Diarrhea is often seen as a purely physical condition, but it can also be a distressing symptom of anxiety. This guide will explain the link between anxiety and diarrhea, focusing on the physiological reasons behind this connection. It will also show you how to manage and reduce the occurrence of diarrhea when you’re feeling anxious, helping you maintain better digestive health.
The link between anxiety and diarrhea
Recent research has shown that anxiety can cause diarrhea. This happens through various mechanisms:
Activation of the fight-or-flight response
- When anxiety triggers the fight-or-flight response, the body releases a flood of adrenaline and cortisol.
- These hormones prepare the body for immediate action but divert energy from non-essential functions like digestion. 1
- The result is increased gut motility—the rapid movement of food through the digestive tract.
- This hurried process prevents normal water absorption, leading to loose, watery stools or diarrhea.
Changes in gut flora
- Chronic anxiety can disrupt the normal balance of gut bacteria, which plays a crucial role in digestion and overall health.
- Stress hormones and anxiety-driven behaviors (like poor diet choices) can encourage the growth of harmful bacteria at the expense of beneficial ones. 1
- An imbalance in these bacteria can lead to inflammation and trigger diarrhea.
Thin intestinal walls
- When you’re anxious, the lining of your intestines can become less effective at avoiding harmful substances. 2
- This condition, known as “leaky gut,” allows bacteria and toxins that should be contained within the gut to enter the bloodstream. 3
- This can trigger inflammation and immune responses that irritate the digestive tract, leading to diarrhea.
Behavioral factors
- Anxiety may alter eating habits, leading to consuming foods that irritate the digestive system or are processed quickly, such as those high in sugar or fat.
- Additionally, anxious individuals might increase their intake of caffeine and alcohol, both of which can stimulate the gut and exacerbate symptoms of diarrhea.
Anxiety and irritable bowel syndrome
Anxiety and irritable bowel syndrome (IBS) often interact in a cyclical relationship, with each condition potentially worsening the other.
The connection between anxiety and IBS
- Anxiety can impact the function of the gastrointestinal (GI) tract, which is especially sensitive to emotional and mental stress. For individuals with IBS, this sensitivity is heightened. 4
- The GI tract is lined with a complex network of neurons that respond to stress hormones released during periods of anxiety.
- This can trigger IBS symptoms such as abdominal pain, diarrhea, constipation, and bloating.
How anxiety worsens IBS
- Stress response: Anxiety activates the body’s stress response, which can increase gut motility and fluid secretion, leading to diarrhea or constipation typical in IBS flare-ups. 5
- Gut sensitivity: People with IBS often feel pain and discomfort in their gut more easily, and anxiety can make this worse, causing stronger feelings of cramping and bloating.
- Mind-gut connection: The brain and the gut are directly linked via the enteric nervous system, often called the “second brain.” Anxiety can disturb this connection, leading to dysregulation of gut function and worsening IBS symptoms.
How do you know your diarrhea is caused by anxiety?
Determining whether your diarrhea is caused by anxiety involves looking at several factors and symptoms:
Symptoms of anxiety-induced diarrhea
- Timing: If you experience diarrhea during periods of high stress or anxious episodes, it could be linked to anxiety.
- Associated symptoms: In addition to diarrhea, you might experience other symptoms of anxiety, such as increased heart rate, sweating, nervousness, or rapid breathing.
- Absence of other causes: If you don’t have a dietary or infectious reason for your diarrhea and it occurs alongside anxiety or ongoing stress, it’s likely linked to your mental health.
Keep a symptom diary
- Tracking your episodes of diarrhea and noting when they occur along with your anxiety levels can provide clear patterns that help identify anxiety as the cause.
- Recording what you eat and drink can help determine if certain foods or beverages trigger both anxiety and digestive issues.
See a doctor
To confirm that your diarrhea is linked to anxiety disorders, discuss your symptoms with a healthcare provider. They can rule out other potential causes like food intolerances, infections, or chronic digestive conditions through:
- Medical history: Share detailed information about your symptoms, diet, and stress levels.
- Physical examinations: Doctors may perform tests to exclude other digestive disorders.
How to treat diarrhea from anxiety long-term
Treating chronic diarrhea caused by anxiety over the long term involves a combination of lifestyle adjustments, therapeutic interventions, and potential medical treatment, in which case you must see a doctor.
Lifestyle modifications
- Stress management: Engage in regular stress-reducing activities like yoga, meditation, or deep-breathing exercises. These practices can help lower anxiety levels and reduce the frequency of stress and diarrhea.
- Regular exercise: Physical activity can alleviate stress and improve overall digestive health. Aim for at least 30 minutes of moderate exercise most days of the week.
- Balanced diet: Avoid foods that trigger your symptoms. Incorporate fiber-rich foods and probiotics, and stay hydrated to support digestive health.
Therapeutic approaches
- Cognitive Behavioral Therapy (CBT): This therapy helps manage anxiety by changing negative thought patterns and behaviors. It’s effective in reducing anxiety symptoms and can indirectly help control diarrhea.
- Mindfulness and Relaxation Techniques: Techniques like guided imagery, progressive muscle relaxation, or mindfulness can reduce stress and anxiety, helping to stabilize the digestive system.
Medical interventions
- Medication: Anti-anxiety medications or antidepressants may be prescribed by your healthcare provider to help manage your anxiety levels, thereby reducing instances of diarrhea.
- Consult a Gastroenterologist: If diarrhea persists, a specialist can provide targeted treatments and rule out other gastrointestinal conditions.
Support and counseling
- Support groups: Joining a support group for people with anxiety or digestive disorders can provide comfort and practical advice on managing symptoms.
- Psychological counseling: Regular sessions with a mental health counselor can be beneficial in dealing with the root causes of anxiety and developing coping strategies.
- Keep a symptom diary: Track both your anxiety and diarrhea episodes to identify patterns and triggers. This information can be invaluable for adjusting treatment plans effectively.
- Regular follow-ups: Regular check-ins with your healthcare providers are important to monitor progress and adjust your treatment plan as needed.
Final thoughts
Dealing with anxiety-induced diarrhea can be challenging, but you don’t have to face it alone. Tailoring your lifestyle, exploring therapeutic options, and considering medical advice are key steps toward relief.
If you struggle to manage these symptoms alone, don’t hesitate to seek professional help. Contact us to discuss how we can help you address your anxiety and improve your overall well-being. Together, we can find the right approach to improve your mental and digestive health.
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Sources
- 1. McEwen, B., & Sapolsky, R. (2006). Stress and your health. The Journal of Clinical Endocrinology & Metabolism, 91(2), E2. https://doi.org/10.1210/jcem.91.2.9994
2. Kozlov, M. (2024). How does chronic stress harm the gut? New clues emerge. Nature. https://www.nature.com/articles/d41586-024-00188-4
3. Camilleri, M. (2019). Leaky gut: Mechanisms, measurement and clinical implications in humans. Gut, 68(8), 1516-1526. https://doi.org/10.1136/gutjnl-2019-318427
4. Sibelli, A., Chalder, T., Everitt, H., Workman, P., Windgassen, S., & Moss-Morris, R. (2016). A systematic review with meta-analysis of the role of anxiety and depression in irritable bowel syndrome onset. Psychological Medicine, 46(15), 3065–3080. https://doi.org/10.1017/S0033291716001987
5. Wilkinson, J. M., & Gill, M. C. (2021). Irritable bowel syndrome: Questions and answers for effective care. American Family Physician, 103(12), 727-736. https://www.aafp.org/pubs/afp/issues/2021/0615/p727.html