by Ken Goodman, LCSW

Ever wonder why you get “butterflies” in your stomach before doing something stressful? Or why you feel like your stomach is “tied in knots” after an argument? Ever had a meeting with a toilet that went longer than expected and it wasn’t caused by anything you ate?  Stomach problems are one of the most common symptoms of stress and anxiety.

Researchers have identified a powerful connection between the gut and the brain. Like the brain, the gut is full of nerves. It contains the largest area of nerves outside the brain with the digestive tract and the brain sharing many of the same nerve connections.

Whether it’s a single nerve-wracking event or chronic worry and stress over time, stress can exact a physical toll on your digestive system.  When you are anxious, some of the hormones and chemicals released by your body enter your digestive tract, where they interfere with digestion. They have a negative effect on your gut flora (microorganisms that live in the digestive tract and aid digestion) and decrease antibody production. The resulting chemical imbalance can cause a number of gastrointestinal conditions.

Common stress-related gut symptoms and conditions include: 

  • indigestion 
  • stomach cramps 
  • diarrhea
  • constipation
  • loss of appetite 
  • unnatural hunger 
  • nausea
  • Irritable Bowel Syndrome (IBS) 
  • and peptic ulcers

Once you suffer with one of these conditions, the condition itself can become a source of anxiety and greatly impact your quality of life. I have had many patients who experience diarrhea for example, who develop a fear having accidents in their pants which makes them afraid to leave their home or go certain places.  If you experience stomach cramps or indigestion, you might become fearful of these symptoms causing you to limit where and what you eat which could impact your social life.

Six Tips for Reducing Stress and Anxiety

  1. Although stress is a normal part of life and impossible to avoid, there is good news. You can manage your stress so that it reduces its impact on your stomach. Here are six tips that can help you reduce stress AND the related tummy troubles.
  2. Take short breaks and breathe. When done right this can really help. Every couple of hours, stop what you’re doing and do one minute of slow, quiet deep breathing.  You’ll be amazed at the results.  Your breathing should be very slow, silent, and through your nose. Push your stomach out when you inhale and let it deflate as you exhale.
  3. Just say “no.” Trying to do everything and please everybody all the time is a surefire recipe for stress. Know your limits and when you’re close to reaching them, don’t accept additional responsibilities.
  4. Exercise or do yoga. Physical activity is a great way to reduce stress, even if it’s only for fifteen minutes a day. When you exercise your body releases chemicals called endorphins which interact with receptors in your brain and trigger a positive feeling in your body.
  5. Instead of stressing over things you can’t control focus on the things you can control, such as how you choose to react to problems. Your reaction is your choice, including how you react to your stomach issues. Accepting stomach problems will reduce your anxiety and curb your symptoms. Worrying about your stomach, only makes your symptoms worse.
  6. Listen to a guided relaxation exercise daily. You’ll not only feel relaxed while doing it, but most people also experience a sense of calm that lasts for hours afterwards. 

Seek the help of a therapist who specializes in anxiety. It’s often too difficult to deal with chronic worry and complicated anxiety on your own. A skilled Cognitive Behavioral Therapist will know what to do. You can find a therapist at  

It takes effort to reduce stress and its impact on the stomach. These suggestions can work if you implement them correctly and if you make them a daily priority. However, expecting immediate results and 100% absence of symptoms will only increase your frustration and symptoms.  Acceptance of some degree of stomach discomfort is important. 

Finally, take a look at your diet. Certain foods are known to irritate the stomach. Consult a doctor and try the recommended medical treatments. Many stomach disorders cannot be resolved with stress reduction alone. You must address the biological, psychological and social aspects when trying to resolve gut related problems.

ADAA_Ken-Goodman-websize-1.jpgAbout the author:

Ken Goodman, LCSW, treats anxiety and OCD in Los Angeles.  He is the author of The Anxiety Solution Series: Your Guide to Overcoming Panic, Worry, Compulsions and Fear, A Step-by-Step Self-help Audio Program., and Break Free from Anxiety, a coloring, self-help book for anxiety sufferers. Ken Goodman is an ADAA board member and Clinical Fellow. Visit his website.


Read Ken Goodman's other ADAA Blog Posts:

Ken Goodman also hosts an ADAA webinar on "Overcoming the Fear of Vomiting." Watch the video on ADAA's YouTube channel.

I have had like weird butterfly sensations after i’ve eaten with like a dull ache can’t explain it has anybody had this it makes my stomach feel strange.

