The relationship between anxiety and stomach pain is a complicated one. It’s not always obvious how or why mental and physical health relate to each other in such complex ways (this is sometimes termed the mind-body connection).
You might have heard the digestive system or gut described as ‘the second brain.’ and for good reason. The nervous system in our gut shares many of the same features as the brain, containing 500 million neurons and 40 neurotransmitters. Production of the neurotransmitter dopamine (responsible for reward and motivation) is split 50/50 between brain and gut, and the gut actually produces 95% of all serotonin, the mood stabilizing neurotransmitter that also impacts our sleep.
While studies dating back to the 19th and early 20th century showed that the brain and our emotional state can influence the function of the gastrointestinal tract, it’s only more recently that scientists have begun to research how and why the reverse might also be true.
It’s now widely understood that the gut can act autonomously, influencing behavior by sending messages to the brain via the vagus nerve. Many studies now are exploring the role of the gut in mental health issues such as anxiety and depression.
Why does anxiety cause stomach pain?
Let’s rewind a little.
If you’ve ever felt nervous or excited then you’ll already know the stomach responds to these emotions. The language we use to describe this is highly evocative – we might say we have a knot in our stomach or that we have ‘butterflies.’ (Likewise, we might talk about a ‘gut feeling’ or relying on our ‘gut instinct’ to make decisions.)
These physical feelings are one of the ways in which the sympathetic nervous system responds to perceived threats or danger, also known as ‘fight or flight.’ It’s an involuntary response designed to keep us alive by flooding our bodies with adrenaline, the stress hormone that prepares us for mental and physical activity.
Our heart beats faster, pumping more blood through our bodies. Breathing speeds up to increase the amount of oxygen in our lungs and brain. The gut slows down, however, as digestion is not vital to survival in dangerous situations. This all happens instantaneously, sometimes before we’ve even registered there is a threat.
Usually, this process is countered by the parasympathetic nervous system, which resets us back to calmness where our breathing and heart rate slow to a steady and balanced baseline.
For some people, the stress response can be triggered when perceived dangers are not life threatening. For others, that calming reset doesn’t happen, and the sympathetic nervous system remains switched on, causing these feelings almost constantly. This can be a result of trauma, although this isn’t always the case.
If you have experienced trauma or PTSD (Post Traumatic Stress Disorder) and would like to explore treatment options, The Center • A Place of HOPE has experienced specialists that can help you.
What does anxiety stomach pain feel like?
As you’d imagine, this can vary from person to person, but stomach problems are one of the most common symptoms of anxiety. Aside from the other symptoms of anxiety, stomach issues related to anxiety can feel particularly strong and even alarming.
Typical symptoms of anxiety stomach pain include:
- A sudden feeling of nervousness or unease in the stomach
- ‘Butterflies’ in your stomach or a fluttery feeling
- Tightness in the stomach
- Retching or gagging
- Loss of appetite
- Stomach pains
- Twitching muscles
How do I know my stomach pain is related to anxiety?
If it’s not obvious you’re experiencing anxiety-related stomach pain, you might need to play detective. The following steps will help you to get a clearer picture of what is happening.
1. Check if you have any other symptoms of anxiety
First, take our anxiety test to get a benchmark of your likely level of anxiety. If you don’t know much about anxiety as a condition, it’s worth reading up on what anxiety is, what anxiety feels like, and the different types of anxiety.
Think about your life and whether there are any factors you’re finding particularly stressful. This could be anything from work stress, money worries, family issues, or any other situations that cause you worry and stress.
2. Identify the triggers
Keep a diary of when your stomach feels painful, including days and times, what you’ve eaten (including food, caffeine, alcohol), any medications, your mood, and any particularly difficult, scary or important things that are happening for you.
This can help you to notice any patterns (if there are any). Then, you can start to make some changes, one by one, and keep tracking your symptoms.
3. Get an expert opinion
Once you’ve spent time learning more about your particular stomach pain, it’s easier to know who to speak to about improving your symptoms.
For example, if you’ve figured out that your stomach is worse after eating specific food types, you might want to see a nutritionist. They can help you to understand what might be happening and to advise on a course of treatment or make dietary recommendations.
If you have connected your mental health to your symptoms, make an appointment with a therapist or book a call with The Center • A Place of HOPE where we offer whole person care to ensure you are well supported in every aspect of your treatment.
4. Is it a physical condition or is it anxiety stomach pain?
If you don’t appear to have any other symptoms of anxiety, nor any difficult life circumstances, it could be physical.
Speak to your doctor to rule out any other factors that might cause similar symptoms to anxiety stomach pain, such as:
- Irritable bowel syndrome (IBS)
- Stomach ulcers
- Inflammatory bowel disease
- Celiac disease
How can I calm my anxious stomach?
