Stomach and Digestive Problems, Distress

Written by Jim Folk
Medically reviewed by Marilyn Folk, BScN.
Last updated February 15, 2025

stomach upset anxiety symptoms

Stomach and digestive symptoms, such as acid reflux, GERD, stomach tightness, bloating, excessive belching, distention, nausea, diarrhea, and so on, are common symptoms of anxiety disorder, including anxiety and panic attack symptoms.

Many anxious people experience stomach and digestive problems and symptoms.

This article explains the relationship between anxiety and stomach and digestive problems and symptoms and what you can do to get rid of them.

Stomach Upset, Discomfort, Distress, Queasy anxiety symptoms common descriptions:

  • a “heavy” stomach
  • a tightness in your stomach
  • abdominal distress, pain, pressure, fullness, discomfort
  • acid reflux
  • an “anxiety” stomach
  • an “empty” feeling in the stomach and stomach region
  • feels like an excess of acidity
  • an uncomfortable fullness in your stomach
  • an uneasiness in the stomach
  • belching, burping, excessive belching
  • bloating, “fullness”
  • burning sensation in the stomach or pit of the stomach
  • heartburn, acid reflux, GERD
  • chronic stomach problems
  • constipation
  • diarrhea
  • distention
  • feel like there is a lump or knot in your stomach
  • feel like you have butterflies in your stomach
  • gas, or being gaseous
  • indigestion
  • Irritable Bowel Syndrome
  • loose stool
  • motion sickness in the stomach feeling
  • nausea (travel-sickness, seasickness, carsickness, airsickness, upsetness in the stomach, unsettled, feeling like you could vomit feeling)
  • slow transit time
  • stomach discomfort or distress
  • unusually loud stomach growling, rumbling, gurgling, and other sounds and feelings
  • unusually strong hunger pangs (which can sometimes lead to nausea and stomach upset)
  • vomiting
  • tension, pressure, pains, and shooting pains in the chest

To name a few.

Stomach distress can also cause erratic and sharp pains to radiate throughout the chest, back, neck, throat, and shoulder blades.

You might experience one, a few, or all of the above symptoms. You might experience the same symptom or symptoms throughout your struggle with anxiety disorder, or they may change and shift over time.

Your symptoms might occur before eating, immediately after eating, not until a few hours after eating, or might persist regardless of when or what you eat.

Stomach distress can:

  • Occur occasionally, frequently, or persistently.
  • Precede, accompany, or follow an escalation of other anxiety symptoms or occur by itself.
  • Precede, accompany, or follow a period of nervousness, anxiety, fear, and stress, or occur "out of the blue" for no reason.
  • Range in intensity from mild, to moderate, to severe.
  • Come in waves where it’s strong one moment and eases off the next.
  • Occur for a while, subside, and then return for no reason.
  • Change from day to day, moment to moment, or remain as a constant background during your struggle with anxiety disorder.

This symptom can seem more noticeable when undistracted, resting, trying to sleep, or waking up.

All the above combinations and variations are common.

To see if anxiety might be playing a role in your symptoms, rate your level of anxiety using our free one-minute instant results Anxiety Test, Anxiety Disorder Test, or Hyperstimulation Test.

The higher the rating, the more likely anxiety could be contributing to or causing your anxiety symptoms, including feeling like impending doom symptoms.

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Causes

Medical Advisory

Talk to your doctor about all new, changing, persistent, and returning symptoms as some medical conditions and medications can cause anxiety-like symptoms.

Additional Medical Advisory Information.

Click to read our Medical Advisory

Stress, including anxiety-caused stress, is a common cause of stomach and digestive problems, such as the ones mentioned above. Here’s why:

1. The Stress Response

Anxious behavior activates the body’s stress response, which secretes stress hormones into the bloodstream, where they travel to targeted spots to bring about specific physiological, psychological, and emotional changes that enhance the body’s ability to deal with a threat – to fight or flee. This survival reaction is the reason why the stress response is often referred to as the fight or flight response [1][2].

Visit the “Stress Response” article to learn how it can affect the body.

The stress response causes many body-wide changes, including:

Shunts blood to parts of the body that are more important for survival, such as the brain and muscles, and away from those less important, such as the stomach and digestive system.

