Anxiety and GI Issues: What's the Connection?

Anxiety and stomach issues often seem to occur together. A queasy stomach is a common experience for people experiencing anxiety, but anxiety may also contribute to other GI issues as well.

Gastrointestinal (GI) disturbances commonly include symptoms of stomach pain, heartburn, diarrhea, constipation, nausea, and vomiting. While there are plenty of possible causes of GI issues, when no medical explanation is found, they are often termed “functional GI symptoms.”

Many studies have shown a correlation between anxiety, depression, and functional GI symptoms. Generally, study results have demonstrated that people who have at least one GI symptom are more likely to have an anxiety disorder or depression than those without any GI symptoms.

Unexplained physical complaints as a whole—including fatigue, headache, stomach upset, nausea, diarrhea, constipation, dizziness, and musculoskeletal pains—are more commonly reported in individuals with an anxiety disorder and/or depression.

Common Anxiety-Related GI Issues

GI symptoms may be associated with generalized anxiety disorder (GAD), social anxiety disorder (SAD), panic disorder, and phobias. Common GI symptoms that have been associated with anxiety disorders include:

• Constipation
• Diarrhea
• Increased hunger
• Indigestion
• Loss of appetite
• Nausea
• Stomach cramps

Dangerous GI Symptoms

Whether or not you believe your GI symptoms are anxiety-related, you should consult your doctor as soon as possible if your symptoms occur with any of the following:

• Blood in the stool
• Feeling bloated or full after eating very little
• Having a bowel movement that is black, tarry, and foul-smelling
• Persistent, low-grade fever
• Unexplained weight loss

These symptoms could mean you have another condition that requires treatment, like hemorrhoids, an infection, intestinal bleeding, or inflammatory bowel disease (IBD). While it can be concerning to know that these symptoms could indicate a serious condition, seeking medical help sooner rather than later will ensure that you receive the right treatment.

GI Conditions Linked to Anxiety

Some GI conditions—such as irritable bowel syndrome (IBS) and gastroesophageal reflux disease (GERD)—have also been linked to anxiety disorders.

IBS

IBS is a GI disorder that causes symptoms like pain, bloating, cramping, flatulence (gas), whitish mucus in the stool, diarrhea, and constipation. While the condition is not life-threatening, it is chronic and can have a serious impact on a person's quality of life.

People who have IBS are also often diagnosed with mood and anxiety disorders.

IBS is a treatable condition. Making dietary changes can often help, as can managing your stress using strategies like yoga.

GERD

GERD is a digestive condition that causes acid reflux, which is when stomach acid enters the esophagus and leads to sensations like heartburn and trouble swallowing.

Common symptoms of GERD include:

• Bad breath
• Chest pain
• Difficulty swallowing
• Hoarseness of the voice, especially upon waking
• Mild pain or stuck-in-throat type sensations
• Persistent dry cough

Some research suggests that people who have GERD are also more likely to experience anxiety. While the exact reasons for this connection are not entirely understood, researchers suggest that high anxiety and stress levels may increase stomach acid and muscle tension that can contribute to symptoms of GERD.

GERD is treatable with medication, diet, and lifestyle changes.

What to Do About Anxiety and Stomach Pain

You should consult with your healthcare provider if you are experiencing unexplained mild to moderate GI disturbances for more than a few days, or if your symptoms stop and then return. They may order tests or refer you to a specialist to rule out any serious medical problem that may be causing your symptoms.

If your doctor determines that you have functional GI symptoms related to anxiety, there are many effective treatments available—both for your GI concerns and the underlying anxiety. Prescribed medications and psychotherapy can help you to reduce your feelings of anxiety and develop healthy ways to cope with stress.

Coping With Anxiety and GI Issues

Learning to manage your anxiety while treating your GI symptoms can be the most beneficial approach for helping you deal with both issues. To help cope with symptoms of anxiety and related GI problems, try:

• Avoiding excessive caffeine: Not only can caffeine increase feelings of anxiety, but many caffeine-containing products can also lead to GI upset.
• Changing your diet: Focusing on a gut-friendly diet may help calm symptoms of GI upset. Make sure that you are eating fiber-rich foods, and try adding foods containing probiotics to your diet (such as yogurt, sauerkraut, and kombucha). Some animal studies have suggested that probiotics may have anxiety-reducing effects, though more research is needed to understand their impact on human mental health.
• Practicing stress management techniques: Stress is a normal part of life, so developing good coping skills is important. Relaxation techniques that can help include deep breathing, progressive muscle relaxation, and meditation.