of fermentation, which can lead to digestive discomfort. 

The Aire supposedly works especially well for four of the FODMAPs , a certain type of carbohydrate that many people can't digest properly. For an additional $30 (on top of the device's $160), you can purchase packets of powdered lactose, fructose, inulin and sorbitol to find out if you're sensitive to one of those FODMAPs. 

This tiny breath-testing device measures the hydrogen in your breath after you eat. Excess hydrogen can be an indicator that your body isn't fully digesting your food. 

Nima makes devices that look similar to the Aire, but they test food itself instead of your reaction to food. The company currently offers a peanut sensor and a gluten sensor , so Nima might work for you if you already know you have a food intolerance or allergy. 

The sensors use antibody-based chemistry to detect traces of gluten protein down to 20 parts per million and peanut protein down to 10 parts per million. Both sensors have been clinically studied and are recognized by the National Institutes of Health, so I'd trust them if I had a gluten or peanut allergy. 

Oh, and a big bonus: Nima sensors are FSA/HSA reimbursable . 

At-home food sensitivity tests

Most people have a sensitivity to one food or another, regardless of whether or not it's considered nutritious. Sometimes the severity of a food sensitivity depends on quantity. For example, I personally don't react well to large portions of dairy, but do just fine with half-and-half in my coffee. There are a few tests on the market that can give you an idea of what foods trigger unpleasant symptoms for you. 

EverlyWell , Test My Allergy , Persona Labs and  What's My Food Intolerance are some examples of at-home test manufacturers. LetsGetChecked , an at-home medical testing company, offers a celiac test . 

Don't confuse food sensitivities (sometimes called food intolerances) with food allergies. Food sensitivities take place in the digestive system when some factor results in your body failing to break down a food, such as lack of a certain digestive enzyme. 

Food allergies, on the other hand, involve the immune system. Food allergies occur when your body recognizes a food as an invader and sends antibodies to attack it, which often results in symptoms like hives and swelling. In severe cases, food allergies can cause life-threatening reactions. 

If an at-home test claims to report back true food allergies, it may be false advertising, as there's no scientific consensus that supports these methods. Always talk to a doctor if you think you have a food allergy. 

EverlyWell and other companies offer food sensitivity tests, but be wary if they claim to identify true food allergies.

Food journals

Perhaps not the easiest option, but definitely the most accessible, food journaling is a tried-and-true way to understand your body. It takes time and effort to log everything you eat, but if you really want to get to the bottom of your symptoms, food journaling is worth it. 

You can opt for a pen-and-paper food journal, or you can download an app. For the best results, make sure to log how you feel before, during, immediately after and a couple hours after a meal or snack.

Digestion-tracking apps

Unlike food journals or food-logging apps, digestion-tracking apps help you log components other than food and reactions to food. For instance, the app Cara allows you to track your food intake , digestive symptoms, mood, stress, stool conditions, menstrual cycle, sleep, workouts and medications to give you an incredible comprehensive look at the way your body reacts to different situations. 

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives. 

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How to Stop Anxiety Stomach Pain & Cramps

Home > Manhattan Gastroenterology Blog > How to Stop Anxiety Stomach Pain & Cramps

Stomach pain usually results from something you ate or stomach flu. Still, if you do not have any symptoms associated with these conditions and continue to experience stomach pain, it could be an outcome of anxiety. A great deal of stress can lead to tension that can tire out the abdominal muscles and cause a feeling of discomfort. If you are going through a stressful time in your personal or work life and believe your persistently recurring stomach pain results from anxiety, seek medical attention before it turns serious. The experienced and board-certified gastroenterologists at Manhattan Gastroenterology determine what may be causing your anxiety stomach pain and how to stop it. The top-rated gastric doctors work closely with you to find out what triggers anxiety-related stomach pain and come up with the best solutions to help you live a better quality of life, free of anxiety, stress, and pain.

Can Anxiety and Stress Cause Stomach Pain?

Anxiety is a complex disorder. It can have a profound and lasting effect on your body. It can put unnecessary stress on the body that can lead to several issues in the long run if you fail to control anxiety or address its triggers. One of the most commonly experienced problems resulting from anxiety is stomach pain.