The body has only a certain amount of blood, so it has to shunt it around as required. The body accomplishes this shunting action by constricting blood vessels in certain parts of the body, which force blood away, and by dilating blood vessels in other parts of the body, which receive the blood.

Since the stomach and digestive system aren’t vital for immediate survival, they are suppressed until the danger has passed.

The stomach and upper digestive tract stop producing digestive enzymes.

Digestion requires energy. When the stress response is activated, the body stops its digestive process so that its energy can be diverted to those parts of the body required to deal with the threat.

A part of that suspension includes reducing the amount of stomach acid [3][4]. Consequently, your foods aren’t assimilated properly or quickly, causing fermentation and excessive acid-like symptoms.

The lower digestive tract tries to eliminate waste as quickly as possible.

When dealing with a threat, we don’t want to have to stop to go to the bathroom. Doing so could be hazardous to our survival. So, the body works to eliminate waste as quickly as possible after a stress response has been activated so that job is out of the way as we prepare to deal with the perceived threat.

Many anxious people feel an urgent need to use the bathroom when anxious or afraid. Some people even soil themselves when they are terrified.

The stomach muscles that regulate the digestive tract tighten.

Stress causes muscles to tighten, including the muscles that control the digestive tract, including the stomach, so the body is more resilient to harm.

Tightened stomach muscles, however, can interfere with gut motility (the stretching and contracting of the muscles in the gastrointestinal (GI) tract - the body’s rhythmic waves that move food through the intestines). This interference can slow transit time (the time it takes for food to travel through the digestive tract), which can cause many digestive problems and symptoms.

Moreover, tightened stomach muscles can force acid-like symptoms into the esophagus, causing acid reflux and GERD symptoms.

Saliva production is suspended.

Saliva is an important component of healthy digestion. When saliva is suspended due to the activation of the stress response, it can prevent the stomach from properly digesting food.

These are just a few of the many changes caused by the activation of the stress response.

Short episodes of stress can cause short periods of stomach and digestive problems. Chronic stress, however, can cause chronic stomach and digestive problems, including causing one or many of the symptoms mentioned above.

Emotional stress can increase pain sensitivity in the esophagus.

Some research has found that emotional stress increases pain sensitivity in the esophagus, increasing the sensitivity of acid reflux and GERD symptoms [5][6][7].

Chronic stress can reduce pressure in the lower esophageal sphincter.

The lower esophageal sphincter is the band of muscle that keeps the stomach closed, preventing acid from leaking into the esophagus. Chronic stress can reduce pressure on the esophageal sphincter, allowing acid to leak up into the esophagus [8].

An anxiety-activated stress response is a common cause of acute stomach distress.

2. Hyperstimulation

When stress responses occur infrequently, the body can recover relatively quickly from the physiological, psychological, and emotional changes the stress response brings about.

However, when stress responses occur too frequently, such as from overly apprehensive behavior, the body has more difficulty recovering. Incomplete recovery can cause the body to remain in a state of semi-stress response readiness. We call this state “stress-response hyperstimulation” since stress hormones are stimulants.

Hyperstimulation is also often referred to as “hyperarousal,” “HPA axis dysfunction,” or “nervous system dysregulation” [9][10].

Hyperstimulation can cause the changes of an active stress response even though a stress response hasn’t been activated. Chronic stomach and digestive problems are common indications of chronic stress (hyperstimulation) due to the above chronic stress response changes.

Hyperstimulation is a common cause of chronic stomach distress.

3. Other Factors

Other factors can create stress and cause anxiety-like symptoms, as well as aggravate existing anxiety symptoms, including:

Select the relevant link for more information.

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Treatment

When other factors cause or aggravate stomach upset, addressing the specific cause can reduce and eliminate this symptom.

When an active stress response causes stomach and digestive problems and symptoms, ending the active stress response will cause this acute anxiety symptom to subside.

Keep in mind that it can take up to 20 minutes or more for the body to recover from a major stress response. But this is normal and needn’t be a cause for concern.

When hyperstimulation (chronic stress) causes stomach and digestive problems, eliminating hyperstimulation will end this anxiety symptom.

You can eliminate hyperstimulation by:

  • Reducing stress.
  • Containing anxious behavior (since anxiety creates stress).
  • Regular deep relaxation.
  • Avoiding stimulants.
  • Regular light to moderate exercise.
  • Eating a healthy diet of whole and natural foods.
  • Passively accepting your symptoms until they subside.
  • Being patient as your body recovers.

