Digestive Health Irritable Bowel Syndrome IBS With Diarrhea How Stress and Anxiety Cause Diarrhea When stress goes to your stomach and gut By Barbara Bolen, PhD Barbara Bolen, PhD Twitter Barbara Bolen, PhD, is a licensed clinical psychologist and health coach. She has written multiple books focused on living with irritable bowel syndrome. Learn about our editorial process Updated on November 27, 2022 Medically reviewed by Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD, is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Gut Reactions to Stress IBS and Diarrhea What Can You Do When to See a Healthcare Provider Frequently Asked Questions A wide variety of situations can cause diarrhea, including stress and anxiety. This is because of the physical changes that occur in your body when you are feeling stressed out. This article explains why diarrhea may occur with stress and anxiety and what strategies you can use to avoid this unpleasant and unwanted physical symptom. Verywell / Joshua Seong Gut Reactions to Stress Experiencing diarrhea when you are stressed is directly related to your body's programmed stress response. This response is called the "fight-or-flight" reaction. What Is Fight-or-Flight? The fight-or-flight reaction is an acute response to stress. When you experience this reaction, your body is responding to a perceived threat. The body reacts with a cascade of physical changes that result from the activation of the sympathetic nervous system, resulting in an increased heart rate, respiration, blood pressure, and decreased digestion. The fight-or-flight reaction did a great job in helping humans survive as a species, particularly back when people faced things like hungry lions. But this same reaction has become more troublesome in modern times, when many of our stressors are not acute, but ongoing. When you come across something that you perceive as threatening, your body reacts with various physical changes, including digestive changes. For example, when your stress response is activated, your digestion slows so that your body can redirect resources elsewhere. During this reaction, the gut and small intestine slow, but the colon's activity increases, and as a result, you might experience gastrointestinal (GI) symptoms, including diarrhea. Recap The fight-or-flight response causes changes in the body, including digestive changes like diarrhea. IBS and the Stress Response IBS and Diarrhea People who have irritable bowel syndrome (IBS) can readily attest to stress's effect on their digestive system. However, it is possible to also experience stress-triggered diarrhea without having IBS. IBS is a syndrome that involves recurrent bouts of abdominal pain and significant and ongoing problems with diarrhea or constipation. Doctors diagnose IBS according to specific criteria known as the Rome criteria. Diagnosing IBS includes a physical exam and tests, which may include: Blood tests Fecal testing Allergy testing Imaging tests of the intestine or colon (like a colonoscopy or sigmoidoscopy) If stress-related diarrhea only happens once in a while, you are likely having a natural stress reaction. However, if it happens pretty frequently, you should make an appointment with your healthcare provider for a proper diagnosis, as other health conditions can cause you to experience diarrhea when under stress. Recap Sometimes, but not always, stress can trigger IBS. For example, if your diarrhea is frequent and recurrent, a doctor may want to confirm if IBS is the cause. Diagnosis may include blood tests, fecal testing, allergy testing, and imaging tests. What Can You Do You do not have to tolerate anxiety-triggered diarrhea. There are a variety of stress management techniques you can use to help your body become more resilient in its response to outside stressors. If you are under significant stress a lot of the time, take an objective look at your life to see if you can make any changes to reduce your overall stress level. In addition, some day-to-day mindfulness habits may help. Yoga and Meditation Two activities that may reduce your body's baseline anxiety level are yoga and meditation. Regularly practicing one or both of these might help you deal more effectively with the stressful situations in your life. Relaxation Techniques There are also some relaxation techniques that you can use "on the spot" to help your body turn down the stress response. Doing so might quiet down your