If you’re looking for quick ways to soothe your painful stomach, you could try the following ideas (although please do consider getting professional advice for longer-term issues).
Mint is a traditional remedy that has been proven to help ease gastrointestinal discomfort including indigestion and IBS.
Take it as a soothing tea (it’s a delicious caffeine-free alternative to black tea or coffee), but avoid it if you’re a heartburn sufferer as mint can make this worse. Peppermint is also available as a peppermint oil supplement or peppermint gum also works.
Another traditional remedy that’s been proven to work, ginger is useful for many types of stomach issues, including morning sickness and motion sickness.
Ginger is available in fresh or dried form, and can be ingested as a tea, soda, or in foods such as cookies or gingerbread. It’s also available as a supplement for daily use, and as an oil that can be inhaled or diffused.
Caffeine is a known stimulant that can add to feelings of stress or anxiety. And it’s not just found in coffee. Check the ingredients of any energy beverages you might be drinking, as well as how much chocolate, tea, or soda you’re consuming.
Make sure you’re drinking enough water as this can also impact your mood.
Some stress is necessary, even good for us. Stress hormones are what get us up in the morning, allowing us to perform at our best in work, at school, or in sports.
Chronic stress or long-term stress is when our bodies are in a constant state of stress, and this type of stress is not good for our health. Chronic stress affects our sleep, the relationships we have with others, causes high blood pressure and heart disease, and affects our digestive system.
Finding ways to release stress and learning to let go can be life-changing.
A body scan is a type of meditative practice that helps to reduce stress and quiet the mind, as well as allows you to identify the areas of your body where you’re holding tension.Multiple studies show the beneficial effects of this type of activity on anxiety and stress levels, making it an easy, inexpensive, and convenient method to try.
The benefits of a body scan go beyond improving anxiety and stress levels. It can help with insomnia, chronic pain, quitting smoking, and improving self-compassion.
- A simple body scan practice requires you to sit or lie somewhere comfortable and supportive.
- Close your eyes and begin to deepen your breath (slow it down and start taking deeper belly breaths).
- Begin at the top of your head, observing how it is feeling and whether you can relax your muscles and soften into any sensations you notice.
- Continue down the body, spending a minute or so on each area, taking note of any feelings of discomfort or pain.
- Keep breathing deeply. If any pain arises, use your exhale to release it from your body. If it’s helpful, you could imagine your inhale filling your body with golden light.
- Some distracting thoughts are likely to arise, but don’t worry about this. Just notice them and let them go.
- When you’ve finished scanning your whole body, sit for a minute or two and notice how your body now feels compared with the beginning of your body scan.
- Take a moment before opening your eyes and continuing with your day.
A regular body scan can be a helpful routine to get into as it allows you to get to know yourself better, what’s normal for you, and what helps when things feel out of whack.
If you’d prefer, try following a guided body scan instead.
Improve your gut health
Some studies suggest probiotics have a positive impact on gut symptoms. Probiotics are the ‘good bacteria’ you can buy as supplements from a pharmacy.
Spend time doing the things that calm you. This could be any of the following:
- Time in nature
- Chatting with friends or family
- Walking the dog or cuddling with pets
Abdominal self massage
The University of Michigan recommends this abdominal self massage protocol to help with symptoms of tightness, pressure, cramping, and bloating, particularly when accompanied by constipation.
Can persistent anxiety stomach pain lead to other conditions?
Yes, it can. The two main conditions related to persistent anxiety and stomach pain are Irritable bowel syndrome (IBS) and ulcers.
IBS affects around 11% of the world’s population, causing stomach pain and changes to bowel movements (constipation, flatulence, and/or diarrhea). While the stress of living with IBS worsens mental health for sufferers, studies now suggest that mental health conditions such as anxiety can cause or exacerbate IBS. One study found that pre-existing anxiety or depression doubled a person’s risk of developing IBS.
There is a range of treatments for IBS, including changes to diet and lifestyle, medication, probiotics, and mental health treatment.
Changes in the way the stomach produces acid and protective mucus can erode stomach tissue, causing a stomach or peptic ulcer. Common symptoms of an ulcer include bloating, pain, and heartburn, while less common symptoms include dark stools, coughing or vomiting blood, and weight loss.
A 2013 study found that any anxiety disorder increased the risk of being diagnosed with a stomach ulcer, although the mechanism for this is unclear. Reducing stress is key to managing a stomach ulcer, so lifestyle changes can help as well as changes to diet.
As you can see, stomach pain is caused by a range of different factors, so it’s important to understand why you might be experiencing this condition. If your stomach pain is being caused by anxiety, there are treatment options that can help. Try not to worry as the stress can add to your anxiety which could make things worse.
Support is available. Contact The Center • A Place of HOPE to see how we can help you today.
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