Why do stress and anxiety cause stomach pain?

Many people report feeling stomach pain, cramps, sensitivity, or other discomfort during stressful situations. Stress and anxiety can contribute to short-term stomach pain and other digestive problems. And when they happen over long periods, they can also play a role in chronic conditions.

Stress lead to these types of stomach pain because your brain and gut have a direct connection and can influence one another — if your mind is in knots, your stomach might be, too. 

This gut-brain connection also means that what goes on in your stomach can affect your mental state, so what you eat could influence your mood. 

While you should visit your doctor for any severe, prolonged, or recurring pains, understanding what nutrients your gut needs to be healthy and happy can likewise help you fuel a healthy, happy mind. 

In this article, you will learn why stress causes stomach pain, what lifestyle changes you can make to reduce your stress and anxiety, and how eating for your unique body can help influence stress and your mood. 

How does stress cause stomach pain?

Your brain may get most of the credit for overall control of your body, but the intestines have their own nervous system that is so powerful, it’s sometimes known as a “second brain.” This system is called the enteric nervous system. 

With the largest collection of nerve cells in the body outside of the brain, the enteric nervous system not only controls gastrointestinal functions separately from the brain, but it also produces and responds to the same stress hormones and neurotransmitters that our brains do.

The link between your gut and your brain stems from this system. Even though these two systems function independently, this connection allows your brain to monitor your digestive tract and modify activity within your gut. 

So, if your brain experiences a state of stress, it can communicate that distress to your digestive system and trigger gut-based symptoms like cramping, bloating, or an upset stomach. 

Stress can also alter your gut bacteria. These bacteria can affect your ability to think and regulate emotions, so sustained changes can impact your mood and vice versa.

Long-term stress and the impact it has on your gut can increase digestive tract sensitivity, which in turn can lead to chronic or exacerbated pain in conditions like irritable bowel syndrome. 

Because of the connection between the gut and the brain, some gut-borne diseases may also spread to the brain. 

What does a stress-related stomach ache feel like?

Just as everyone experiences stress differently, they may experience the stomach discomfort it causes differently. 

People with stress- or anxiety-related stomach pain most often complain of a knotted feeling, cramping, churning, bloating, indigestion, nausea, or diarrhea. 

Broadly speaking, stress increases the movement and fluid secretion of your gut, which can leave you feeling like your stomach is either unusually blocked or extra active.  

While acute or chronic stress has the potential to exacerbate the symptoms of any digestive condition, there are a number of specific stomach complaints that have been linked to stress, each with its own symptoms.

  • Irritable bowel syndrome (IBS): Functional gastrointestinal disorders (of which IBS is the most common) affect up to 40% of the world’s population and are characterized by recurring, persistent symptoms like erratic stomach pain or contractions and increased digestive sensitivity. Not everyone experiences IBS in the same way — some people have diarrhea, some have constipation, and others may have both.

  • Inflammatory bowel disease (IBD): In the two main types of IBD — Crohn’s disease and ulcerative colitis — the body perceives food or helpful microbes as dangerous. This triggers a disproportionate immune reaction, which then causes persistent bowel inflammation. Symptoms will vary depending on the type and severity of the IBD.

  • Gastroesophageal reflux disease (GERD): More simply referred to as “reflux” — when acid moves back from the stomach through the esophagus — the most common symptom of GERD is heartburn, a burning pain behind your chest that occurs after you’ve eaten or when you’re lying down or bending over. Other symptoms might include persistent sore throat, chest pain, nausea, burping, or coughing.

4 ways to help reduce stress and stomach pain

According to a poll that tracks negative experiences of people in 115 countries, 2020 was the year the world reached its highest stress peak in over 15 years. Around 40% of the surveyed population reported experiencing significant stress. 

While you should see a doctor if your stomach pain is severe, prolonged, or recurring, there are things you can do to calm a nervous stomach and help reduce the kind of stress and anxiety that could lead to stomach problems. 

1. Mindfulness, meditation, and breathing techniques

Mindfulness, meditation, breathing techniques, and progressive muscle relaxation have all been linked to evoking the relaxation response by reducing anxiety, heart rate, and blood pressure, and improving energy, concentration, and self-awareness. 

This relaxation response is the opposite of your “fight-or-flight” impulse, which is your stress response. When you experience a relaxation response, your body no longer feels threatened by perceived danger, so your brain tells your gut it can safely revert to normal functioning.  

2. Counseling and cognitive behavioral therapy

One of the best ways to reduce stress and its psychological and physiological impact on the body involves learning effective management and coping techniques through counseling or cognitive behavioral therapy (CBT).

These therapies work to identify self-critical, distorted thought, or behavior patterns that cause negative emotions. They then assess which of these patterns might be connected to digestive symptoms and help you develop logic- and science-based strategies for reframing these emotions and physical responses. 

