Anxiety and Diarrhea - What's the Cause and How to Stop It?

Can anxiety cause diarrhea?

We already know the gut-brain connection is strong, and anxiety can take a toll on your digestive system. Panicking that diarrhea might catch you out at the worst possible time can become an endless thought loop in your mind that’s hard to silence—sometimes anxiety about diarrhea can feel worse than the event itself. 

Here’s what’s happening in your body: when you’re anxious, hormones and signals from your brain are entering your digestive tract, causing a chemical imbalance that can interfere with digestion. This can lead to diarrhea and other gastrointestinal (GI) symptoms. If you have IBS or another gut-related condition, it may even trigger a flare-up.

If you’re experiencing both anxiety and diarrhea, it's a good idea to speak to your doctor about your symptoms. They will be able to diagnose what’s going on in your gut and hopefully get to the root cause of the issue. 

While it may solely be related to your anxiety, it's important to check for other conditions as well, such as:

• inflammatory bowel diseases – ulcerative colitis and Crohn’s disease
• diabetes
• overactive thyroid (hyperthyroidism)
• poor absorption of certain nutrients (malabsorption)
• IBS.

Why do stress and anxiety cause diarrhea?

There are a few ways anxiety can trigger diarrhea. 

Firstly, it could be related to your body’s stress response. Anxiety prepares us to confront a crisis by putting our bodies on high alert, which is sometimes known as being in fight or flight mode. Nerve signals from your brain travel through your body in response, and blood flow is diverted away from your abdominal organs. Unfortunately, this is when diarrhea or nausea may kick in.

Emptying your bowels then becomes the way your body is preparing for survival.

Your digestive system starts working hard to provide more blood flow to other areas like your skeletal muscles. Although your fight or flight response was useful in ancient times, unfortunately, it’s often unnecessary in our modern world.

Another cause of diarrhea relates specifically to IBS.

One study found that people with IBS-D (diarrhea) had higher levels of inflammatories that could affect the way the digestive tract absorbs water in stools. When you experience more stress, it can lead to higher amounts of this compound. This can prevent your body from absorbing water, eventually leading to watery, loose stool.

If you also experience abdominal pain with diarrhea, it might be IBS—this is the time to speak to a doctor about your symptoms.

What is irritable bowel syndrome?

IBS is a gastrointestinal disorder. Sometimes it might not feel this way, but it is considered ‘functional’. This just means it’s not life-threatening, and there’s no underlying physical disease. Essentially, IBS is a disorder of the gut-brain connection. And it’s commonly seen in people with anxiety disorders and depression. 

IBS symptoms should never be underestimated. Many are very real—and distressing. 

Common IBS symptoms include:

• diarrhea or constipation

• abdominal pain (which is often relieved by passing a bowel motion or wind)

• abdominal bloating

• cramping.

IBS itself isn’t uncommon: it affects one in seven people globally. Though it is more common in women. 

The cause of IBS isn’t known and a quick-fix cure isn’t an option. It’s thought that environmental factors, such as emotional stress or a change in your routine, may trigger an attack. Anxiety is also closely associated with IBS, both its onset and the worsening of symptoms.   

Diagnosing IBS

IBS is diagnosed by what’s known as the Rome-IV criteria.

This includes recurrent abdominal pain at least one day per week in the past three months. It’s also associated with two or more of the following:

• related to defecation
• associated with a change in frequency of stool
• associated with a change in form (appearance) of stool.

Just keep in mind that while IBS is one of the common links between diarrhea and anxiety, it’s not the only one. Be sure to talk to your doctor for a diagnosis.

Types of IBS

There are three IBS categories. It can all depend on the types of symptoms you’re experiencing. 

• Diarrhea-predominant IBS (IBS-D): you experience diarrhea, usually first thing in the morning or after eating.
• Constipation-predominant IBS (IBS-C): you experience constipation. Abdominal pain and cramping are commonly triggered by eating.
• Mixed IBS (IBS-M): you experience alternating periods of diarrhea and constipation.

If your anxiety is triggering diarrhea, it’s possible you have diarrhea-predominant IBS (IBS-D), which is also the most common form of IBS.

Is diarrhea common with anxiety and stress?

Diarrhea can be a big part of your life if you deal with daily anxiety and stress. In fact, people with anxiety are more than twice as likely to experience diarrhea. 

40 to 60% of people who’ve been diagnosed with IBS also have a generalized anxiety disorder.

‍What is the gut-brain link?

Whether or not you have IBS, anxiety disorders are linked to diarrhea by what’s known as the ‘gut-brain axis’. 

This is the two-way connection between your brain and your bowel, involving nerves, hormones, and gut bacteria. The key component of the gut-brain axis is the enteric nervous system (ENS).

