If you’ve ever had nervous butterflies in your stomach or gut-wrenching anxiety, you already know that your brain and gastrointestinal tract are in sync. Your nervous and digestive systems are in constant communication.
This relationship is necessary and important for bodily functions, such as digestion. Sometimes, however, this connection can cause unwanted symptoms, like stomach pain, constipation, or diarrhea.
Thoughts and emotions triggered by stress can have an effect on your stomach and bowels. The reverse can also occur. What goes on in your gut can cause stress and long-term upset.
Chronic constipation, diarrhea, and other types of bowel conditions may trigger anxiety, causing a vicious circle of stress.
Whether it’s your brain or your bowels that are steering the stress ship, constipation is not fun. Figuring out why it is happening and what you can do about it may help.
Most of your bodily functions are controlled by the autonomic nervous system, a network of nerves that connect the brain to major organs. The autonomic nervous system contains the sympathetic nervous system, which prepares your body for fight-or-flight emergencies and high-anxiety situations.
It also includes the parasympathetic nervous system, which helps calm your body down after experiencing fight-or-flight. The parasympathetic nervous system also prepares your body for digestion by communicating with the enteric nervous system located in your gastrointestinal tract.
Enteric nervous system
The enteric nervous system is filled with neurons, and is sometimes referred to as a second brain. It uses chemical and hormonal neurotransmitters to communicate back and forth with your brain and the rest of your nervous system.
The enteric nervous system is where most of the body’s serotonin is manufactured. Serotonin helps with digestion by constricting the smooth muscles, which support the movement of food in your colon.
During periods of heightened anxiety, hormones such as cortisol, adrenaline, and serotonin may be released by the brain. This raises the amount of serotonin in your gut, and causes stomach spasms to occur.
If these spasms happen throughout your entire colon you may get diarrhea. If the spasms are isolated to one area of the colon, digestion may halt, and constipation may result.
When you eat, the neurons that line your digestive tract signal your intestines to contract and digest your food. When you’re under stress, this digestive process can slow down to a crawl. If the stress you have is severe or long-term, symptoms such as stomach pain and constipation can become chronic.
Stress can also cause inflammation to occur in your gastrointestinal tract, increasing constipation and worsening existing inflammatory conditions you may have.
Certain conditions that cause constipation can be made worse by stress. These include:
Irritable bowel syndrome (IBS)
There is currently no known cause for IBS, but psychological stress is thought to play a role. A 2014 review of studies cited evidence that stress might contribute to the development, or worsening, of IBS symptoms by increasing or decreasing activity within the autonomic nervous system.
Stress can also cause bacteria in the gastrointestinal tract to become imbalanced. This condition is called dysbiosis, and it may contribute to IBS-related constipation.
Inflammatory bowel disease (IBD)
IBD encompasses several conditions earmarked by chronic inflammation of the digestive tract. They include Crohn’s disease and ulcerative colitis. A 2005 review of scientific studies cited evidence linking stress to flare-ups of these conditions.
Chronic stress, depression, and adverse life events all appear to increase inflammation, which might set off flares of IBD. Stress has been shown to contribute to IBD symptoms, but is not currently thought to cause it.
In true chicken-or-the-egg fashion, IBS and IBD both react to and cause stress. Some experts believe that people with IBS have colons that respond intensely to anxiety, causing muscle spasms, abdominal pain, and constipation.
Major life events have been linked to the onset of IBS, such as:
- death of a loved one
- early childhood trauma
Because the colon is controlled by the nervous system, you may feel depressed or anxious if you have this condition. You may also have anxiety not related to IBS, which can increase symptoms.
People with IBS or IBD may also feel pain more intensely than those without these conditions. That’s because their brains are more reactive to pain signals from the gastrointestinal tract.
It may be a cliché, but when you’re stressed you may be more likely to reach for the double-fudge ice cream instead of a kale salad. Stress and bad food choices sometimes go together. If you’re experiencing stress-related constipation, this can make matters worse.
Try passing up the foods that you know cause problems. It may help to keep a food diary so you know which ones affect you most. Most often the culprits include:
- very spicy foods
- greasy foods
- high-fat foods
Fiber-filled ingredients may be a good choice for some, but for others they may make constipation worse. That’s because they are harder to digest. Try experimenting with healthy foods to see which ones work best for you.
If you have IBS, you may also benefit from eliminating carbonated sodas, caffeine, and alcohol from your diet permanently, or until your symptoms subside.
If stress is causing your chronic constipation, you may benefit most from addressing both issues:
- Over-the-counter laxatives can help reduce or eliminate occasional constipation.
- Lubiprostone (Amitiza) is a medication approved by the U.S. Food and Drug Administration (FDA) for treating IBS with constipation and other forms of chronic constipation. It is not a laxative. It works by increasing the amount of fluid in the bowels, making it easier to pass stool.
- Yoga, exercise, and meditation may all help to alleviate stress.
- Consider talk therapy or cognitive behavioral therapy to help you manage feelings of anxiety and depression.
- If you have IBS, low-dose antidepressants may help reduce feelings of anxiety by affecting the neurotransmitters in both the brain and the gut. These medications include selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs).
- Make healthy lifestyle changes, such as adjusting your diet and getting enough sleep.
Your body is a magnificent machine, but like all machines, it can be sensitive to stressors. Anxiety and heightened emotions can cause or make constipation worse.
If this happens often, talk to your doctor. They may be able to suggest solutions that can help you combat constipation and the stress related to it.