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'Stress belly': how can stress affect your gut and what can you do?
Written byLiz Connor
Reviewed byHeeral Patel
A hectic period at work or home can leave your stomach in knots, causing bloating, diarrhoea and a host of other digestive issues. So, what can be done? A dietician lays down the facts
Summary
1Impact of stress on the gut
“When stress levels rise, digestion tends to slow down. Long-term stress can cause inflammation, weaken the lining of the intestines…”
2Main gut-stress symptoms
“Bloating and abdominal pain, diarrhoea or constipation, butterflies, nausea and appetite changes, indigestion and heartburn…”
3Get back on track
“Try box breathing exercises, inhaling for a count of four, holding for four and releasing for four. This can engage the vagus nerve…”
You’re probably clued up on the classic signs of stress – racing thoughts, shallow breathing, prickly cold sweats – but did you know that too much pressure at home and work could also affect your gut health?
Thanks to a two-way communication pathway between your brain and your stomach, known as the 'gut-brain axis', scientists have discovered that our digestive system could be directly tapped into our stress levels.1
And with research showing that 74% of us have felt stressed to the point of being overwhelmed in the past year, it’s perhaps not surprising that over half of us are regularly experiencing gut health problems too.
If you’ve landed on this article, chances are you’re looking for answers. That’s why we asked Aleks Jagiello, Doctify-rated registered dietitian, to break down how stress affects your gut, and what you can do to manage it.
How does stress impact the gut?
First things first, it’s important to establish how the gut and stress are linked. “When we feel stressed, the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic nervous system, better known as your body’s ‘fight or flight’ response, releases stress hormones like cortisol and adrenaline into your system,”2 Aleks explains.
These hormones can disrupt the delicate flow of digestion in a variety of ways. “Stress can suppress muscle contractions, slow the release of digestive enzymes and interfere with the communication between the brain and gut,”3 Aleks notes. So when stress levels rise, digestion tends to slow down.4
If stress continues long-term, it can have more serious effects on gut health. “It can cause inflammation, weaken the protective lining of the intestines and increase gut permeability,5 leading to a health issue some people call ‘leaky gut’, where harmful substances can freely pass through the gut lining and trigger inflammation,” warns Aleks. Leaky gut, however, is not a medical diagnosis, and if you have these symptoms it’s important to get it checked out by a GP.
Added to this, the gut-brain connection can also mess with the gut microbiome – the trillions of bacteria in our intestines that help with digestion and immunity. “Studies on rats6 have found that stress reduces the beneficial gut bacteria lactobacillus, which plays a key role in reducing inflammation and protecting the gut barrier,” explains Aleks.
While human research in the same field is still emerging, one study7 found that university students had lower levels of lactobacillus in their stool during exam season, suggesting that even everyday psychological stress may disrupt the delicate balance of gut bacteria in our bods.
What are the main gut-stress symptoms to look out for?
If you’ve ever had a stomach ache right before delivering a high-pressure work presentation, you already know that stress and digestion are closely linked. But according to new studies, stress may even trigger a range of gut symptoms, including:
- bloating and abdominal pain: “Many people describe their stomach feeling ‘in knots’ when they’re anxious, which is caused by muscle tension and slower digestion,” explains Aleks. Stress was also found to trigger gut spasms, creating extra cramping and discomfort in people with IBS
- diarrhoea or constipation: “For some people, stress speeds up digestion, which leads to diarrhoea. For others, it slows things down, causing constipation,”8 she adds
- butterflies, nausea and appetite changes: that fluttery feeling in your stomach when you’re nervous is actually a type of mild stress response,9 with stronger stress causing nausea and even vomiting in extreme cases. “Some people lose their appetite, while others find themselves stress-eating for comfort,” adds Aleks
- indigestion and heartburn: according to Aleks, “stress10 can worsen indigestion, causing an unsettled, gassy or burning feeling in the upper abdomen.” It can also increase stomach acid production11 and affect the esophagus’s barrier, making it more vulnerable to acid reflux
- an increase in gas: when you’re panicking, you tend to breathe in rapidly, which can cause you to swallow extra air. “Stress can also alter the bacterial makeup of the microbiome, increasing fermentation in the gut and causing more gas,”12 explains Aleks
- IBS and IBD flare-ups: “For people with chronic digestive conditions like IBS or IBD, stress is a well-known trigger,”13 she adds. If you have IBS, you may notice more bloating, cramping, diarrhoea or constipation14 during busy periods at work
Feeling stressed? 5 top tips for getting your gut back on track
- Activate your ‘rest and digest’ response
Since your panicky ‘flight or fight’ response puts the brakes on digestion, it makes sense that actively trying to put your body into its opposite state, ‘rest and digest’, can counteract some of the unpleasant symptoms.8
“Try box breathing exercises, inhaling for a count of four, holding for four and releasing for four,” suggests Aleks. “Slow, diaphragmatic breathing can engage the vagus nerve and switch your body into a calmer state, easing stomach tension.”15 - Book that overdue pilates class
Endorphin-releasing exercise is one of the best stress-busters out there, and it benefits your gut too.16 “Physical activity helps regulate stress hormone levels and releases endorphins that improve your mood and stress resilience,” says Aleks.
“It also stimulates healthy intestinal contractions,” she adds. “Studies17 have found that exercise can relieve constipation and improve symptoms for people suffering from IBS, while also reducing anxiety.” - Don’t skip meals
The timing of your meals can either soothe or stress out your gut. “To minimise the impact of stress, support your digestion with good eating habits,” instructs Aleks. “First, stick to regular meal times and don’t skip breakfast, even when you’re busy or anxious.”
She continues: “Eating at consistent times helps regulate your gut’s internal clock and can prevent IBS flare-ups triggered by erratic eating. Eat slowly and mindfully, chewing well, as rushing or eating on the go can aggravate bloating and indigestion.”18 - Practise five minutes of yoga in the morning
Beyond the basic relaxation routines, certain mind-body techniques specifically targeted to the gut-brain axis have evidence for helping digestive disorders.19
“Yoga and tai chi combine gentle physical activity with breath focus and have been shown to reduce stress, while improving IBS symptoms,” notes Aleks. “Even simple yoga poses20 that relax the abdominal muscles, like child’s pose or supine twists, may relieve tension and bloating.” - Set limits with TikTok
Your overall lifestyle plays a big role in how stress affects your gut, and if you’re burning the midnight oil scrolling on social media, you could be setting yourself up for an unpleasant bout of tummy pain.
“Prioritise eight hours of good quality sleep, as lack of rest is a stressor that can disrupt your gut microbiome and increase cortisol,” Aleks notes. “Poor sleep quality has been linked to GI symptoms, whereas adequate rest helps your body recover and digest properly.”21
The final say
As well as giving the above tips a whirl, working on your general stress management is always a good way of bolstering your gut health.
“If you’re constantly feeling frazzled, finding outlets for emotional stress, whether it’s
talking to a friend, practicing a hobby or spending time in nature can have a big impact on digestion issues,” says Aleks.
Often just sharing your worries can physiologically calm your gut’s stress response, soothing bloating, reducing pain and minimising digestive discomfort in the long run.5
For any pro-longed gut issues or concerns, please speak to your GP to rule out any gut conditions.
This article provides informational advice and is not a substitute for medical care. Curated by experts for accuracy, we take great care to ensure the information is up-to-date and relevant. However, you should always consult your GP or healthcare professional before using supplements or alternative products, particularly if you have medical conditions or are under supervision.
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