Stomach cramping, pain, and intestinal discomfort that are hard to explain are the most frequently experienced symptoms of persistent anxiety.

Some stress-related symptoms and conditions include:

• Indigestion
• Stomach cramps
• Constipation
• Loss of appetite
• Unnatural hunger
• Irritable bowel syndrome (IBS)
• Peptic ulcers

Stress and anxiety are significant contributors to various health conditions, mainly stomach issues. A gastroenterologist can determine if your stomach pain or GI symptoms are related to stress or other medical conditions that require different treatment.

Diagnosing Anxiety-Related Stomach Pain

It often becomes challenging for healthcare professionals to diagnose stomach pain or anxiety-related discomfort. It is because cramps and indigestion are physical responses. The same type of responses from your body would occur if you suffered from some physical or organic health issue.

If your stomach pain is severe or accompanied by fever or other symptoms, you should visit a doctor as it may be a sign of some medical disorder. Anxiety can cause stomach pain in a way that can result in indigestion and other problems.

Anxiety-Related Stomach Issues – How They Can Result in Pain

Anxiety can cause several problems that can lead to pain or discomfort in the abdomen.

Anxiety can result in the following types of stomach pain:

• Abdominal tension – Stress can cause great tension in the abdominal region. This tension can tire out abdominal muscles and lead to a recurring feeling of discomfort.
• Indigestion – Stress and anxiety can affect hormone levels, and hormones play a crucial role in digestion. If you are stressed out, it can result in abdominal imbalance that results in indigestion and accompanying symptoms such as bloating, intestinal pain, and others.
• Irritable Bowel Syndrome – Anxiety is one of the most likely causes of irritable bowel syndrome, popularly known as IBS. The body’s digestive system functions poorly without any definite underlying cause. The disturbed digestive system function can result in altered bowel movement and abdominal uneasiness.

Research shows that anxiety releases a stress hormone called cortisol, which causes the body to produce excess stomach acid. This acid can irritate the esophagus lining and lead to stomach pain, nausea and vomiting, and in severe cases, ulcers triggered by stress. These are some ways anxiety can cause pain and strange stomach sensations that affect your overall wellbeing.

Can Stress Cause Stomach Pain?

Even though they are technically different conditions, stress and anxiety are closely related. You may experience a significant amount of stress without experiencing anxiety. However, the causes of stomach pain which results from tension are the same as the feelings you experience when you go through anxiety.

Muscle tension and digestive issues are some of the problems that result from stressful conditions and lead to stomach pain.

Tips for Reducing Stress and Anxiety

Stress and anxiety are a normal part of life, and sometimes it is impossible to avoid them. The good news is there are tips for managing stress to reduce its impact on your digestive and overall health.

Top tips for reducing stress and anxiety include:

• Take short breaks and take deep breaths. When taken the right way and with focus, it can help. After every few hours, stop what you are doing and do one minute of slow, deep breathing, and you will see how it calms you down. Breathe slowly, silently through the nose, and push your stomach out when you inhale and let it deflate as you exhale.
• Learn to say no. Trying to do everything and pleasing everyone all the time is a recipe for stress and long-term mental suffering. Understand yourself and only do what you can easily with a peaceful mind and avoid doing what you cannot do.
• Exercise and yoga are great ways to reduce stress and feel better, even if they are done only for a few minutes each day. When you exercise, the body releases chemicals called endorphins that interact with receptors in your brain and trigger a positive feeling in your body.
• Instead of worrying over things you cannot control or seem to cope with, focus on ways that help you respond to problems. Your reaction is your choice, including how you deal with the stomach pain and control the anxiety. Stressing over your condition or thinking about stomach pain all the time will aggravate it further.
• Seek professional help if you cannot handle the stress on your own. Consulting an experienced therapist, particularly someone specializing in anxiety, will help you control behaviors and relax your mind and body.

Understanding what you are going through and finding the best solutions that work for you can reduce anxiety and related tummy troubles to a great extent.

