Can Stress Cause Diarrhea? How Anxiety or Nervousness is linked to Diarrhea & Stomach Pain

Can stress cause diarrhea? How does anxiety, nervousness or stress relate to watery feces and stomach pain? What are the mechanisms behind it? Read on to find details in kids, toddlers, adults and ways to prevent and cure diarrhea-induced type of tension or worry.

Nervousness, Anxiety Stress and Diarrhea-what is the Link?

Stress offers an acute threat to the normal function of the body (homeostasis). It is the mechanism through which owing to the environmental demands, an organism is forced to increase its adaptive capacity. This may result in biological and psychological changes. Stress is a response to a stimulus; stressors.

How does/can stress cause diarrhea and stomach pain? prevention and treatment
Stressed individual

Mechanism of stress

To understand how the body responds to a stressor, the mechanism through which stress occurs should be understood.

Stress may be of environmental, biological or psychological origin:

  1. Environmental stress – this involves environmental situations and experiences that require enhanced adaptive demands.
  2. Biological stress – results from emphasis on up regulated physical demands of the body with psychological influence.
  3. Psychological – results from self-perception with regards to your ability to adapt and cope to certain demands at different situations. 1 Jansen M. Emotional disorders

With presentation of such stimuli (stressors), there arises an interaction with the adaptive changes in the body. This increases the susceptibility of an individual to illnesses of varying types.

However, effects of stress varies from person to person based on genetic predisposition, personality, social support and therapy. You perceive to be ‘stressed’ upon belief that you cannot effectively deal with the situation at hand or lack the necessary resources. This emotional cause of stress creates a clear cut line between rates of susceptibility.

Eustress, Distress and Relation with Diseases

Stress is however not all negative. ‘Eustress’ is a term coined for the body’s tolerance to stress by using it to overcome lethargy and improve overall performance. It provides a challenge and a positive perspective towards nerving situations.

It warns, motivates and increases your strength. It is also responsible for positive or negative feedback mechanisms in the body in maintaining the normal functioning of the body. It warrants optimal health. When stress is not tolerated, but instead becomes disturbing, tiring and confers a negative effect in behaviour or physique, then call it distress. It causes sub-standard performance. 2 Oxford University Press; 1995.

Stress is what you meet every day as expectations drive your motives. Life is all stressful! But one thing for sure, it places you in the way of opportunistic diseases. Such diseases include, gastrointestinal diseases such as peptic ulcer disease (PUD) and ulcerative colitis (UC), migraine headaches and diabetes. This piece of information focuses on its effect on the gastrointestinal diseases.

Stress and the Gut

The whole digestive system can be put up in an uproar once a cascade of hormones are unleashed upon stress of the brain. These hormones have different and at times contradicting functions.

Mechanism 1

The Brain-Gut Axis – there lies an appreciable interaction with the enteric nervous system with the brain. The alterations produced in the brain-gut interactions lead to the development of a broad spectrum of GIT disorders, food antigen-related adverse responses, gastro esophageal reflux disease, ulcerative colitis and peptic ulcer 3 J Gastroenterol Hepatol.

The major effects of stress on the gut include:

  1. Increase in visceral perception
  2. Alterations in gastrointestinal motility
  3. Changes in gastrointestinal secretion
  4. Increase in intestinal permeability to large antigenic molecules.
  5. Negative effects on intestinal normal flora
  6. Reduced regeneration of gastrointestinal mucosa
  7. Negative effects on mucosal blood flow
  8. Increased anti-allergy response such as activation of mast cells. Mast cells result in production of histamine and chemicals that lead to inflammation. This affects the gut physiology.

Mechanism 2

Hormone CRH (short for corticotrophin-releasing hormone). This is one of the body’s alarm bells being pumped out to stimulate the adrenal gland to secrete cortisol and adrenaline. These two offer your enhanced ability to run or fight through a presenting problem. The effects of cortisol include:

  1. Reduction or increase in appetite depending on an individual.
  2. Elevated blood pressure by constriction of the blood vessels
  3. Suppression of immune cell number and activity
  4. Reduced synthesis of brain neurotransmitters

Cortisol and adrenaline are initially produced in the mild stress. Upon failure of the body to resolve the stress response, cortisol is produced in much higher amounts while the production of adrenaline is reduced.

With this understanding the relation in adults, kids and toddlers can be understood.

Adult Stress

In adults, stress is caused by difficult life events, family issues, divorce, overworking, age-related diseases such as psychiatric disorders and failure among many others. The communication between the gut and the brain is therefore both gut-brain and brain-gut related. The unfolding of the events after such interplay result in an array of disorders as stated in the previous sections.

In Japan and China, overworking is a norm and even death resulting from stress-causing overworking has a name – karoshi and guolaosi respectively.4 OSHRC Newsletter

Kids and Toddler Stress

Kid and toddlers are not expected to get stressed but they also do. This is seen in the following situations:

  1. Separation from parents – fear from separation when parents leave for work triggers the brain-gut pathway and even result in a release of cortisol.
  2. Social pressure – toddlers and kids may have a hard time trying to fit in a social setting. Especially that which is new.
  3. Home environment – when the family is unstable, or they are exposed to abuse, they become stressed.
  4. Illness – biological stress may result as the body tries to reinstate its normal functioning and this may cause psychological stress.