Visit our “60 Natural Ways To Reduce Stress” article for more ways to reduce stress.

Recovery Support members can view chapters 5, 6, 7, 14 and more for more detailed information about recovering from hyperstimulation and anxiety disorder.

As the body recovers from hyperstimulation, it stops sending symptoms, including this one.

Symptoms of chronic stress subside as the body regains its normal, non-hyperstimulated health.

However, eliminating hyperstimulation can take much longer than most people think, causing symptoms to linger longer than expected.

As long as the body is even slightly hyperstimulated, it can present symptoms of any type, number, intensity, duration, frequency, and at any time, including this one.

Since worrying and becoming upset about anxiety symptoms stress the body, these behaviors can interfere with recovery.

Passively accepting your symptoms – allowing them to persist without reacting to, resisting, worrying about, or fighting them – while doing your recovery work will cause their cessation in time.

Acceptance, practice, and patience are key to recovery.

Keep in mind that it can take a long time for the body to recover from hyperstimulation. It's best to faithfully work at your recovery despite the lack of apparent progress.

However, if you persevere with your recovery work, you will succeed.

When you do the right work, the body has to recover!

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Short-term strategies

Even though eliminating hyperstimulation will eliminate chronic anxiety symptoms, including stomach and digestive symptoms, some people have found the following strategies helpful.

However, keep in mind that each person can have a unique symptom experience since each person is somewhat physically, chemically, psychologically, and emotionally unique. What might work for one person might not for another.

  • Take an over-the-counter antacid: Some people have found taking an over-the-counter antacid reduces their stomach distress. I took Gaviscon frequently to help manage my stomach upsetness. It seemed to have worked, for the most part, in settling my stomach.
  • Drink plenty of fluids: Some people have found drinking plenty of fluids to help reduce stomach and digestion irritation.
  • Eat smaller more frequent meals: It seemed the more I ate, the more problems I had. Eating smaller, more frequent meals made things easier. I also found that when I waited four or more hours before I ate, while I felt better initially after eating, my stomach problems were worse about an hour later. Then, they persisted much longer than usual. Eating smaller, more frequent meals reduced the severity of this symptom for me.
  • Avoid high-sugar, high-fat, and highly processed foods. Since these foods are harder to digest, avoiding them can reduce stomach and digestive problems.
  • Pay attention to food combining. Eating healthy foods in the correct combinations can also reduce this symptom. Since not all foods digest at the same time and in the same way, eating the right combination of foods can also make a difference.
  • Pay attention to the activities you undertake after eating. Digestion requires energy. If you’ve eaten a big meal and then go out and undertake a rigorous activity, that could take away from the digestion process. Conserving your energy after you eat can aid in healthy indigestion.
  • Avoid stimulants.
  • Avoid foods high in salt. Salt stresses the body and can aggravate hyperstimulation-caused symptoms, including stomach and digestive symptoms.
  • Avoid foods high in MSG. MSG is a neural exciter, which can stimulate the nervous system and aggravate stomach and digestive problems.
  • Avoid processed fruit juices. Many of the fruit juices we buy today contain high levels of glucose and fructose, which can rapidly boost blood sugar and cause the “spike then plunge” phenomenon.
  • Avoid alcohol. Alcohol adversely affects blood sugar as well as punishes the nervous system. Either of these effects can exacerbate hyperstimulation and its symptoms, including stomach and digestive symptoms.

To name a few.

For more information, including information about your specific situation and circumstances, it's best to work with a Nutrition Science Practitioner, such as Liliana Tosic.

Recovery Support

The Recovery Support area of our website contains thousands of pages of important self-help information to help individuals overcome anxiety disorder, hyperstimulation, and symptoms.

Due to the vast amount of information, including a private Discussion Forum, many of our Recovery Support members consider it their online recovery support group.

Therapy

Unidentified and unaddressed underlying factors cause issues with anxiety. As such, they are the primary reason why anxiety symptoms persist.

Addressing your underlying factors (Level Two recovery) is most important if you want lasting success.