How Do You Know It Is Anxiety and Not an Ulcer Causing the Pain?

If you suffer from stomach pain frequently without apparent reasons, it may be ulcers causing the distressing symptoms. For some people, instead of anxiety, it is ulcers that result in pain and an upset stomach after eating.

Only a qualified and trained doctor can diagnose if your pain is coming from an ulcer as some clues point towards it. The clearest signal is the presence of blood in your stool or acid burps if you also suffer from acid reflux. Also, if the pain or discomfort usually occurs after eating and is unrelated to a similar condition such as heartburn or acid reflux, it may be something other than anxiety. These symptoms indicate an ulcer.

Sometimes things become more complicated as ulcers are stimulated by long-term stress and anxiety that lead to the overproduction of stomach acid. The harsh stomach acid can break down the gastric or intestinal lining and cause open wounds that may affect your overall health and wellbeing.

Stomach Pain and Long-Term Health

Stomach pain is unsuitable for long-term health, whether it results from anxiety or ulcers. Due to the extra acid in the stomach and the changes it brings in the way the body processes nutrients, stomach pain can be a big problem if you do not seek timely treatment.

Ulcers are just one of the many problems that can cause stomach pain. Many people experience heartburn from anxiety and eat less often, and because of this, their bodies do not get the required nutrients. Stomach pain that results from anxiety or stress occasionally is not dangerous. But, if it persists, it is necessary to treat it as it can affect your overall health in the long run. It becomes hard to manage if left untreated for a long time, leading to further complications.

When Is Stomach Pain Most Likely to Occur?

Stomach pain can occur any time if you suffer from anxiety, even when there is no such thing. However, many people experience the pain during panic attacks.

Health experts were unable to find the exact link between an anxiety attack and stomach pain, other than the fact that during a panic attack, the body is under extreme stress, and the hormones are on overdrive. Also, people with anxiety attacks are more vulnerable to hyperventilation, which leads to symptoms close to abdominal muscle tension and stomach pain.

How to Stop Anxiety Stomach Pain?

Anxiety-related stomach pain usually does not result from something you ate or poor lifestyle choices, even though these factors may increase the risk of anxiety in many circumstances. There are no specific dietary changes that can stop anxiety-induced stomach issues.

It is essential to understand that people with panic attacks are more prone to experiencing severe stomach discomfort even when they do not suffer from anxiety. Simply put, it is possible to have stomach pain even without a panic attack. Also, people with anxiety attacks and severe stress could be suffering from over-sensitization. It means they are more likely to notice and feel smaller, even regular changes in the body that can trigger anxiety attacks.

If your diet contains foods that cause gas, bloating, stomach discomfort, or mild indigestion, it is best to avoid them, as even slight discomfort can worsen the feelings and may trigger a panic attack. Eating healthy is very important for people who experience stomach pain with anxiety.

Your diet should consist of:

• Water and fresh juices
• Whole-grain carbohydrates

If you suffer from stress-related hyperacidity, you must increase your intake of dairy products and non-spicy foods to soothe your stomach. Over-the-counter antacids can also help keep your acidity and other symptoms down in severe cases. It would be best if you avoided overeating or eating till you are too full, as the nervous system may interpret the feeling of fullness as pain, and it could trigger a panic attack and further pain.

Other Symptoms Associated with Anxiety Stomach Pain

What makes anxiety-related stomach pain so complicated is that it can change sensations in the body. While for many, feeling full is nothing wrong, for others, it can cause many other symptoms, including:

• Feeling of lightheadedness
• Stomach discomfort

For people without anxiety, these symptoms are natural, but for those suffering from anxiety, these sensations can be severe and trigger a full-blown panic attack.

How to Relieve Stomach Pain

There is no cure for anxiety stomach pain symptoms. You can only relieve pain by taking care of the problem that is causing the discomforting sensations. When the body is under stress, the stomach hurts due to excessive production of stomach acid or the inability to digest the food you consumed. If you have stomach pain associated with anxiety, waiting for the attack to pass can relieve the symptoms.

