Does Anxiety Cause Diarrhea?

You know that feeling. Your heart is beating out of your chest and you can’t seem to catch your breath. You’re fidgety and unable to concentrate on the task at hand. Your mind is racing and you can’t fall asleep. 

Sound familiar? 

Anxiety is a normal and unavoidable part of life. So normal, in fact, that in 2021 the Anxiety & Depression Association of America (ADAA) reported that 6.8 million adults, or 3.1% of the U.S. population, are affected by generalized anxiety disorder.

Whether it’s an occasional episode or a chronic condition, it doesn’t feel good. And if anxiety becomes excessive and prolonged, it can take its toll on you—both mentally and physically.

Symptoms of Anxiety

Anxiety can present itself in several ways. Mentally, you may experience worry, fear, dread and rumination which can lead to insomnia and depression. 

There are also physical symptoms. Things like sweating, trembling, rapid heartbeat, shortness of breath, tension, and fatigue are all signs of anxiety overload. 

Anxiety can also cause gastrointestinal issues like diarrhea, stomach pain, gas and bloating. Left untreated, these symptoms can lead to dehydration and impede your body’s ability to absorb nutrients from food.  

Anxiety and Diarrhea 

So why exactly does anxiety cause diarrhea? When you’re anxious or stressed, the sympathetic nervous system is activated and your body goes into fight-or-flight mode. The adrenal glands kick in and hormones like adrenaline and cortisol are released to give you the energy to fight or flee a threatening situation. If you’ve ever experienced feelings of “butterflies” or “knots” in your stomach, that’s a result of those hormones wreaking havoc on your digestive system.

Unfortunately, the body doesn’t know the difference between a real physical threat—like a speeding car coming at you—or the ongoing anxiety of something less dangerous like working in a toxic environment. Extended periods of anxiety and stress can disrupt the gut flora in the gastrointestinal tract resulting in diarrhea, gas and bloating. 

The Gut-Brain Connection

The link between the bowel and brain is known as the gut-microbiota-brain axis. This two-way communication channel is made up of the central nervous system (CNS) and the enteric nervous system (ENS). The CNS consists of the nerves, neurons, and neurotransmitters of the brain and spinal cord. The ENS, sometimes referred to as our second brain, consists of the same types of nerves, neurons, and neurotransmitters as the CNS but runs along the entire digestive tract.

This gut-brain connection is made via the vagus nerve. The vagus nerve is the main nerve of the parasympathetic nervous system; it controls the body’s rest and digestion response when it is in a state of relaxation, rest or feeding. It also allows information to travel back and forth between the CNS and ENS. What does this mean? It means that your gut affects your brain, and your brain affects your gut. 

Simply put, diarrhea can trigger the gut to send signals to the brain that cause anxiety. Anxiety can trigger the brain to send signals to the gut that cause diarrhea or a flare-up of other bowel conditions like ulcerative colitis, Crohn’s disease and irritable bowel syndrome (IBS).

Link Between Anxiety and IBS

Irritable bowel syndrome (IBS) is a chronic condition that affects the large intestine. Symptoms include gas, bloating, abdominal pain, cramping, persistent diarrhea and/or constipation.  

While it can be painful, IBS doesn’t usually affect bowel tissue or cause damage to the intestine, so it’s considered a gut-brain communication disorder, not a disease. Experts don’t know exactly what causes IBS, but it is commonly experienced by people who suffer from anxiety and depression. A 2019 study about intestinal microbiota and anxiety symptoms suggests that anxiety causes changes in the gut microbiome. These changes in the gut flora make food pass more quickly through the intestines resulting in diarrhea.

8 Tips for Reducing Anxiety-Induced Diarrhea

The good news is anxiety—and the resulting gastrointestinal issues—are treatable. If you suffer from anxiety-induced diarrhea or IBS, reducing stress can help. It may sound easier said than done, but with a few lifestyle changes you can learn to reduce and manage your symptoms.

Practice Deep Breathing

When you find yourself in a stressful situation, take a few moments to do some deep breathing. This will help calm your mind and nervous system. Practice box breath: Inhale for the count of four, hold for the count of four, exhale for the count of four, and hold for the count of four. Repeat this cycle a few times.

Slow Down

Overextending yourself is a sure-fire way to trigger stress and anxiety. Don’t pack your day with back-to-back appointments. Leave time in between meetings to relax, breathe and collect your thoughts. Block off time for meals so you’re not eating on the run.

Learn to Say No

Take a hard look at your life and how you spend your precious time. Let go of activities that no longer serve you. If it’s not a “Heck yes!” then don’t do it. If you’re a people pleaser this may take a little practice, but you’ll find saying “no” gets easier the more you do it.

Exercise Regularly

Going for a brisk walk or practicing yoga are easy and gentle ways to get your exercise in and reduce stress. Regular physical activity improves your mood and reduces cortisol and adrenaline—the stress hormones that contribute to tummy troubles. 

Meditate

Taking as little as five minutes a day to sit quietly can help reduce stress. Focus on your breathing, repeat a positive affirmation or listen to a guided meditation. Don’t worry about “doing it right.” Just sit quietly and relax.

Look at Your Diet

Certain foods can cause or make diarrhea worse. Common culprits include caffeine, alcohol, spicy or fried foods, wheat, eggs, dairy, too much fruit, and certain sweeteners like sorbitol and xylitol. Keep a food diary to track if you have symptoms after eating certain foods.

Stay Hydrated

Diarrhea can lead to dehydration so it’s important to drink plenty of water. Don’t wait until you’re thirsty to start drinking. Make it easy by carrying a water bottle with you and refilling as needed.

Let Go of Control

Look at how you respond to certain situations. Can you learn to practice gratitude and let go of things out of your control? You may not be able to do this 100% of the time and that’s okay, it’s a practice.  

When to See a Doctor

If lifestyle changes aren’t helping, it may be time to see a doctor to make sure there are no other underlying conditions. Contact your healthcare provider if you experience any of the following:

• Sudden or excessive weight loss
• Blood in the stool
• Fatigue
• Bowel movements that don’t relieve pain 
• Diarrhea during the middle of the night
• Symptoms lasting for several weeks

Medication, supplements, or dietary changes may be prescribed to reduce the episodes of diarrhea, or to control the spasms in the intestines to help slow down the digestion of food. 

If anxiety and diarrhea are affecting your relationships, work or school, it may be time to talk to a mental health professional. Cognitive-behavioral therapy (CBT) and hypnotherapy have been shown to help manage anxiety-provoking thought patterns. Treatment plans may include talk therapy or a combination of talk therapy and medication such as an antidepressant. Your doctor can help find the best treatment for you.

Anxiety and diarrhea are uncomfortable and can feel impossible to manage, but you can get some relief. Start by showing yourself some patience and self-compassion as you navigate lifestyle changes and treatment plans to find what works for you.

Become a Health Coach

Want to learn more about the mind-body-gut connection? Join HCI’s Become a Health and Life Coach program to learn about health, wellness, diet and nutrition. For those looking to make a career shift, you can begin coaching in as little as six months. If you’re already a coach and want to advance your skills, check out HCI’s Coach Mastery program. Feel free to get in touch with one of our clarity coaches directly by calling 1-800-303-2399.