3. Exercise

Exercise doesn’t just have a positive impact on your overall health and well-being. It also provides relief from stress and potentially a protective effect against stress-related ailments. 

In addition to decreasing symptoms of depression and anxiety, cardiovascular exercise can lower cortisol, decrease heart rate, lower blood pressure, and stabilize heart rate variability. 

As with any new exercise regimen, you may want to consult your doctor before getting started, as certain forms or levels of exercise may not be appropriate for your condition. 

For example, in the case of GERD, while exercise that leads to weight loss may improve symptoms in people with obesity or overweight, strenuous exercise may induce more GERD symptoms

4. Diet

With your gut and brain communicating in a two-way system, stress can impact what you eat just as what you eat can impact stress. 

Who hasn’t reached for a pint of ice cream or a big bowl of chips when feeling under pressure? Stress eating often involves ultra-processed foods, which are typically high in sugar and unhealthy fats that can upset your stomach when eaten in excess. 

There’s nothing wrong with a little indulgence, but sticking to a balanced diet filled with a variety of plants will avoid irritating your gut further.

Some studies suggest diets rich in fiber and omega-3 fatty acids may be linked to reduced risk of developing symptoms of anxiety and stress. But more research is needed to confirm these findings. 

Others have found associations between probiotics and improved mood. Probiotics are living microbes — most often found in fermented foods like live yogurt, sauerkraut, kimchi, and miso — that help to increase the diversity of your good gut bacteria. 

This diversity is crucial in supporting your gut microbiome in its functions, including digestion, vitamin production, and immune system health. Your gut microbiome is the collection of all genetic material from microbes in your gut. 

Since your brain is connected to and influenced by your gut, your diet and gut functionality also impact your brain functionality.

At ZOE, we know everyone’s gut microbiome and responses to particular foods are different. There’s no universally perfect diet for everyone, so the best way to find the right diet for your body is to know what your gut needs to be healthy and happy.

An at-home ZOE test can tell you: 

  • which of the 15 “good” and “bad" gut microbes we’ve identified live in your gut

  • which foods are your personal “gut suppressors”

  • which foods are your specific “gut boosters” that may increase the diversity of your “good” gut bugs.


Your brain and your gut are two independent hubs of key bodily functions, but they are in constant communication and can influence each other. If one isn’t feeling well or functioning at its best, the other likely isn’t, either. 

This means that if your brain experiences acute or chronic stress, your stomach can experience many forms of digestive distress, like pain, knotting, cramps, bloating, churning, constipation, diarrhea, or nausea. 

Depending on the severity and persistence of these conditions, you may need to see a doctor, but you can also work to reduce the effect of stress on stomach pain through your lifestyle. 

Focus on effective stress management and quieting your body’s stress response by practicing relaxation techniques, considering counseling or CBT, exercising regularly, and eating a diet filled with diverse, colorful plants.  

Ready to find out which microbes are affecting your health and how you can modify your diet? Take our free quiz to learn how you can eat the best foods for your body.


2020 sets record for negative emotions. (2021). 


A review of dietary and microbial connections to depression, anxiety, and stress. (2018).


Association between dietary pattern and perceived stress. (2021).


Chronic stress, exercise and cardiovascular disease: placing the benefits and risks of physical activity into perspective. (2021). 


Cognitive-behavioral therapy for patients with irritable bowel syndrome: current insights. (2017).


Diaphragmatic breathing for GI patients. (n.d.).


Effects of probiotics on cognitive reactivity, mood, and sleep quality. (2019).


Functional gastrointestinal disorders: advances in understanding and management. (2020.)


Gastroesophageal reflux disease and physical activity. (2006). 


Gastrointestinal hormones and the gut connectome. (2017). 


GI patient center. (n.d.). 


Gut-focused psychological therapy. (n.d.).


Is stress from COVID-19 upsetting your stomach? 7 self comfort tips to try. (2020).


Mechanisms of stress-induced visceral pain. (2018). 


Meditation may relieve IBS and IBD. (2015). 


Mindful eating: a review of how the stress-digestion-mindfulness triad may modulate and improve gastrointestinal and digestive function. (2019). 


Neurotransmitters: the critical modulators regulating gut-brain axis. (2017).


Relaxation techniques to manage IBS symptoms. (2014).


Stress and eating (2013).


Stress and your gut. (n.d.).


Stress effects on the body. (2018).


Stress triggers flare of Inflammatory Bowel Disease in children and adults. (2019).


The association between peptic ulcer diseases and mental health problems. (2017).


The bowel and beyond: the enteric nervous system in neurological disorders. (2016).


The power of the relaxation response. (2008).


Weight loss can lead to resolution of gastroesophageal reflux disease symptoms: a prospective intervention trial. (2013).


What is a functional GI disorder? (n.d.).