Sipping cool water can help in this condition. Antacids may also relieve stomach pain, but if you experience stomach pain frequently, consult a healthcare provider who will take a detailed look at the causes of stomach pain and recommend the best course for treatment.

If your stomach pain is from recurring panic or anxiety attacks, the doctor may suggest counseling or therapies to relieve stress and its resulting symptoms. For some people, diagnosing the source of anxiety and learning ways to control it can eliminate the painful symptoms.

Do not let anxiety-related stomach pain affect your home and work life and keep you from activities and foods you love. Consult the top gastro doctors at Manhattan Gastroenterology to learn what could be triggering your anxiety and how it leads to stomach discomfort. The gastrointestinal specialists focus on your medical history and ask about your symptoms, their frequency, and the level of pain you experience to develop the best treatment plans to help you feel better. They recommend therapies to alleviate your stress, lifestyle changes, and medications to relieve the painful anxiety symptoms and ensure you are on the road to a speedy recovery.

Our site is the source of information about the gastroenterology related conditions and procedures. This information is intended for patients looking to learn about our gastroenterology practice in New York (Midtown, Financial District, and Upper East Side Gastroenterology) and make an appointment to see one of our physicians. This information is only intended to provide guidance, not definitive medical advice. Please consult a doctor or GI specialist about your specific condition. Only a trained physician can determine an accurate diagnosis and proper treatment. Terms and conditions are subject to change.

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Gastrointestinal Symptoms to Never Ignore

Stomach cramps, swollen belly, bloody vomit, belly button pain, bloody stool or urine, pain in the upper stomach, lower right abdominal pain, constantly feeling full, black stool, sudden pulsing pain, strong hunger pangs, constant diarrhea.

Gastrointestinal (GI) symptoms affect most people from time to time. The gastrointestinal tract is the body’s digestive system . Common GI symptoms include bloating, indigestion , and heartburn . Other symptoms that may indicate a health problem may include sudden abdominal pain, constant diarrhea, and bloody stool.

This article discusses serious GI symptoms that should never be ignored, their possible causes, and what to do about them. 

Kate Wieser / Getty Images

Stomach cramps are a common GI symptom that often feels like a dull, aching pain. The discomfort may be constant or come and go. Common causes of stomach cramps include constipation , gas, diarrhea, a virus, hormonal medication, a menstrual period , pregnancy, and ovulation.

Serious causes of stomach cramps may include:

• Irritable bowel syndrome (IBS) : a condition that causes diarrhea, constipation, and cramping
• Gallstones : hard deposits that block the bile ducts and may cause cramping and pain  
• Inflammatory bowel disease : Crohn’s disease and ulcerative colitis cause chronic inflammation in the GI tract, stomach cramping, and pain  
• Kidney stones : hard deposits that may become lodged in the urinary tract or ureter
• Diverticulitis : occurs when small sacs or pouches in the colon become inflamed and cause pain and cramping
• Appendicitis : an inflammation of the appendix that causes significant abdominal pain and cramping  
• Pancreatitis : an inflammation of the pancreas that causes abdominal pain, cramping, and vomiting
• Endometriosis : when endometrial tissue grows outside the uterus and causes significant pain and cramping during the menstrual cycle

If you notice a swollen belly, it is likely due to bloating. Common causes of bloating are gas, indigestion, premenstrual syndrome (PMS) , IBS, or lactose intolerance , which causes bloating, gas, and diarrhea after ingesting lactose (dairy products).

Serious causes of a swollen belly include:

• Ascites : a buildup of fluid in the abdomen caused by chronic liver disease
• Pancreatitis
• Ovarian cyst : a fluid-filled sac on or in the ovary that causes abdominal pain and swelling

Bloody vomit indicates bleeding somewhere in your digestive tract. Never ignore bloody vomit because the cause of the bleeding requires treatment. Possible causes of bloody vomit include:

• Bleeding ulcer : a sore on the lining of the stomach or small intestine that may bleed and cause vomiting  
• Chronic pancreatitis: may lead to bleeding in the upper part of the GI tract
• Tumor: a tumor in the GI tract may irritate the tissues and cause bleeding
• Traumatic injury: an injury to the abdominal area that may lead to internal bleeding (see a healthcare provider immediately if this happens)
• Esophageal varices : swollen veins in cirrhotic patients

Pain around your belly button usually indicates a mild condition like indigestion or constipation. Serious causes of belly button pain may include:

• Abdominal wall hernia : occurs when part of an organ protrudes (sticks through) an area of muscle, leading to pain around the belly button
• Crohn’s disease : causes inflammation and pain around the belly button
• Appendicitis
• Bowel obstruction : occurs when the intestine is blocked and stool cannot pass through
• Bowel perforation : a hole that develops in the stomach or colon

Blood in the stool or urine means you are bleeding somewhere in your lower GI or urinary tract. A small amount of bright red blood with straining may indicate hemorrhoids . Serious causes of bloody stool may include:

• Anal fissure : a small tear in the lining of the rectum that causes drops of red blood when you wipe after using the bathroom  
• Diverticulitis: a condition that can lead to diverticular bleeding
• Infectious colitis: an infection in the colon that causes inflammation and bleeding
• Colon polyps : growths on the lining of the colon and rectum that may become irritated and start bleeding
• Colorectal cancer : cancer of the colon or rectum in which cancerous growths may cause bleeding

A small amount of blood in the urine after a procedure on the bladder or urinary tract is common. For example, you may experience a small amount of bleeding after having a catheter. People who menstruate may notice blood in their urine caused by their menstrual period. Serious causes of bloody urine may include:

• Urinary tract infection (UTI) : a bacterial infection of the urethra that may cause irritation and bleeding
• Kidney stones
• Sexually transmitted infections (STI): Blood in the urine is a possible sign of chlamydia or gonorrhea
• Bladder or kidney cancer: the cancerous growth may cause irritation and bleeding
• Sickle cell disease : an inherited red blood cell disorder that causes pain and bleeding

Pain in the upper area of your stomach may indicate indigestion or heartburn. Sudden upper abdominal pain may indicate a problem with the organs located in that area. The stomach, pancreas , spleen, liver, gallbladder, and bile duct s are in the upper abdomen. Serious causes of upper stomach pain may include:

• Stomach ulcer : may cause pain in the upper stomach
• Splenomegaly : an enlarged spleen may cause upper abdominal pain
• Cholecystitis : an inflammation of the gallbladder that often causes nausea and upper abdominal pain
• Hepatitis : Inflammation of the liver is usually caused by an infection; one sign of hepatitis is upper abdominal pain
• Cancer: cancer of the stomach, pancreas, liver, gallbladder, or bile ducts may cause pain

Pain in the lower abdominal area may indicate constipation, diarrhea, or menstrual cramps. If you notice pain localized in the right side of the lower abdomen, it may be your appendix . Lower right quadrant pain could mean inflammation in your appendix (appendicitis). Rarely, it could indicate appendix cancer.  

Feeling full without eating or after eating only a small amount is not normal. Temporary causes of feeling very full could be eating habits, indigestion, or constipation. More serious causes of constantly feeling full may include:

• Gastroesophageal reflux disease (GERD) : occurs when contents from the stomach come back up the esophagus; this can cause you to feel full
• Gastroparesis : a disorder that causes the stomach to empty slowly
• Gastritis : an inflammation of the stomach lining that may cause you to feel full

Black stool usually means that there is bleeding in the digestive tract. Certain foods and supplements, such as blueberries or iron supplements , can make stool appear darker. Black stool could mean esophagus, stomach, or small intestine bleeding. It may also mean that you have a bleeding ulcer.  

It is possible to feel a pulsing sensation in the abdomen because of a large blood vessel called the abdominal aorta. You may feel the abdominal aorta pulse when there is more blood flow due to pregnancy, eating, or positioning (lying down). An abdominal aortic aneurysm could cause sudden pulsing pain in the abdomen.  

