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 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.

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.

I have had a lot of stress in my life. My stomach has always been affected. It makes you more anxious when you are at work and constantly worry about whether you will have to run to a toilet. Its caused me so much problems in my work, even had to leave jobs as there have been too many meetings I cant deal with it's too embarrassing in turn I get panic attacks again. Think the damage has been done. I thought for years I had IBS not until I went to an acupuncture lady did I realise my stomach issues only happened in stressful situations and mainly at work or places where you dont know well and not being familiar with toilet facilities. Since we have had lockdown because I am home my stomach is so much better and eating whatever I want no issues. Now my worry is going back to work and this nightnare process will start all over again. Surely taking imodium frequently is not good for you but nothing else works long term.

Hi Kelly,
I suffer from IBS and at the moment my stomach cramps have been worse. What does usually help me get a stable stomach is an Activia Yoghurt after lunch every day.

I suffer all of the above also for many years.
I have been finding the Medical medium protocol very good, especially celery juice to kill off bugs in gut. I have come off meds and been able to keep UC at bay with tumeric and glutamine. Have a read up on this info and see if resonates. Good luck

Hi' same thing with me. Could be gerd. I have morning anxiety from morning acid building up. Watch what you eat. Sugar and hard to digest foods also dairy. Hope this helps. 🤗

If you have a good relationship with your primary care provider, and your therapist confirms an anxiety diagnosis he or she could provide your primary with diagnoses, and possibly recommend medical treatment for your anxiety. Sounds like its bad. If you have tried medicines over and over with no relief, perhaps ask about ketamine therapy. Works for PTSD, depression, anxiety, chronic pain, even neuropathic pain. Not a first line treatment though it works miracles in some. Good luck!

I feel sharp pain on the left side of my stomach just below my left rib, is it cause by anxiety?

I have quite a few issues with my body. Mostly inside. After years of suffering!!! I am doing what I can on my own to educate myself, as not one of my doctors through the years has taken me down this road! Now I want to learn what kind of anxiety I have (probably all) and what I can do to heal myself without the meds!! I know I have pretty crippling anxiety mostly every morning! I have had a lot of surgeries for ulcerative colitis, due to stress and anxiety! I have epilepsy due to some stress and anxiety,some neurological epilepsy, PTSD, OCD...well I am only taking Lavella (lavender)for it. It helps a little, enough for now, without having to take more meds. I just cleared my system of clonazepam! Now I'm 53 years old and ready to try help from outside...I don't have people in my life besides my small family! What I learn is from here and my doctor. I desperately need someone to help with experience and knowledge! I can't find therapy for myself!!! I don't even know if I need that.?? More to say...

You can try Ayurveda remedies. It helped me. You can give it a try. Also, don't be worried abt side effects. Ayurveda is more of herbal therapy that's closer to nature.

And ginger root help with any gut pain which may occur due to gas build up and the apple cider vinegar balances the stomach acid also avoid spicy foods completely.. Drink plenty of water and don't stress too much about what's happening and you could try multi vitamins and probiotics and gaviscon double action helps too.. But the main thing is to cut down the stress and understand that its an illness like any other illness and there are others who have much bigger health issues...