Anxiety Diarrhea: Why It Happens and How to Manage It

Anxiety diarrhea, along with other digestive problems that often accompany anxiety, can happen because of the connection between your gut and your brain, known as the gut-brain axis.

The axis connects your central nervous system to your enteric nervous system (ENS), which acts as your gut's nervous system. The ENS helps regulate processes in your gastrointestinal (GI) tract. But it also has an effect on your emotions and behavior through its link to your brain.

When you're distressed, chemical messengers carry signals from your brain to your gut. Your gut sometimes responds to these signals with physical symptoms, including diarrhea, nausea, or constipation.

This link works both ways. If you have digestive issues or other GI problems, you might experience psychological symptoms. And having irritable bowel syndrome (IBS) or related conditions is linked to an increased risk for anxiety and other mood symptoms.

If you regularly get diarrhea while in distress, it might be worth ruling out IBS. This common condition can make you more likely to experience diarrhea when you feel anxious.

Experts aren't sure exactly what causes it. But anxiety and stress are known triggers for IBS flare-ups.

Some experts believe people who develop IBS may have an overly sensitive colon. This sensitivity can increase the chance you'll have GI symptoms when you eat specific foods or experience anxiety or other emotional distress.

Many people have both anxiety and IBS. In fact, research consistently suggests that IBS commonly co-occurs with anxiety and depression. Living with either condition can increase your risk for the other and affect symptoms you already have.

In other words, just as you might experience increased GI distress as a result of anxiety, living with IBS can worsen mood and emotional symptoms.

know the signs

Common signs of IBS include:

• pain and discomfort in your abdomen that doesn't go away or keeps coming back
• stomach cramps
• increased gas
• diarrhea, constipation, or alternating diarrhea and constipation
• symptoms that get worse when you smoke, have a lot of caffeine, or eat certain foods, including dairy, red wine, or wheat, among others

If you have these symptoms for three months or longer, you could have IBS.

Getting help for anxiety can make a big difference in both mental and physical symptoms. Talking to a mental health professional is a good first step.

A therapist can help you find the treatment that best fits your needs, whether it's therapy or a combination of therapy and medication. Some people who experience GI symptoms and anxiety or depression find that antidepressants help with both sets of symptoms.

Certain lifestyle changes could also help you manage symptoms of anxiety. Some tips that may be especially helpful for diarrhea and other stomach issues include:

• avoiding alcohol and tobacco
• decreasing caffeine intake
• staying hydrated
• eating a balanced diet that includes whole grains, lean protein, and fruits and vegetables
• getting regular exercise

It's also important to know how to cope with anxiety and stress as you experience it. If you're working with a therapist, they can help you explore coping methods.

quick fixes

When you start to feel your stomach knot up (or before you even experience the first twinge), the following strategies can help:

• Take a few minutes to breathe. Slow, deep breathing can help reduce anxiety and may calm your stomach.
• Take a short, brisk walk.
• If you can't get outside, try some indoor stretches, yoga, or meditation.
• Take a moment for self-compassion. What would you tell a loved one facing the same stressful situation? Say those same words to yourself.
• Try a relaxation exercise.
• Reach out to a loved one. Hearing from someone you care about can remind you of the support in your life and help make difficult situations seem less challenging.
• Try a grounding technique. If anxiety tends to make it hard to focus on what's happening around you, grounding techniques can help calm you and keep you present.

On a larger scale, it may also help to take inventory of your daily tasks, both at home and at work. If they feel overwhelming, set aside time to go over your responsibilities. Ask yourself if they're essential, or if there's anything that's adding unnecessary stress to your life.

Can increased self-care or division of responsibilities reduce your load? Sometimes, taking a careful look at everything you're dealing with can help you find new ways to address challenges. If possible, involve a trusted co-worker or loved one in the process.

Talking to a medical professional may help if you experience both anxiety and digestive issues, but it's a good idea to see your healthcare provider if lifestyle changes don't seem to improve your symptoms.

You may also want to make an appointment if:

• symptoms get worse or don't go away after several weeks
• you get diarrhea during the night
• you have bloody stools
• bowel movements and gas don't relieve your pain or cramping
• it's hard to swallow
• you experience weight loss
• you vomit for no clear reason

A medical professional can help determine what's causing your symptoms and offer suggestions for treatment, including any dietary changes that may help relieve symptoms.

Talking to a therapist is recommended if any symptoms negatively affect your quality of life. For example, feelings of fear and worry may affect your relationships, work, and school. They might also make it hard to sleep or do the things you'd normally do.

Concerned about the cost of therapy? Our guide to affordable therapy can help.