It is normal to feel hunger pangs when you have gone a long time without eating. Hunger is your body’s way of communicating that it is time to eat. Common causes of hunger pangs include hunger, dehydration , and constipation. Serious causes of intense hunger pangs may include:

• Peptic ulcer
• Anxiety : causes physical symptoms, including stomach discomfort and intestinal spasms that may feel like hunger pangs
• Medications: including antidepressants , antipsychotics, diabetes medications, steroids, and anticonvulsants ( seizure medications), which can cause hunger and weight gain

Most people experience diarrhea or loose stools from time to time. If you have been experiencing constant or chronic diarrhea , see a healthcare provider. The types of diarrhea that may indicate a health problem include:

• Watery: may be caused by an infection, food poisoning, or IBS
• Fatty: usually means that your body has a problem breaking down fats in the diet; causes may include celiac disease , small intestinal bacterial overgrowth (SIBO) , or gastric bypass surgery
• Inflammatory: occurs when the colon is inflamed from infection, IBD, diverticulitis, or cancer 
• Bloody: indicates inflammation or colon cancer

A Word From Verywell

Serious symptoms that warrant evaluation by a healthcare provider include vomiting blood, rectal bleeding, severe abdominal pain after a surgical or endoscopic procedure, or a painful, tense abdomen after a surgical procedure.

Gastrointestinal symptoms are common and often include heartburn, indigestion, bloating, and cramping. Other GI symptoms are more serious and may indicate a health problem. If you ever experience bleeding with vomiting, urinating, or releasing stool, see a healthcare provider. Seek medical attention if you notice sudden abdominal pain that does not improve.

National Institute of Diabetes and Digestive and Kidney Diseases. Irritable bowel syndrome (IBS) .

National Institute of Diabetes and Digestive and Kidney Diseases. Definition & facts for gallstones .

Centers for Disease Control and Prevention. What is inflammatory bowel disease (IBD)?

National Kidney Foundation. Kidney stones .

MedlinePlus. Diverticulosis | Diverticulitis .

National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms & causes of appendicitis .

MedlinePlus. Pancreatitis .

World Health Organization. Endometriosis . 

National Institute of Diabetes and Digestive and Kidney Diseases. Lactose intolerance .

American Liver Foundation. Ascites .

Office on Women’s Health. Ovarian cysts .

National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms & causes of peptic ulcers (stomach or duodenal ulcers) .

American Cancer Society. Signs and symptoms of gastrointestinal stromal tumors .

Mount Sinai. Bleeding esophageal varices .

Pandya B, Huda T, Gupta D, et al. Abdominal wall hernias: an epidemiological profile and surgical experience from a rural medical college in Central India . Surg J (N Y) . 2021;7(1):e41-e46. doi:10.1055/s-0040-1722744

MedlinePlus. Intestinal obstruction .

Mount Sinai. Gastrointestinal perforation .

Johns Hopkins Medicine. Hemorrhoids .

MedlinePlus. Anal fissure .

NewYork-Presbyterian.  Colitis .

National Institute of Diabetes and Digestive and Kidney Diseases. Colon polyps .

Centers for Disease Control and Prevention. What is colorectal cancer?

Bladder & Bowel Community. Catheter problems .

Centers for Disease Control and Prevention. Urinary tract infection .

Centers for Disease Control and Prevention. Chlamydia — CDC detailed fact sheet .

National Cancer Institute. What is bladder cancer?

Centers for Disease Control and Prevention. What is sickle cell disease?

Aldulaimi S, Mendez AM. Splenomegaly: diagnosis and management in adults . Am Fam Physician . 2021;104(3):271-276.

MedlinePlus. Acute cholecystitis .

Centers for Disease Control and Prevention. What is viral hepatitis?

National Institute of Diabetes and Digestive and Kidney Diseases. Acid reflux (GER & GERD) in adults .

National Institute of Diabetes and Digestive and Kidney Diseases. Gastroparesis .

National Institute of Diabetes and Digestive and Kidney Diseases. Gastritis & gastropathy .

MedlinePlus. Black or tarry stools .

MedlinePlus. Abdominal aortic aneurysm .

National Institute of Mental Health. Anxiety disorders .

