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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 ADAA.org.  

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.

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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.

The most common kind of abdominal pain is a stomach- or bellyache, which happens from time to time throughout our lives. People with abdominal pain often double over, clutch their gut, feel nauseated or dizzy, and avoid food and water. The first step to addressing mild stomach pain not associated with a medical condition or trauma is to try to identify and avoid the trigger. For example, overeating or eating rich or gas-inducing food can cause heartburn, distended stomach, and abdominal pain, which can be avoided by practicing dietary changes and moderation. You can also refer to this article which states all the necessary details about abdominal-pain https://www.everydayhealth.com/abdominal-pain/guide/

Thank you Jane! Mine caused me to develop severe ulcerative colitis! At the time I had never thought of me and anxiety or had never heard of colitis! After years of pain and surgeries... the doctors had to remove my large intestine and the other bottom stuff Due to severe colitis. That was 15yrs.ago,now for the last year or so,I have had what I think is what I call white knukling anxiety,really bad the first 3-4 hours of the morning!! I don't know why!!! I have never felt this before! It's worse than before. My primary doctor referred me to a therapist...told me he couldn't help me...
Well,I am looking for someone and information I trust and relate to that I can talk to!! Share information with! Possibly help me find help I need where I live! Sincerely!

Try having a snack before you go to bed and have ginger tea and crackers before you get out of bed.
Cook as much as you can with ginger root.

Try lemon balm tea or ashwagandha capsules,they say it helps with lowering cortisol levels,mine is worst in the morning,I literally cant eat without getting nauseous during those days,and ofcourse my IBS D gets activated than,I do take xanax and it helps me a lot to eat and not get malnourished from stomach anxiety,my anxiety gets worse before and during period btw

After a bad stomach upset recently, it has throw my anxiety into overdrive in the mornings too. I'm scared of getting the stomach pains again.

Since you've mentioned the timing of your period, please look into PMDD, see if that fits your symptoms. :)

Try hot herbal tea but on the brake not on the work and think how good is that for your stamac,than take a minute to breathe and slowly start the work and increase step by step carefully by not accepting the stomac to upsetting you.
All in the brain

Don’t suffer alone. Go see a psychiatrist. You can also make an appointment wit a gastroenterologist. I suffered for a long time and finally made the choice to get help.
it take Bentyl for my stomach pain and it also helps to calm my anxiety.

I made an appointment with a gastroenterologist and he diagnose me with IBS the medicine he prescribed is Bentyl. It really helped to calm my stomach down.

Hi...for the past week I have been waking extra early than normal..cant sleep and immediately my stomach begins to ache and almost feel like butterflies or a nervous stomach. I then need to use the bathroom which is somewhat loose. It's been happening for a week now...I also think it's due to this crazy virus outbreak we are having now...please help

Hi. Did you get any answers on your stomach ache? I feel like this this week.

Yes I have had GAD General Anxiety Disorder
for most of my life.wake up EVERY morning with anxiety attacks and gives me those butterflies in your stomach. I see a psychologist every week to help with cognitive therapy and take benzodiazepines to keep the anxiety down. I do workout daily and walks which helps. It’s crazy and frustrating sometimes you feel like crying.

Yup me tooooo it’s stress I am eating ginger candy chews & juicing also doing juicing 💕

You gals are not alone! I have had diarrhea, pain, flatulence, fever. I am a Christian and people prayed for me and the Lord said it was from stress! I have never had stomach trouble before!

Whenever I’m anxious I suffer with acid reflux and diarrhea. I’ve been taking some pills to relief the pain but I wanted to know how to control myself

Have you found any solutions? I suffer from some constipation and Miralax helps but for months it feels like my intestines are twisting. I eat very bland. I've had 2 CT scans. I drink ginger tea, fennel tea and try to do everything I can to help but nothing is working. I do have some stress due to spinal stenosis and a surgery that made it worse.

I started with heartburn I've had it a week it sent my GAD out of control, I've googled everything about it and now I'm even worse freaked out cos nothing I take is curing it I've prayed too, I'm a born again Christian I've asked the Lord to show me, but my anxiety is real bad and I know I'm yo be anxious for nothing yet I can't stop it, it's awful,,,

I'm so scared of this I can't even sleep, I've got a fear of having cancer

I wake up during the night it’s at is worse , feel constantly like I’m going to sit a months worth of exams constantly feel sick because of this feeling something bad is going on inside me I’ve suffered IBS for years

Same here, it is the worst feeling I've ever had! Especially when my stomach tightens up!

I’m having the same exact thing, mine is in the morning and night and I seem to be kind of spitting up after I eat a little bit. And I feel very strange after I drink fluids.

I can relate! I can't seem to beat this thing. Stomach feels as if I want to burp but feels as if there is froth preventing it, especially after some liquids. And tea seems to set my heart racing.

Same exact symptoms!!! It’d been 6 weeks for me ! How long for you ? Ugh it’s awful! I have been taking prescription Pepcid and it does nothing ! :(

Just a thought but having read a lot about Covid 19 virus symptoms it has been shown that some people do have feelings of anxiety and gastrointestinal problems like diarrhoea, nausea and stomach cramps. Everyone has different symptoms from just what I described with nothing else to more flu symptoms of dry cough, temperature, body aches to severe respiratory problems.

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.

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.

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 apps..it really helps to calm.down and breadthing excercices

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