Anxiety can cause a number of physical symptoms, including shortness of breath, rapid heart rate, muscle tension, and sweating.
And, perhaps unsurprisingly, it can trigger gastrointestinal (GI) symptoms as well.
"There's quite a bit of evidence that anxiety, worry, and stress can play a major role when it comes to gastrointestinal function," says Ashkan Farhadi, MD, a gastroenterologist at MemorialCare Orange Coast Medical Center in Fountain Valley, California.
Anxiety can impact digestive motility (movement of food through the digestive tract) — either by processing food too fast, leading to diarrhea, or processing it too slowly, prompting constipation, says Dr. Farhadi. It can also increase inflammation, potentially causing or worsening digestive issues, he says. That's why recognizing the role of anxiety and working to reduce its effect can benefit not just your brain, but also your gut.
The connection between the
digestive system and the central nervous system is called the gut-brain axis. This also includes the enteric (intestinal) nervous system and the vagus nerve, a major part of the parasympathetic (rest and digest) nervous system. Messages are sent between them in both directions: The brain informs the gut about emotional shifts via the nerves, while the digestive tract sends messages to the brain about factors like
gut bacteria (microbiome) activity, nutrient absorption, and digestion challenges.
When there's stress or anxiety, hormones and neurotransmitters are released to prime the body for potential threats, which can negatively impact digestive function.
Because the messaging process is bidirectional (meaning it goes both ways), it's possible that anxiety originating in the mind can negatively affect the digestive system, and inflammation or exacerbation of gut symptoms could be a source of anxiety as well, says Farhadi.
"Many times, it's difficult to know which came first, the anxiety or the gastrointestinal difficulties, because they affect each other so much," he says. "Because of that, focusing on habits that reduce anxiety while also supporting gut health tends to be useful."
When anxiety affects the gut, it can result in a number of symptoms, says Rudolph Bedford, MD, a gastroenterologist at Providence Saint John's Health Center in Santa Monica, California. They can include bloating, gas, abdominal pain, loss of appetite, tightness (feeling like your stomach is "in knots"), diarrhea, and constipation, he says.
Research suggests anxiety affects just over 43 percent of people with
reflux conditions, about 32 percent of people with inflammatory bowel disease (IBD), and about 32 percent of people with disorders of gut-brain interaction, such as irritable bowel syndrome (IBS).
Fortunately, there are some strategies that may be able to ease symptoms and support overall health.
Get Regular Physical Activity
When it comes to a tactic that eases both body and mind, physical activity should be at the top of the list, says Dr. Bedford.
"Exercise has been shown to be beneficial in many ways for both gut function and mental health," he says. "It can boost the immune system, lower inflammation, and affect sleep. All of those play a part in both your gastrointestinal system and your anxiety level."
One research review of studies on college students with anxiety found that
aerobic exercise, yoga, and tai chi were effective in improving their symptoms, but the authors stated that exercise should be used alongside treatments like psychotherapy and medication.
Moderate exercise also provides advantages for digestive health. A research review of 231 studies noted that regular moderate-intensity exercise such as walking, cycling, and yoga led to lower inflammation, improved gut barrier integrity, and better gut motility in people with GI disorders. But it also found that high-intensity or lengthy workouts could contribute to digestive symptoms like nausea, diarrhea, and pain.
Focus on Quality Sleep
Poor sleep can sabotage both your mental health and your GI function, says Farhadi. Issues like insomnia, sleep apnea, frequent waking, and inconsistent bedtimes and wake times can contribute to alterations in your gut bacteria, increasing harmful types of bacteria while reducing beneficial kinds. Sleep challenges can also lead to more food cravings and more sluggish digestion, which may exacerbate stress and anxiety.
According to one study, sleeping seven hours or less a night was significantly linked to a higher risk of
anxiety across demographic groups, while sleeping nine or more hours nightly was associated with an increased risk of anxiety in certain groups, including unmarried people and younger adults.
Because of that connection, a good starting point for alleviating both anxiety and gut issues is to focus on establishing a solid sleep schedule that allows for seven to nine hours of sleep every night, and to stick to it, even on the weekends.
Eat a Mediterranean Diet
“
Mediterranean diet” is an umbrella term used to describe the dietary habits of individuals living in countries along the coast of the Mediterranean Sea, including Greece, southern France, Crete, Spain, and parts of the Middle East.
The approach is primarily
plant-based with some fish, poultry, and dairy products. It's recommended that foods like red meat and sugary treats are limited to just two to three and two servings per week or less, respectively.
Other components include:
- An emphasis on fruits, vegetables, whole grains, beans, nuts, and seeds
- Olive oil as a primary fat source
- Limited consumption of added sugars, sugary beverages, sodium, highly processed foods, refined carbohydrates, saturated fats, and processed meats
- Sticking to low-fat or fat-free dairy products
Eating this way has been shown to
lower inflammation, which is why it's often recognized as a healthy diet for supporting gut health and preventing chronic disease.
One study found that a Mediterranean dietary pattern can also have a positive effect on mental health, including anxiety,
depression, and stress.
Another study found that not only did this dietary approach improve anxiety levels in college students, it also played a part in boosting self-esteem.
Talk With a Mental Health Professional
An estimated 31 percent of U.S. adults will experience an
anxiety disorder at some point in their lives. While everyone experiences anxiety sometimes, those who are diagnosed with an anxiety disorder experience:
- Anxiety that impairs your ability to function
- Reactions that aren’t in line with situations (overreacting)
- An inability to control your anxious thoughts
Types of anxiety disorders include:
- Generalized anxiety disorder (GAD)
- Social anxiety disorder
- Panic disorder
- Separation anxiety disorder
- Agoraphobia, or fear and avoidance of certain places or situations
- Specific phobias, or fears
- Selective mutism, or declining to speak in situations that cause anxiety or fear
"Addressing the potential root of your anxiety is an important aspect of managing your mental health as well as anything that might be going on with your gastrointestinal health," says Farhadi.
Connecting with a therapist, social worker, psychologist, or psychiatrist can be a helpful starting point in getting the support you need, he says.
Get Evaluated for Underlying Conditions
If you've been trying lifestyle changes that include getting more physical activity, improving sleep quality, and eating a healthy diet but you're still struggling with anxiety and gut issues, it can be helpful to check in with your health provider to see if there may be an undiagnosed condition in play, says Bedford.
"You may think your digestive problems are a result of anxiety, when in actuality they might be connected to something else like inflammatory bowel disease or another condition like irritable bowel syndrome," he says. "Often, if those conditions are managed effectively, it can improve mental health and mood as well."
Talk to your doctor about the situation, especially if symptoms have worsened over time.