I've had a bad anxiety attack and now since last night I'm waking up with nervous stomach uncontrollable, it feels like I'm hungry and nervous together, it's really weird I can't stop it doing it,

I am just the same, I had a breakdown in January and still suffer with bad anxiety I can’t keep off the toilet in the mornings and it’s down to my uncomfortable stomach which wakes me up early hour of the night then I can’t get back to sleep. I now struggle to go shopping and no appetite. I worry about everything and can’t help it. I go to bed and ask god to please help me. It’s ruining my life. I have tried different antidepressants and still not found one that stops my shaking and stomach Anxiety. You feel so alone with every day the same. I am glad it’s not just me but it still doesn’t help as you feel so alone with stress and anxiety plus stomach aches every day. I just don’t know how to stop all this.

I get butterflies every morning ,I shake my legs go like jelly I feel naeuseous and cant sit still I keep googling symptoms tried antidepressants but they dont seem to do anything

For the last six months or so I’ve had a weird on off stomach gripping and fluttering bloating, with some wind. I’ve tried buscopan but not really sure what it is. Seems like it comes on worsening as the day goes on. Not pain but discomfort

I get exactly the same as you and it’s been going on 7 or 8 months now. Bloated, then fluttering can also get wind and a tugging sometimes. Very strange. Had blood tests all ok. No further than that tho. Stools seem to be different at times. I’m sure it’s ibs. Tho I’m a massive health worrier which doesn’t help

I have something very similar to you and I feel for everyone suffering with what I can only describe as very debilitating mentally. There is no doubt about it that if all the tests come back negative then the cause is stress brought about by thoughts going round in circles on how to resolve something and just not being able to. How we remove whatever is causing our distress is not easy. I have believed for weeks I have some intestinal disorder brought about by the food I ate. I still have that belief. I am going for a scan when the letter arrives - it can't come soon enough for me. I make loads of lists when something upsets me. They say it helps to write things down. I don't have a fear of getting the virus - it's not about that, but I am sure it exacerbates my existing problem. it is about what is causing my stress. I do know what it is but how to a) live with the problem that is causing it I find impossible to answer. If I can change the way I think I know I can get somewhere to getting relief. Only then, I will be free of the physical issues that greet me every morning afternoon and evening. It is said that crying helps the body to heal. Some of us find it difficult to cry, I know I do. Some of us look upon it as a weakness but it is the body's natural way of releasing oxytocin and endogenous opioids, otherwise known as endorphins. These feel-good chemicals can help ease both physical and emotional pain. Sorry for going on so long, I hope this has helped...and it helped me to write it down.

I’ve had pain on right side of my stomach for over 3 years now. It feels like the right side of my stomach is contracted and like the muscles on the right side can’t relax. If also feels like there is a blockage preventing either air or blood from circulating in the right side. I’m the mornings I often twist my body to try to relax my right side and to increase airflow or blood flow. Doing this usually results in a lot if flatulence or noises in my stomach. I’m not sure if the pain in my side is a result of stress, dietary or some disorder. Over the past three years I’ve been to countless doctors appointments including, primary care, Gastrointestinerologist, urologist, neurology. I’ve had cats scans, ultra sounds, MRIs, Hidascan, and colonoscopy and still none of the doctors, tests or procedures were able to diagnose or fix the problem. I’ve made short lived attempts to change my diet and lifestyle habbits, but doing so hasn’t really helped because I’m not sure what the problem is. Not knowing what the problem is had prevented me from being able to seriously pursue any direction towards curing the problem because I’ve found that extreme dieting or changes to lifestyle may be actually bringing additional stress and undermining my efforts to Solve the stomach pain problem or maybe even making it worse. After 3 years I’ve surrendered to living with daily pain and discomfort. But I am still taking steps to reduce stress, exercise and eat healthier. I pray God will cure me and also everyone else on this forum who is experiencing pain. Good luck everyone.

Have you try to stop eating everything that comes from flour (breads, pasta, pizza, cookies and etc). Also casein (milk protein) causes lots of problems in our guts). So, all dairies products are bad for our gut lining. All GMO foods like wheat, corn and peanuts and the casein from the milk are the silent destroyers of our gut. Overtime they will damage the intestines walls and compromise the production and the absorption of nutrients. People don’t that the highest percentage of serotonin is made in the guts. This happy chemical is what give us the feeling of well being and modulates our mood. The lack of this neurotransmitter in our body is known to live us with an anxious and depressed mood. A health diet without GMO foods and dairies is the right path to keep our guts and us healthy and happy. The available meds are just temporary bandaids. The Problem and the cure are the food we choose to eat. Try to cut those culprits from your daily eating habits for a month and will see the change. Good luck for you all.

