Stress and Diarrhea: What’s the Link?

Perhaps you’ve felt an overwhelming sense of nausea or “sick to your stomach” after hearing bad news. Or maybe you’ve felt a flutter in your belly or “butterflies in your stomach” when you were nervous about something. If so, you are not alone. That’s because there is a link between emotions and the digestive system.  

The digestive system has so many nerve cells that it is called the second brain, or the enteric nervous system (ENS). This means the gut responds to the same experiences and emotions that the brain does. Turns out, up to 600 million nerve cells line our entire gut. Scientists are learning more about the links between our brain and digestive system. This is called the brain-gut axis. 

What is stress?

Stress refers to a feeling of physical or emotional tension. It’s usually brought on by something that you are worried about or that your body perceives as scary.

Stress is not always bad, especially if it is short lived. It is a normal response that can help you quickly respond to a threat. When you feel stressed, it triggers a flight-flight-freeze response in your body. This causes a release of adrenaline and cortisol, the hormones that prepare your body for danger. 

Can stress affect your bowels?

It is common for your gut to reflect how you are feeling. And if you feel stressed, it can influence how you digest your food. For some, stress can cause you to have more stools or even diarrhea. Diarrhea is when you have loose, watery poop three or more times a day. 

Anxiety may cause people with irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD) to have more diarrhea. But stress can also cause diarrhea in people who have no digestive problems at all. 

Why does stress make you poop?

When you have a fight-flight-freeze response, it can affect digestion in different ways. Stress can lead to diarrhea by:  

• Making blood flow away from your gut: In response to stress, your body increases blood flow to your muscles instead. This makes it harder to digest and absorb food. 

• Releasing cortisol and adrenaline: When this happens, your digestive system slows and has a hard time working properly. 

• Changing the types of bacteria that live in your gut: Your gut naturally has many different bacteria in it that help with digestion. High levels of stress over time can lead to more unhealthy bacteria and can affect how you digest your food. 

The relationship between stress and diarrhea seems to go both ways. Stress can not only make you poop, but digestive issues may make you stressed as well. People with digestive conditions like IBD are also more likely to develop anxiety. 

What should I do to treat my stress-related diarrhea?

The best approach is one that focuses on diet and lifestyle. You should:

• Avoid foods that can make diarrhea worse. Common triggers are dairy, alcohol, and fatty foods.

• Find ways to reduce stress. Mindfulness-based techniques like mediation, yoga, and deep breathing exercises can be especially helpful. If your anxiety levels are very high, you might benefit from therapy, with or without treatment with medications. 

• Keep your body hydrated. Drink plenty of fluids like water, clear juice, broth, electrolyte solutions, or tea. In some cases, medications to slow diarrhea may be helpful. 

• Keep track of patterns. If you notice that you get diarrhea every time you have an exam, you might want to start relaxing days in advance. This can help your body deal with stress more effectively. 

When should you worry about diarrhea?

Diarrhea from stress doesn’t last more than a few days. It usually goes away once the stress is gone. 

Sometimes, diarrhea can be a symptom of a more serious medical condition. You should contact your healthcare provider if you have:

• Diarrhea that lasts more than a few days or frequent episodes of diarrhea

• Other symptoms like fever, vomiting, or abdominal pain

• Blood in your stool

• Weight loss

• A family history of IBD, like Crohn’s or ulcerative colitis

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Written by:

Karen Hovav, MD, FAAP

Karen Hovav, MD, FAAP, has more than 15 years of experience as an attending pediatrician in a variety of clinical settings. She has worked in a large academic center in an urban city, a small community hospital, a private practice, and an urgent care clinic.

Edited by:

Kelsey Abkin

Kelsey Abkin has been working as a journalist since 2016. She has held many titles throughout her career, including editor, content strategist, digital strategist, and writer.

Reviewed by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

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