Have you ever wondered whether or not your stomach issues could be related to stress? Growing research points to a correlation between stress and the gastrointestinal tract, so we’re shining a light on what sort of issues could be stress-related, common symptoms of stress-induced diarrhoea, how to identify them, and how to manage and treat it.

At Augmentive, we aim to provide holistic, tailored mental health support to everyone so they can live their life to the fullest, so if you have questions about stress, anxiety and the physical symptoms they can produce, we’re here to help.

How are stress and the gastrointestinal tract linked?

It’s no surprise that gastrointestinal problems can cause mental health issues, with one study finding that 39.1% of IBS (irritable bowel syndrome) patients had anxiety symptoms and 28.8% had depressive symptoms. But could the reverse be true; can anxiety and stress cause gastrointestinal issues?

Everyone is different when it comes to their susceptibility to stress — seemingly stressful events will not affect some people, while others will be deeply affected by the same thing. Studies suggest this can be due to our genetics, our coping style when under pressure, our individual personality, and the support we have around us.

In addition, it can be extremely difficult to identify stress as the root cause of certain health issues, since stress is usually intangible and immeasurable.

More recent research has found that there is an axis connecting our central nervous system to our enteric nervous system, which is essentially the gut’s nervous system. This system works to regulate what happens in the gastrointestinal tract, but it also regulates our emotions and behaviours thanks to its link to the brain. When you experience stress in your brain, chemical messengers carry signals down to your gut, which (for some people, and in some situations) responds with physical symptoms like diarrhoea, nausea or constipation.

Then, there’s the autonomic nervous system which is also linked to the enteric nervous system. Our autonomic nervous system helps to regulate key bodily functions such as our breathing, our heartbeat, our blood pressure and our temperature. When we are stressed and experience a ‘fight-or-flight’ reaction, our body tends to activate certain functions such as an increased heart rate, increased respiration, higher blood pressure, and decreased digestion. This last one can be the reason for the stomach issues people experience.

According to one study, gastrointestinal diseases such as stomach ulcers and ulcerative colitis have been known to be influenced by stress, and although it doesn’t point to a definitive link, one possible example of this in reality is the research that shows stomach ulcers occur twice as often in air traffic controllers as in civilian copilots.

Some stressful life events have been linked to the onset of, or exacerbation of, common chronic digestive disorders like functional gastrointestinal disorder (FGD), inflammatory bowel disease (IBD) and gastro-oesophageal reflux disease (GERD). It is also thought that early life events such as various forms of abuse can contribute to the development of issues like inflammatory bowel disease later in life. One study of 845 children even found that “sexual abuse preceded or coincided with abdominal pain in 91% of cases”.

What kind of gastrointestinal problems can be caused by stress?

According to data published by Harvard Health, gastrointestinal disorders affect 35% to 70% of people at some point in their life, and women are affected more often than men. Many of us have experienced an occasional bout of stress-related gastrointestinal issues; you may have felt things like butterflies in your tummy before an exam at school, felt nausea before a big presentation at work, or had to run to the bathroom multiple times before attending a social event. Not everyone feels stress and anxiety manifest in their stomach, but many people do.

Stress is thought to cause symptoms such as bloating, cramps, gas, constipation, nausea, acid reflux, stomach pain, indigestion, and of course, diarrhoea. Researchers have known since the 1940s that stress can lead to intestinal cramping and diarrhoea, and today, the CDC (Centres for Disease Control and Prevention) believes that stress accounts for around 75% of all doctor visits.

Stress is responsible for a lot more than we might think, with physical stress-related symptoms including everything from headaches to back pain.

What are common symptoms of stress-induced diarrhoea, and how do I identify them?

It can be difficult to determine whether or not stress is the cause of your diarrhoea, but if it is, you may also notice some accompanying symptoms, such as:

• Fatigue
• Headaches
• Tense muscles
• Feelings of overwhelm, sadness or frustration
• Sleep issues
• Changes in your sex drive
• Depression
• …and more

When stress is the issue, you may also notice physical issues such as breathing changes, panic attacks, sweating, rashes or itchy areas on skin, blurry eyesight or pain in your eyes, indigestion, heartburn, nausea, dizzy spells or fainting, sudden weight loss or gain, changes to your period or menstrual cycle, and more.