Addressing Level Two recovery can help you:

  • Contain anxious behavior.
  • Become unafraid of anxiety symptoms and the strong feelings of anxiety.
  • End anxiety symptoms.
  • Successfully address the underlying factors that so often cause issues with anxiety.
  • End what can feel like out-of-control worry.

All our recommended anxiety therapists have had anxiety disorder and overcame it. Their personal experience with anxiety disorder and their Master's Degree and above professional training give them insight other therapists don't have.

If you want to achieve lasting success over anxiety disorder, any one of our recommended therapists would be a good choice.

Working with an experienced anxiety disorder therapist is the most effective way to treat anxiety disorder, especially if you have persistent symptoms and difficulty containing anxious behavior, such as worry [11][12][13].

In many cases, working with an experienced therapist is the only way to overcome stubborn anxiety.

Research has shown that therapy is the most effective treatment for anxiety disorder, and distance therapy (via phone or the Internet) is equally, if not more effective, than face-to-face in-person therapy [14][15][16].

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Prevalence

In an online poll we conducted, just over 83 percent of respondents said they had stomach and digestive symptoms because of their anxiety.

The combination of good self-help information and working with an experienced anxiety disorder therapist, coach, or counselor is the most effective way to address anxiety and its many symptoms. Until the core causes of anxiety are addressed – which we call the underlying factors of anxiety – a struggle with anxiety unwellness can return again and again. Dealing with the underlying factors of anxiety is the best way to address problematic anxiety.

Additional Resources

Return to our anxiety disorders signs and symptoms page.

anxietycentre.com: Information, support, and therapy for anxiety disorder and its symptoms, including the anxiety symptom stomach upset.

References

1. Chu, Brianna, et al. “Physiology, Stress Reaction.” StatPearls, 7 May 2024.

2. Godoy, Livea, et al. "A Comprehensive Overview on Stress Neurobiology: Basic Concepts and Clinical Implications." Frontiers In Behavioral Neuroscience, 3, July 2018.

3. Esplugues, J.V., et al. "Inhibition of gastric acid secretion by stress: A protective reflex mediated by cerebral nitric oxide." PNAS, Dec 1996.

4. Leonard, Jane. "What is hypochlorhydria?" MedicalNewsToday.com, 17 July 2018.

5. Song, Eun Mi, et al. "The Association Between Reflux Esophagitis and Psychosocial Stress." Digestive Diseases and Sciences, Sep 2012.

6. Bradley, L.A., et al. "The relationship between stress and symptoms of gastroesophageal reflux: the influence of psychological factors." American Journal of Gastroenterology, Jan 1993.

7. Fass, Ronnie, et al. "The Effect of Auditory Stress on Perception of Intraesophageal Acid in Patients With Gastroesophageal Reflux Disease." Gastroenterology, Dec 2007.

8. Johnson, Jon. "Acid reflux and anxiety: What to know." MedicalNewsToday.com, 21 July 2022.

9. Elbers, Jorina, et al. "Wired for Threat: Clinical Features of Nervous System Dysregulation in 80 Children." Pediatric Neurology, Dec 2018,

10. Teixeira, Renata Roland, et al. “Chronic Stress Induces a Hyporeactivity of the Autonomic Nervous System in Response to Acute Mental Stressor and Impairs Cognitive Performance in Business Executives.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, 2015.

11. Hofmann, Stefan G., et al. “The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-Analyses.” Cognitive Therapy and Research, U.S. National Library of Medicine, 1 Oct. 2012.

12. Leichsenring, Falk. “Is Cognitive Behavioral Therapy the Gold Standard for Psychotherapy?” JAMA, American Medical Association, 10 Oct. 2017.

13. Kingston, Dawn.“Advantages of E-Therapy Over Conventional Therapy.” Psychology Today, Sussex Publishers, 11 Dec. 2017.

14. Markowitz, John, et al. “Psychotherapy at a Distance.” Psychiatry Online, March 2021.

15. Thompson, Ryan Baird, "Psychology at a Distance: Examining the Efficacy of Online Therapy" (2016). University Honors Theses. Paper 285.

16. DISCLAIMER: Because each body is somewhat chemically unique, and because each person will have a unique mix of symptoms and underlying factors, recovery results may vary. Variances can occur for many reasons, including due to the severity of the condition, the ability of the person to apply the recovery concepts, and the commitment to making behavioral change.