Obesity Medicine Association. Medications that may increase weight .

National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms & causes of diarrhea .

By Carrie Madormo, RN, MPH Madormo is a health writer with over a decade of experience as a registered nurse. She has worked in pediatrics, oncology, chronic pain, and public health.

Watch CBS News

What caused the Dali to slam into Baltimore's Francis Scott Key Bridge? What we know about what led up to the collapse

By Kerry Breen

Updated on: March 27, 2024 / 7:43 PM EDT / CBS News

Shocking video showed the moment a massive cargo ship collided with Baltimore's Francis Scott Key Bridge early Tuesday morning, sending parts of the decades-old suspension bridge, along with people and vehicles, into the Patapsco River. 

Six people who were on the bridge are missing and presumed dead , officials said late Tuesday. Two others were rescued from the water. All eight were construction workers who were repairing potholes on the bridge, officials said. There were 22 Indian nationals, including two pilots, aboard the cargo ship. 

Investigators and officials are now crafting a timeline of events, including what caused the Singapore-owned vessel , called the Dali, to hit the bridge just minutes after leaving port . Here's what we know so far. 

What caused the Dali to slam into the Francis Scott Key Bridge? 

The Dali, which was chartered by shipping giant Maersk and operated by Synergy Marine Group, hit the Francis Scott Key Bridge shortly after leaving the Port of Baltimore. 

An unclassified memo issued by CISA, the Cybersecurity and Infrastructure Security Agency, said the ship reported losing propulsion . Maryland Gov. Wes Moore said the ship's crew reported a "power issue." A spokesperson for the National Transportation Safety Board, which is investigating the crash, said the agency still needs to verify that the Dali lost power before striking the bridge column. 

Two U.S. officials told CBS News multiple alarms rang out on the ship, alerting pilots and crew to an issue on board. The crew ran several system tests to attempt to remedy the loss of propulsion from the motor, but the tests proved unsuccessful. At that point, the ship's pilots alerted the Maryland Department of Transportation and the Maryland Transit Authority. 

That alert allowed local officials to stop traffic on the bridge and likely saved lives , officials said. 

The ship's crew tried to deploy the anchor, though it remains unclear how much progress was made, multiple officials said. The massive ship is over 900 feet long and was moving at about 8 knots, or just over 9 miles per hour. Authorities said that speed is considered "very rapid." 

Captain Michael Burns, executive director of the Massachusetts Maritime Academy's Maritime Center for Responsible Energy, told CBS Boston  that stopping a cargo ship is difficult, especially in such a short time. 

"It's extremely challenging, and takes years of experience and training in order to be able to do this safely," he said. "It can take up to a mile for some of these ships to get stopped, depending on the circumstances, so we really need to think well out, miles ahead of the ship."

Why did the Dali lose propulsion? 

It's not clear what caused the vessel to lose propulsion, officials said. 

A spokesperson for the NTSB told CBS Baltimore that it had collected the ship's data recorder, and would review and analyze the material there to determine what happened aboard the vessel in the moments before the collision. 

That data recorder will also be used to establish a timeline of events. 

What happens when a ship loses propulsion? 

James Mercante, the president of the New York Board of Pilot Commissioners, told CBS News that a ship that has lost steering and power is essentially "a dead ship just being carried by the current or its own momentum." 

He highlighted a moment in the video of the crash that appears to show a "big, big puff of black, real dark black smoke" which might indicate that the vessel's power was "restored at the last minute" and that the pilot was "attempting to make an emergency maneuver" to avoid hitting the bridge. However, he emphasized that it would be difficult to stop the massive cargo ship, especially in such a short time. 

"It would take quite a while — probably the length of five [or] six football fields — to bring that ship to a stop, even after dropping the anchors, because of its power and momentum," said Mercante. "This is a behemoth." 

• Francis Scott Key Bridge
• Bridge Collapse

Kerry Breen is a reporter and news editor at CBSNews.com. A graduate of New York University's Arthur L. Carter School of Journalism, she previously worked at NBC News' TODAY Digital. She covers current events, breaking news and issues including substance use.

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