The ENS is often referred to as your ‘second brain’ due to its complexity. It consists of millions of neurons that surround your digestive tract and control digestion. The ENS connects to your central nervous system, brain, and spinal cord—it’s literally affected by processes in your brain.

When you get diarrhea because of anxiety or IBS, it’s a sign your ENS is malfunctioning. And signals controlling motility (the speed of materials transiting through your intestines) are being disrupted, bringing on that urgent need to defecate.

This is why your anxiety may be leading to physical digestive symptoms such as diarrhea.

How to stop anxiety diarrhea

If you’re experiencing sustained, ongoing diarrhea (even without anxiety), you should seek immediate medical help if you have:

• blood in your stools
• rectal bleeding
• a fever that lasts for three days or more
• severe abdominal pain
• vomiting
• rapid weight loss
• bowel movements that don’t relieve pain.

If you don’t have these symptoms, treatments for diarrhea and stress-management strategies can help you feel better. 

Though, it’s still a good idea to chat with your doctor about your treatment options.

Treatments for diarrhea

Rehydrating your body is often priority one for managing your anxiety-related diarrhea symptoms.

Here’s what you can try:

• Rehydration: although not technically a treatment, it’s important to counteract the dehydration in diarrhea.
• Oral rehydration: this will help you replace lost salts and minerals from diarrhea.
• Medications: try anti-diarrheal medications, or antibiotics might help if your diarrhea was caused by an infection.
• Avoid exercise: take a break from your workout as strenuous exercise may lead to further dehydration.
• Fluid IV replacement: this option is for severe cases where rehydrating your body is critical.

You should consult your doctor to confirm the best treatment for your condition, particularly if you think you have an ongoing issue like inflammatory bowel disease. 

Stress-management strategies for diarrhea

As well as treating your diarrhea, implementing stress-management strategies may help relieve some of your anxiety, which could be the root cause of your symptoms. 

These techniques and treatments will work to prevent your body from being triggered by outside stressors. 

Here are some ideas:

Cognitive Behavioral Therapy (CBT) 

CBT can help you identify thoughts that generate anxiety. And you’ll learn how to change your behavior to respond differently in anxiety-provoking situations. CBT can lessen anxiety and improve your gastrointestinal symptoms.

Hypnotherapy

First you’ll undergo a hypnotic induction. Then, suggestions are made to address your thought patterns that are associated with anxiety. Hypnotherapy has been proven to be at least as effective as CBT for treating anxiety disorders and IBS. You can try hypnotherapy through a mobile app like Nerva or in-person with a hypnotherapist.

Mindfulness meditation 

This practice of focusing awareness on the present moment has been shown to reduce anxiety and stress. IBS symptoms such as abdominal pain and bloating in particular could improve with mindfulness meditation.

Yoga 

Practicing yoga can relieve stress and also specific symptoms of diarrhea-predominant IBS. And research has shown yoga can be more effective in relieving symptoms than anti-diarrheal medication.

Lifestyle adjustments to improve diarrhea

Over a more extended period, there’s a range of lifestyle adjustments you can make that will help prevent diarrhea symptoms. 

These include:

• staying hydrated
• avoiding alcohol and tobacco
• getting regular exercise
• considering a low FODMAP diet
• ‍prioritizing sleep
• taking probiotics‍.

Scientific insights into anxiety and diarrhea

Researchers have recently illuminated some fascinating links between your brain and gut. These insights are helping us better understand the connection between diarrhea and anxiety.

Anxiety increases the speed of transit of food through your gut

‍One study showed that generalized anxiety disorder (GAD) causes physical changes to your digestive system. In anxiety patients, the transit of food from mouth to rectum was found to be 14 hours on average. This is much faster than the 42-hour average in the control group. 

Therefore, this research demonstrates that anxiety can physically alter the speed at which food passes through your intestines, which is one more explanation for the link between diarrhea and anxiety.

Online hypnotherapy reduces IBS symptoms

‍Researchers found that IBS symptoms improved in 65% of subjects who received hypnotherapy delivered online. This was just slightly lower than the 76% of people who improved their IBS after face-to-face treatment. 

With the Nerva program, 89% of users reported better managed gut symptoms after six weeks of at-home hypnotherapy.

The Wrap Up

Your nervous system and stomach are intimately linked. It’s possible that experiencing anxiety can trigger a flare-up of diarrhea. Anxiety and diarrhea may also be a sign of IBS. If you experience diarrhea or other IBS symptoms and mental health conditions such as anxiety disorders, there are treatments available to help you manage stressful situations and improve your anxious stomach. Relaxation techniques may help improve your gastrointestinal symptoms and tame your upset stomach, with digital hypnotherapy like Nerva being especially beneficial.