Ileocecal valve is about 2-21/2 inches from your hip bone on the right side. If that is were you get the discomfort you can massage the area and it will open or close the valve that gets stuck. Google or you tube it. I hope it helps and that you feel better.

I feel the same way and have been taking medication for mine too. You are so right about crying making the body feel better. I know this may sound a bit crazy, when I’m feeling anxious and overwhelmed i feel like crying and i do and it seem to help. I really appreciate the response that you all wrote, I thought I was the only one feeling this way, glade to see its not just me. I just want some relief and my life back. I have good days and bad. It’s really taking a tole on my life and I just want some help.

Same here, a weird butterfly sensation that can last for hours at a time and comes and goes ranging from dull to severe. I did notice i get the shakes sometimes with it and even when i do sometimes its just the left side of my body that feels it the most.

I’ve been dealing with these symptoms on and off for nearly 35 years. These comments made me want to cry because I’m used to this fear, but I can see now how the virus is affecting everyone. It will pass. Meditation helps. Try an acupuncture mat. Hot baths. Medication can help (Benzos are addictive so be careful! Bentyl has helped me from time to time.) Be sure you are taking time away from news, set limits. Find something you enjoy doing that helps you escape, like painting or taking a walk in nature. Limit irritating foods for your stomach: high fats, tomato sauce. Etc (FodMap can help... limit onion and garlic!).. Also remove and toxic people and set boundaries!! I’m living proof anxiety won’t kill you!! Hang in there!!

I feel the same way it sucks I also feel a sense of lonelyness and discomfort, something I can't control, I feel vulnerable.

Try guided meditation on really helps to calm.down and breadthing excercices

I have been feeling the same way my stomach is in knots. Sometimes it's bothering me bubbling a lot. It feels so nervous inside my stomach. When I go to bathroom many times it's very loose. Also at times I don't want to eat much at all. That is not like me I'm a major foodie I'm usually always eating. I know it's this Corona Virus that has me like this. I'm so stressed about me or my family getting it's messing up my stomach.

I have the worst right sided stomach pain. It's def this virus that has my anxiety through the roof!

I have the same issues with more pain on lower right side. At first I thought maybe my appendix, but no fever and comes and goes. I have had such anxiety so after reading the feeds it sounds like stress is causing the anxiety and all these stomach/intestional issues. I drink tea with ginger and do meditation which helps.

No one here is crazy and most likely none of you have stomach issues, It all begins with the brain and a long wandering nerve called the Vegas nerve it travels through your body and through your digestive tract and further, you’re fight or flight response is what’s giving you that nawing anxious feeling in your stomach and It can have many other symptoms, poor concentration, anxiety and panic attacks and most of all lots of gastro problems,
Whatever you’re worrying about must have been going on for some time and you have reinforced this response between the brain and your stomach so you need to break the loop, you can try slow deep breathing or pinching your skin on both sides of your body up and down from head to toe until your brain turns off the flight or fight response then try to distract yourself and concentrate on something else, Repeat this whenever it happens train yourself not to have that response

Hi... I can relate to you, the same thing is happening to me I went to the doctor and I got some muscle relaxers. Today is my 2nd day taking them and I’m feeling the same way. I think it’s because of everything that is going on.

I’ve had the same stomach issues for a week. My anxiety is through the roof and not being able to get to the gym is not helping. It’s nice to feel like I’m not alone.

Because of this virus outbreak my anxiety starts thats why a lot of Bad things that happen to me like constipated, feeling that i have diahrrea, stomach ache, Insomnia, and loss of appetite :(

I hear you. I was okay for the first 2 weeks of social isolation but now my anxiety is over the top. My adult son had to come home as he has no work, no money and he already has anxiety, my youngest is living in London, England and I am worried about him. I find I have stomach cramps depending on what I eat, I actually have lost my appetite and I have loose stools. Not sure whether to up my Effexor

Hi Northern girl,
How long do your cramps last when you have them? I've had the same thing but I can't figure out if it's just stress induced or more. Doesn't seem related to any certain types of foods and sometimes lasts for hours. Then I start worrying about it and I'm sure the anxiety/cortisol just makes it worse and worse. Can't get into a GI doctor until mid-May and basically living off pepto & ibuprofen & it's impairing my work since it often starts after 2 PM for the first time. Hope you're feeling better.