bowels, sparing you from further diarrhea episodes. These techniques include: Visualization Deep breathing exercises Muscle relaxation exercises Like all skills, these relaxation exercises are more effective when practiced regularly. Psychotherapy It may be helpful to initiate some psychotherapy to help you better manage the stresses and challenges that are contributing to your stress-induced diarrhea. When to See a Healthcare Provider Even if you are relatively sure that stress is the culprit, you should discuss any unusual physical complaint with your healthcare provider. Doing so will help ensure that no other health condition is contributing to the problem. Seek immediate medical attention if you experience any of the following: Blood in stools or any sign of rectal bleeding Dehydration Fever over 102 F or fever that lasts more than three days Rectal bleeding Severe abdominal pain Summary Stress can sometimes lead to diarrhea. That's because part of the fight-or-flight response involves diverting energy from the digestive tract to elsewhere in the body. Sometimes, this can result in symptoms like diarrhea. In addition, stress can sometimes trigger diarrhea in IBS. If you experience diarrhea frequently, you should see a healthcare provider to confirm whether or not health conditions may be contributing. A Word From Verywell Diarrhea can be an inconvenient and embarrassing problem. But, there are some things you can do if you experience stress-induced diarrhea. Lowering your stress may be easier said than done, but things like yoga, meditation, relaxation techniques, and psychotherapy can help. Also, if you have frequent bouts of stress-induced diarrhea, be sure to contact a healthcare provider to rule out other health conditions. Frequently Asked Questions Can anxiety and stress cause vomiting? Yes, severe anxiety and stress can cause nausea and in some cases vomiting. Stress can also lead to bloating and other types of stomach discomfort. Can stress lead to constipation? Yes, stress can lead to constipation. The exact reason for this is not conclusive, but it is theorized that stress affects the brain-gut axis, which in turn changes gastrointestinal functions to cause constipation. The brain-gut axis is a communicative link between the brain and digestive system that allows for bodily information to be exchanged. Are there diseases caused by stress? Yes, there are certain diseases that have been linked to chronic stress, including heart disease, headaches, skin conditions, autoimmune disorders, as well as several gastrointestinal disorders. 9 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Chang Y, El-Zataari M, Kao J. Does stress induce bowel dysfunction? Expert Rev Gastroenterol Hepatol. 2014; 8(6): 583–585. doi:10.1586/17474124.2014.911659 American Psychological Association. APA Dictionary of Psychology: Fight-or-Flight Response. Bringham Young University. Stress and the Digestive System. Lacy B, Patel N. Rome Criteria and a Diagnostic Approach to Irritable Bowel Syndrome. J Clin Med. 2017;6(11):99. doi:10.3390/jcm6110099 Korzenik J. Don't Worry, Be Happy: Psychological Interventions in Inflammatory Bowel Disease. Gastroenterology. 2019;156(4):856-857. doi:10.1053/j.gastro.2019.02.013 Ghassemi KA, Jensen DM. Lower GI bleeding: epidemiology and management. Curr Gastroenterol Rep. 2013;15(7):333. doi:10.1007/s11894-013-0333-5 American Psychological Association. Stress Effects on the Body. Devanarayana N, Rajindrajith S. Association between Constipation and Stressful Life Events in a Cohort of Sri Lankan Children and Adolescents. Journal of Tropical Pediatrics. 2010;56(3).144–148. doi:10.1093/tropej/fmp077 Carabotti M, Scirocco A, Maselli MA, Severi C. The gut-brain axis: interactions between enteric microbiota, central and enteric nervous systems. Ann Gastroenterol. 2015;28(2):203-209. PMID:25830558 Additional Reading Chang L. The Role of Stress on Physiologic Responses and Clinical Symptoms in Irritable Bowel Syndrome. Gastroenterology. 2011;140(3). doi:10.1053/j.gastro.2011.01.032 National Institute of Diabetes and Digestive and Kidney Diseases. Diarrhea. Sarna SK. Colonic Motility: From Bench Side to Bedside. San Rafael: Morgan & Claypool Life Sciences. By Barbara Bolen, PhD Barbara Bolen, PhD, is a licensed clinical psychologist and health coach. She has written multiple books focused on living with irritable bowel syndrome. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit