Can anxiety cause diarrhea?

The stresses and travails of everyday life are known to have physical implications for our bodies. The gut and the brain have a strong connection and are linked by many of the same nerves, known as the brain-gut axis. ^[1]

Diarrhea is one such symptom that can be caused by anxiety. Diarrhea is the term for when you need to excrete more than 3 times a day, and when you do, you produce loose, watery bowel movements. ^[1]

If you’re prone to getting diarrhea during stressful situations or events, such as examinations or performances, you are not alone. It can feel uncomfortable and embarrassing, but it is common to experience an upset stomach with anxiety. ^[2]

Why can anxiety cause diarrhea?

Studies dating back to the 1940s indicate that stress can cause stomach cramps, which in turn causes diarrhea. ^[3] This is due to the gut-brain axis – a system connecting your enteric nervous system (ENS) to your central nervous system (CNS).

The ENS aids in the regulation of your body’s gastrointestinal processes, and simultaneously impacts your behavior and emotions due to its link to your CNS. ^[4]

At the onset of stress, your brain sends neurotransmitters to your gut. In some individuals, your gut can respond with physical symptoms such as cramping, nausea, and diarrhea. ^[5]

If you are experiencing prolonged bouts of chronic stress, you may have an anxiety disorder. And, unfortunately, with that you may experience prolonged episodes of stress-related diarrhea. ^[2]

Anxiety and IBS

Irritable bowel syndrome with diarrhea (IBS-D) is a medical condition associated with abdominal pain, bloating and frequent episodes of diarrhea. ^[6]

While many doctors do not believe anxiety is a direct cause of IBS-D, research regularly indicates that IBS commonly occurs alongside anxiety and depression, with roughly 75% of IBS sufferers experiencing depressive and anxious symptoms. ^[6]

Anxiety and stress can exacerbate IBS-D symptoms. As your mood worsens, your gut bears the brunt, due to the neural interplay between the brain and the gut. ^[2]

In turn, IBS-D can cause greater anxiety in sufferers. The constant stress of managing their symptoms or the fear of having an episode in public can prove anxiety-inducing and depressing. ^[6]

Treatment for anxiety and diarrhea

To treat diarrhea caused by anxiety, treating the root cause may help reduce symptoms. Combining mental health treatments with a healthy, balanced diet is the way to go. ^[6] Here are some steps you can take to reduce symptoms:

• Cut out foods that can prove harmful to gut health – Typically, avoiding large amounts of caffeine, spicy foods, and foods containing lactose is advisable. ^[3] All our bodies are different and through working with a dietician, or through trial and error, you can work out what foods your body best responds to.
• Therapy – Talking therapies, such as cognitive behavioral therapy, can help a person identify anxiety inducing patterns and replace them with positive behaviors. Specialists can impart technical expertise to help you manage your condition.
• Wellness practices – Stress-busting activities and relaxation techniques can help a person alleviate symptoms of anxiety. These include yoga, tai-chi, acupuncture, mindfulness and meditation.
• Hypnotherapy – A study showed that hypnotherapy can prove useful in the reduction of IBS-d symptoms, such as bloating and stomach pain. ^[6]

You should consult a doctor if you’ve had diarrhea for two to four weeks without any known underlying cause e.g., bacterial or viral infection. ^[6]

Let the doctor know about any mental health conditions you may have or any other symptoms you’ve been experiencing alongside the diarrhea. They can advise you on next steps.

There are a range of medications and at-home methods to aid in the management of anxiety and soothe the gut-harming symptoms that can accompany it.