Hi, I’m experiencing cramps, especially after running. It feels like menstrual cramps and I almost faint & have thrown up when really bad. I exercise for a living, so this just started. I do believe it’s from high cortisol levels because I am stressed out right now over multiple things. I eat fresh ginger and eat healthy. Please let me know if you find a supplement or tea that might reduce cortisol.

Please dont use nsaids..ibuprofen. it will eat into your stomach lining. I have gotten erosive gastritis from over use of ibuprofen. Stay away from that stuff!

I am a 31yrold male from the uk never experienced anxiety before and I am exactly the same no appetite ( I love food) stomach is constantly churning.

I have had a small problem for years,but found using the same technic as gripe
waters as with babies helped ,using just a little whisky in water,a tea spoon is what I use,I know perhaps we should not use spirits but it hits though's nerve endings that you can not get to and has helped me in the past.If I do this by the third day ,my stomach start to forget to feel that feeling and I may not get it again for three months.As with this virus ,I was fine for 6 weeks but now in trouble,as I picked up a cough with the anxiety,have been given all clear from a test ,but are suffering the same as you.Having tried writing lists of good things as they say.I now have dicided to try again the gripe water as a third try ,so far not too bad. There are many many people out there suffering and hope you find a way through this strange time for us all.

Has anything helped im having this issue now but my mouth gets so dry while its happening

Yes me too, I think it's anxiety with the dry mouth from a mix of gastric issues and worrying about this virus. Also feeling tired and shaky or tremble.

How’s your anxiety and your stomach? Ten days ago I started getting stomach issues and I went to the doctors and he said something triggered it. I think it was stress. I’m on day 12 and still the same but a little better. Do you think it’s from the stress of this virus ?

No it's just irritable from diet ibs and nerves at the same time. My husband is like this every morning for years. No virus, thats how his system breaks his food down. He drinks in the evening and in the morning he's loose.theres meds to help that just how some people is. When i get excited i have to pee right away. Hppe this helps

That same exact situation is happening to me. I wake up early and have to go to group conditioning/running. I’m so worried that one of these times my stomach problems will cause problems during my workout out.

Very uncomfortable feeling walking helps but it seems to return!
I’m 72 now I know bodily functions are changeable with age!
Having the herbal teas and wonder whether it a wheat intolerance that I have??
Doctor check up recently bloods and urine tested also blood pressure and ECG clear!
Any Answers welcome!

I’m curious if you were able to work. My son says he can’t work most days because of his anxiety causes so much stomach issues. Were you able to take something that worked for you or did you work it out another way?

Hi Jane Wooda. I too suffer awful. I have GERD so bad it us like having a cold and sore throat 24/7. I also have crippling runs about 4 times a month. I end up on that toilet doubled over and have 6 to 10 bouts in a row. I have been diagnosed with chronic anxiety. I get stuck home all the time. Afraid to eat and leave the house fir fear of accidents not by a toilet. Afraid to drink water. It sounds like you and I are in the same boat.

Try touching your toes it solved my stomach issues cause due to anxiety. Stand straight join your legs raise your arms straight then keep moving slowly downward try to touch toes 25-30 times i did that for like a week and it had great results.

Ive suffered from IBS D since my late teens. I avoid gas causing foods but if im not sure if a certain food will cause gas i take Beano (TM) or the generic before i eat. I always have Gas X (TM) pills in my purse. Google gas causing foods It really helped me Also try to treat yourself like you are your own Mother Dont allow stressful people, media or situations in your life GOD bless you Pray this helps

I suffer from anxiety and recently I got bad attacks of flire ups with vomiting and all. I would smoke Cannabis to relax but my dr told me not to as it adds to my IBs? I don’t see how when it’s to relax but since I haven’t smoked but anxiety is a mid grade as that was my sleeping poison. Any advise ??

I have exactly the same too much gas causing fluttering and many many ectopic heartbeats really horrible!

I have the same awful butterflies like my stomach is always twitching plus the heart thumps, it’s so scary just wish it would go away, it’s this awful virus causing so much fear for everyone. I haven’t slept a wink last night and still got the knotted tummy, there must be something out there to help us.