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.

Hi there, I’m suffering from chronic anxiety
Everyday 4 loose stools feels dizzy
Leg cramps
Feeling like food struck in my mouth
Can anyone suggest what to do with this
How to deal this?
Is it good to take medication
Pls help me

I can't say for sure when this started but there are days I wake up light-headed and nausea, I figure maybe I have low blood sugar and I should eat something. However, after I eat I still feel light-headed and nauseus. Yes lately, I felt stress due to personal issues I don't know if its anxiety or am I really sick ? I eat small portions just in case I overeat and I bloat. What do u think it could be? Help!

I get such an intense awful feeling in my stomach when a fleeting thought of worry or negative thought appears, i wouldnt say it is anything like a butterfly feeling it is much more intense than that and can sometimes lead to heart palpitations. This feeling in my stomach sometimes occurs during digestion too, it is so very difficult trying to describe my feelings to a GP that i have basically given up going to the surgery but i suffer on a daily basis with this and the whole thing is making me feel very depressed.

Hi Tyrone I have the same issue, a horrible feeling of a "knot" in my stomach. I've had this for quite some time and 5 years ago a doctor wanted to do an endoscopy, well I have horrible anxiety and I wouldn't let him. It's as if my brain focuses on my stomach and all the sress and anxiety stays right in that area. I feel tense all the time and I'm constantly focused on my stomach, like an OCD type thing. I also belch all the time even after drinking water. I feel you, again that stomach knot is always there as if my brain doesn't know how to turn off the switch! Frustrating for sure.....

Iam a bit like you Trevor. I've had anxiety all week which makes my stomach flare up and makes my GERD tummy is like a washing machine . And as I speed up with my breathing . I get the burbs. And nausea. As soon I go to bed it stops till I get up . When I do awake you can feel it start again. Tight chest and over breathing. Horrible. I've had it for over 20yrs.

Hi Tyrone-this sounds like panic attacks to be honest! I feel like that before mine, and as soon as the heart starts to pound i am in full panic mode. Propanalol is great as it stops the pounding hear sensation. Ask to speak to another doctor as panic attacks are no joke! Hope you get this sorted soon :)

Hi Tyrone,

I have the exact same thing. The only way i can explain it is the same feeling you get when you get a big fright, for example while driving and something happens that could have caused an accident. You get this sudden rush trough your body that ends in your stomic like a jabbing feeling.

From all my reading, research and introspection i have come to the conclusion that we suffer from what i refer to as an nervious stomic. There is this gut - brain connection connected by the vagus nerve and i susspect that in some people this connection is mutch more sensitive. It could be as a result of high stress levels from childhood or perhaps underlying conditions such as IBS and GERD or perhaps a combination of both. Im also a very sensitive person in general, for example when i have an argument or speak to a stranger i would go over the converstuon or re hash it in my head for some time after. This "extra sensitivity" may also have something to do with it.

I have not come across any easy cure, all i can tell you is that there are things one can do to improve your Gut health such as taking pro biotics, watch your diet and do regular exercise. I seem to have good periods lasting for weeks up to month sometimes followed by down times where anxiety takes over and followed by the gut and GERD. I think it has allot to do with one's emotional condition, one feeds of the other.

My only advise is to stay strong, and always remember nothing is permanent, it will get better again.

Your comment nailed how I feel. Even the slightest thought or worry that skims my mind creates an all-out intense knotted sickly stomach as though the world is about to end. I'm 'not' anxious, yet constantly 'feel' anxious, which I suppose is the same thing, but I have no idea why.

I thought I was the only one of my kind with this weird connection between my brain and my gut. Like most comments mentioned, I usually have cramps in the morning due to a lack of sleep having to wake up at an early hour 5 am for work. During the morning hours, I have cramps and loose stool which would go away completely after I rest or go home. As I switch to second shift the symptoms disappear completely, sometimes they come back but way less worse and don’t last long. The only time in which these symptoms disappear, even when I am doing morning shifts, is when I fast (for religious reason) everything goes back to normal with no issues at all. But the fasting lasts only a month. Unfortunately, the symptoms come back with the first week after the fasting period is over.

Have had an anxiety disorder for over 30 years. This symptom is the worst. During a panic attack my stomach tightens up and I really want to burp to feel better but can’t. When I’m calm I can burp no problem. It feels like my stomach and throat just tighten up and can’t get the burp out. Doctor said all anxiety related as I’m tensing up my muscles when the should be relaxed.

Does this make any sense? Of all the physical anxiety symptoms I’ve had (and I’ve had pretty much all), this is the worst.!!


Frank..yes..I suffer from that too. Feel like I need to burp but can't. It's awful! I also feel like there's a tight band around my neck sometimes when I'm anxious. So miserable 😔

Why does my stomach feel like any minute something bad is going to happen an it's a nervous feeling and I most of the time have diarrhea I do have anxiety disorder what can I do to relieve these symptoms

I too have been feeling this in the night, awake in the middle of the night then incredible stomach pain the next day. I need to avoid sugary foods which is what I've been craving too.

Ugh! Glad to find these posts because I seriously thought I was the only one this is happening to right now. Like some of the other posters said, nothing I do seems to make it better. I feel like there's literally no way to de-stress in the middle of this Coronavirus pandemic. :-( This has literally thrown all my hormones off balance, bothered my stomach and caused some kind of inflammatory response because one finger joint has hurt non-stop for 3 weeks. Hoping it goes away soon.

