The science behind why stress can wreak havoc on your stomach


by Katerina Wells, MD

Jul 18, 2018

We all go through periods of stress or moments of heightened anxiety. Although stress often feels like it’s all in your head, what you might not realize is that stress can have a very tangible — and sometimes long-term — effect on your body.

Stress impacts all parts of the body, including the cardiovascular system, reproductive system, musculoskeletal system and the digestive system. The digestive system is particularly affected by the impact of stress. Changes to the gastrointestinal tract manifest into symptoms like nausea, vomiting, diarrhea, constipation, heartburn and abdominal pain that can disrupt your everyday life.

How your body responds to stress

The science behind your body’s reaction to stress is complex. The majority of the changes that affect the digestive system actually begin in the brain, so let’s start there.

When your body experiences stress, your brain releases a hormone called corticotropin releasing factor (CRF). This activates the hormone system that responds to stress, which causes your body to produce more cortisol aka “stress hormone” than normal.

This also causes changes in your digestive tract that can be problematic. By slowing down contractions in the upper digestive tract and increasing contractions in the lower digestive tract, this hormone release can cause some uncomfortable symptoms. These could include nausea, reduced appetite and more trips to the bathroom than you’re used to.

You’ve probably heard of the fight-or-flight response your body experiences in times of stress or danger. What you likely don’t know is that the epinephrine your body releases as part of this response can actually slow down your digestive system, contributing to these uncomfortable symptoms. 

Even low levels of stress, such as preparing for an exam or giving a public speech, can trigger these responses and contribute to the digestive discomfort you might experience.

Can stress have a long-term impact on your digestive health?

Long-term or “chronic” stress can have lasting negative effects on your body. Although the relationship is still unclear, stress can cause changes to the gut microbiome that alter how your body manages fats and immune defenses. These changes promote development of the metabolic syndrome, which is a collection of diseases including obesity, Type 2 diabetes, hyperlipidemia, fatty liver disease, coronary artery disease, high blood pressure and a proinflammatory state.

Stress itself can also produce real digestive diseases, including gastrointestinal reflux/heartburn (GERD), peptic ulcer disease (PUD) and irritable bowel syndrome (IBS). During population-wide stressful events such as the London air raids of WWII, prisoner of war camps during the Vietnam war and the Great Hanshin-Awaji Earthquake Disaster of 1995, increases in peptic ulcer disease and perforations were reported.

Several studies link irritable bowel syndrome (IBS) with higher rates of mental illness compared to the general population. A history of physical or sexual abuse is present in up to 44 percent of people with IBS, suggesting that a significant stressful event can have lasting effects on digestion.

Whether a large-scale traumatic event or minor stresses of your job, there’s no denying that your brain and your gut are linked — and it’s important to take care of both.

Diagnosing and treating stress-related digestive symptoms

The interplay between psychological underpinnings of stress and the medical disorders that can result make treatment of digestive distress complex. Often, psychological treatments are used in combination with medical treatments. These might include psychotherapy, cognitive behavioral therapy, hypnosis or anti-anxiety medications.

Before assuming your symptoms are stress-related, it’s important to consult with a physician to rule out serious or life-threatening diseases like inflammatory bowel disease, infection or colorectal cancer. Whether stress-related or not, a doctor can help you find relief.

Find a digestive specialist near you.

About the Author

Katerina Wells, MD, is a colorectal surgeon on the medical staff at Baylor University Medical Center. She specializes in the management of colon and rectal cancer and in the management of benign colon and rectal diseases. She also treats patients with pelvic floor dysfunction and inflammatory bowel disease (IBD). 

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