These events are all affect the two mechanisms above.

“It is beyond toddlerhood when you get into stress-triggered abdominal pain complaints,” – Chris Tochler, MD, FAAP, a pediatrician, 5WebMD. Therefore ruling out physical causes of stress, observe the child’s response to different stressful situations.

How and Under what circumstances can Stress Cause Diarrhea?

Stress can cause diarrhea when it persists for long without resolve of the underlying issue. This is a case of distress. A Eustress is okay and will not adversely cause gut effects. However, with varying modes of coping with stress and personality among other factors that affect individuals differently, may or may not lead to diarrhea.

Diarrhea is caused by the brain-gut interplay with:

  1. An increase in the colonic permeability to antigens – this may cause a loss in the integrity of the intestinal epithelium (wall). The bacteria also gain access to the cells and exert their toxicity on them such as in the cholera toxin. This has a negative effect on the water balance in the lumen and the cells. Diarrhea occurs.
  2. Immune response against micro biota in the gut causing dysbiosis (imbalance in the population of ‘good’ and bad bacteria). This imbalance pre-exposes the gut wall to the bacterial toxins as they adhere without competition from the ‘good’ bacteria. Diarrhea may result from the exposure to the toxins.

Stress can cause diarrhea for two weeks. This is very dangerous as you will be very dehydrated probably admitted by then.

Stress can cause diarrhea with stomach cramps – if the balance in the gut normal flora is disrupted, then exposure to any other opportunistic bacteria such as the E. coli may cause cramping and diarrhea. Cramping may also result from excessive inflammation when the mast cells are activated.

During distress, the amount of cortisol in the body overrides the immune system causing suppression and consequent susceptibility to other bacteria. This ‘other bacteria’ may cause diarrhea and cramping. Parasites may also take advantage of this and cause abdominal pains.

Stress can cause diarrhea and nausea

Nausea generally arises from adrenaline effects. This disrupts the acid, enzymes and normal functioning of the gut. Anxiety also reduces the ability of the gut to properly digest food and cause irritable bowel syndrome (IBS). IBS causes nausea. Stress also increases tension of abdominal muscles. It therefore squeezes the stomach and may lead to retching and nausea.

Stress can cause diarrhea and weight loss

Since the gut is not properly digesting food, nutrients are not completely broken down to easily absorbable products. This causes malnutrition and weight loss. Inflammation of the gut due to activation of the mast cells leads to loss of integrity of the epithelium. This does not allow proper absorption of digested food.

Stress can cause diarrhea during pregnancy

With the lowered immunity and improper diet of most pregnant women coupled with stress, diarrhea is a sure thing.

stress diarrhea pregnancy
Expectant mother

Stress Stomach Pain-How does stress result to Stomach Pain- Symptoms and relief Options


Pain may be caused by reduction in the mucus production in the stomach. This causes corrosion of the stomach wall by the acids. This is mainly caused by constriction of the mucus ducts with adrenaline. Other causes of stomach pain include inflammation of the gut wall that may cause obstruction and pain.


Mainly pain that is localized to the upper part of the abdomen; just above the belly button. The pain may delocalize upwards along the center of the rib cage along the esophagus indicative of gastro esophageal reflux disease.

Anxiety, Stress, Nervous Diarrhea Home remedies, Cure/Treatment

  1. Probiotics – affect the brain-gut interactions. They prevent the development of stress-induced disorders in the gut. These include fermented milk.
  2. Drink water – prevents dehydration and promoted proper digestion that may trigger a vicious cycle of anxiety.
  3. Eating foods that are a ‘see-through’ such as jelly
  4. Take bananas, carrots, rice, toast and applesauce – they bland, soothing and their pectin constituent allows adsorption of excess fluid.
  5. Drink black tea with sugar – this rehydrates and contains an astringent that reduces inflammation (tannins).
  1. OTC medicines – tums, peppermint, and Pepto-Bismol. This are effective against anxiety nausea.

How to prevent Nervous, Stress or Anxiety Diarrhea?

  1. Deep breathes – close your eyes, inhale deeply and exhale slowly. Repeat several times with the arms raising and spreading with each inhalation.
  2. Exercise – walk, jog on the spot, stretching reduces anxiety.
  3. Meditate – this means taking some time each day before or after stressful activity to focus on your breathing.
  4. Take some time off work – distract yourself with other activities that are fun like playing video games or hanging out with friends.
  5. Talk and share – do not suppress stress. Find a friend or a family member who is sympathetic.
  6. Take care of your diet – avoid alcohol; eat enough but not over-eating.
  7. Take on what you can handle

Sources and References

  1. 1  Jansen M. Emotional disorders in the labor force: Prevalence, costs, prevention and rehabilitation.Internat Labor Rev. 1986;125:605–15
  2. 2 Cohen S, Kessler RC, Gordon LU. Strategies for measuring stress in studies of psychiatric and physical disorders. In: Cohen S, Kessler RC, Gordon LU, editors. Measuring stress: A guide for Health and Social Scientists. Oxford: Oxford University Press; 1995.
  3. 3 J Gastroenterol Hepatol. 2005 Mar;20(3):332-9
  4. 4 OSHRC Newsletter More mental disorders or suicide may be certified as occupation-related. 2001 Jan ;( 22):57.
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