My anxiety is causing all sorts of digestive issues from bloating heartburn gurgling stomach which sets my anxiety worse

Hi when I awake in morning I feel impending doom feel quite bloated and breathless also don't feel rested want to sleep shortly after being up don't feel like doing anything can't be bothered joints ache and generally feel not well I have tried several anti depressents but they don't help I also tend to drink alcohol to relax but this makes tummy worse next day I then stop drinking and symptoms get worse any advice would be welcomed thank you

The first of six steps is not a step. My stomach hurts worse now because my anxiety has been driven up by not being able to find a sixth step. Please advise.

I’m a 25 year old Male, I have started suffering with anxiety again after a year and a half!

And I have had different issues this time round consisting of hot flushes with stomach issues with pains, wind and inconsistent bowel movements, and last night woke up randomly with night sweats which followed by a bowel movement and had to shower to make me feel better!

I am struggling with stomach issues and can’t stop focusing on it when I feel bad.

My previous battle with anxiety was heart palpitations mainly! But this time round it’s an all over the place stomach.

Any advice would be appreciated.

Take care everyone and keep smiling.

Every night just as I’m falling asleep my stomach feels like it’s turning over which is a in pleasant feeling

My stomach has been aching for months. When I mention it to my doctors, they all make sympathetic noises but that’s it, not helpful. I suspect the case is anxiety, but don’t sit around worrying. I have plenty to worry about health wise, but don’t actively think about the scary places I’ve been and are going to. So, the question is what to do. I take Tylenol, an antidepressant, put a heating pad on, will myself to relax And finally bought some Pepto yesterday. Starting to feel a little desperate. This thread makes me feel less alone but still not sure what to do. People keep saying relax, don’t worry - again not helpful. After reading the other comments I’m not looking for answers anymore. Appreciate being able to vent though 😀 good luck all.

About 2 months ago, everything would be fine during the day but as soon as I went to bed for the night, I would have a strong feeling of anxiety pass over me, my heart would beat heavy, and my stomach would have a lot of pain in it. Gradually, this "panic-anxiety-apprehension" feeling would increase to where I could not fall asleep until 4, 4:30 am, but only after taking some Alleve. On other nights, I would take other pain relievers or sleep aids just to get some sleep. It has now progressed to the point where I cannot fall asleep until 4, 4:30 am, wake up about 6 am, have a lot of tightness, butterflies, pain, anxiety, apprehension, etc. coming from my stomach, can only sleep on my right side, etc. Definitely a brain-gut connection coming from stress overload. The riots are only exacerbating the condition. I was wondering what kind of doctor to go to but, after reviewing these posts, I am considering the gastroentologist route.

So for the past 5 days I’ve been suffering so much because of my stomach. I wake up and it’s instant anxiety like pretty much panic. I’ve seen that Bentyl has helped with the stomach issues as well as being able to calm the person down. So I just got prescribed it and I really hope it helps me because it’s not the pain from the stomach issues I can’t handle but the crippling anxiety that comes from my stomach issues. I’m so glad I’m not alone with these feelings and I can reassure you that you will get better

I've been ha ing the same issues as you guys and gals. The more ings are the worst for me waking up to such a anxious feeling like I'm having a panic attack then when I get up the dizzynes starts followed by a trip to the toilet where it's very lose, I end up pacing around the house which I know in my self just heightens my stress levels but I feel at a lose as to what to do I can't eat until I'm at the point of starving and the headach gets to much but food does help my headach and stomach and feel better after it, I have a girlfriend who is super supportive but I fear even she has her limits. Who wants to wake up to a anxious man every morning who thinks he's world is ending. In a good note reading all your comments has made me realise I'm not alone in this so thank you all for commenting we are the silent warriors because only we know the pain we suffer both mentally and physically. Much power to you all keep on fighting never give up!

I have had these symptoms on and off for 12 months with no physiological cause (though I had a bleeding duodenal ulcer 18 months ago which was treated and resolved). I found my symptoms were closely linked to times when I was anxious - before flights, visitors etc. I discovered a practitioner in BWRT (brain work recursive therapy) which reprogrammes the stimulus/response neural pathway that the brain can establish linking anxiety to physical gastroscopy-intestinal symptoms. After three sessions I had a remarkable cessation of all symptoms and enjoyed 6 months of freedom from anxiety and gut response to it. I feel the symptoms returning now, perhaps the whole lockdown issue has exacerbated it, or maybe the effects wear off and I need a top up session. It’s worth checking out BWRT to see if it may help anyone. Best wishes to everyone

I have been bi polar for many years and take medication but recently l have been ubder a lot of stress due to a family pet that died and worry about my parents because of covid.
My stomach has been really achey
And l have periods of nausea l already take meds for mental health and Omeprazole so is there anythibg else l can do to help with my stomach as one thing makes the other worse and l dont want to annoy the doctor.

i like to go out and hang out with my friends and my friend invited me to go the beach with her for a weekend but i’m getting anxiety about feeling nauseous and from the anxiety i get nauseous and it’s just this big chain but i can just do yoga at the beach any other tips?

My stomach has been feeling like its nervous every night for two months. It's always making noise. Happens only at night. I went to doctors and they dont understand what's happening. I also lost 10kg for I dont know why. Any suggestions?

I am amazed by all the comments. It's so releving to see that we all have so much in common. You really have to let positivity over take the anxiety, take it day by day. Keep researching this condition and you will find answer... Love concours all


September 21, 2020

In reply to by Julie

I cannot believe I found this site. I have so much in common with so many if you. I’ve searched for answers for months and knowing I’m not alone is comforting. I take .25 mg of Xanax and it does help. I’m trying all the advice I receive. I also take 20mg of Omeprazole before lunch. The fear of all these symptoms are really crippling. It holds you back from living your best life. You feel so helpless. Hope we all overcome this terrible condition.