Sometimes you may be able to see a pattern in the timings — for example, if you experience diarrhoea every time you need to present your work in front of a large group of people — however you could also experience symptoms at seemingly random times.

With stress, you could also notice any existing physical health problems becoming worse. If this is the case, bring it up with your doctor so you can come up with a plan of action.

Keep in mind that one other notable symptom of stress is chest pain. While this pain may be nothing to worry about, any unexplained, sudden chest pain should be considered an emergency, and you should go straight to your nearest A&E or call 999.

What else could be going on?

As above, gut issues can be a symptom of a number of health conditions, so it’s important not to make any snap judgements and diagnose yourself.

In the case of diarrhoea, it usually clears up on its own relatively quickly (or after the stressful event has passed), but if it doesn’t or if you have other symptoms that indicate more than stress, you should speak to a medical professional to discuss further.

What is the treatment for stress-related diarrhoea?

If you identify your diarrhoea as stress-related, you will see far greater results by seeking help to treat the underlying stress you feel, rather than the diarrhoea. In many cases, diarrhoea will start to ease or clear up completely when the root cause of stress is addressed.

If, however, you are still suffering from stress-related diarrhoea in the meantime, here are a few things that could help, as recommended by the NHS:

• Drink plenty! Dehydration can be a big issue if you have diarrhoea for a while, so drink lots of water and other fluids to stay hydrated.
• Speak to a pharmacist who may be able to recommend over-the-counter medications to reduce the diarrhoea, as well as oral rehydration solutions.
• Don’t be tempted to avoid solid food. Keep eating as often as you need to.

How can I manage stress-related diarrhoea day-to-day?

If you tend to experience diarrhoea every time something stressful happens, you will likely be looking for ways to manage this and reduce it during high-stress moments in life. By reducing your stress levels, you may be able to lower inflammation in your gut and ease some of the tension felt in your gastrointestinal tract.

Gentle, calming activities like yoga or a mindful meditation can work wonders to calm your mind and, as a result, relax your body. Eating a healthy diet is recommended to ensure your gut can properly manage any instances of stress. Smoking is known to increase the risk of developing GI diseases and ulcers, so quitting is also recommended to those who tend to experience stress-related GI issues.

Should I see a doctor about stress-related diarrhoea?

Stress-related diarrhoea is hard to diagnose since many conditions can cause diarrhoea, and stress can also cause many other symptoms. Whether it appears to be stress-related or not, you should speak to your doctor about any unusual physical symptoms you have so they can check for anything serious and rule out other health concerns.

If your diarrhoea persists for more than 7 days or you see blood in your stool, experience rectal bleeding or severe cramping, or feel a high fever that lasts more than 3 days, seek medical attention to ensure everything is OK.

I’ve had stress-related diarrhoea for a long time. What should I do?

If your diarrhoea has been consistent for a while and you have identified that it is stress-related, you may wish to consider starting work with a qualified therapist who can help get to the root of your ongoing stress.

One 2017 study published in the Journal of Consulting and Clinical Psychology looked at how effective cognitive behavioural therapy was when it came to quality of life, anxiety and depression in those with irritable bowel disease, when compared to the same factors for those undergoing standard medical care, and a control group. The group with IBD who received CBT ended up reporting a higher quality of life and lower levels of depression and anxiety.

If you are interested in exploring how cognitive behavioural therapy or another kind of therapy could help you address your stress issues, Augmentive can offer a free consultation to point you in the direction of a therapist who specialises in exactly what you need, and who can help move you towards a future where stress has less impact on your life, both physically and emotionally.

Whether you’re feeling off-kilter or want to shake up your routine, our state-of-the-art mental wellbeing platform gives you quick and seamless access to world-class support on your terms, from private psychiatric assessments and reviews to broader mental health care: join us today.

If you have a question about stress-related symptoms, we’re here to assist on your journey. Our free 15 minute consultation can guide you to the most relevant specialists to answer your questions and discuss next steps.

DISCLAIMER: The content published by Augmentive is not designed to treat, diagnose, cure, or prevent any disease or condition. Always consult your GP or a qualified healthcare provider with any questions regarding a medical condition and before starting any therapy, diet, exercise, or any other health-related programme.