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Digestion with mental health issues (e.g. stress and anxiety)

Written by: Fit for Work team | Posted in: Blog

Suffering from ‘butterflies’ in your stomach before a daunting event, like a job interview or a presentation at work, is a well-known feeling for most people. For some, nerves may be ‘gut-wrenching’ or make them nauseous. But these common physical signs of nervousness underline the link between mental stress and anxiety and physical changes in the gut.

The brain and gut have a close two-way connection. When we think about eating, the stomach is spurred into action and releases juices to help break down food, and suffering with stomach pain can be the cause of worry and distress. The link between the brain and the stomach is so important to the working of our bodies that some people refer to the gut as the body’s second brain.

How stress causes digestive problems

  • Fight or flight. Stress and anxiety are believed to activate our innate ‘fight or flight’ instinct, which helped our ancestors escape from dangers, such as wild animals. While the ‘fight or flight’ response heightens the sharpness of the brain, raises our heart beat and diverts extra blood and nutrients to our arms and legs, it balances this by slowing, or even stopping, the workings of the gut. In the short-term, this change could go unnoticed, but enduring periods of stress and anxiety can cause the digestive system to work ineffectively.
  • Acid attack. Stress increases the amount of acid in the stomach, which leads to indigestion and heart burn.
  • Bacteria. The stomach depends on bacteria in the intestine to break down food. An imbalance in the nature of the bacteria can cause digestive problems. Stress may have an impact on this balance of ‘good’ and ‘bad’ bacteria.
  • Sleep. Sleep is crucial to good digestion and it is well known that stress and anxiety can make it harder for some people to get a good night’s sleep.

Physical symptoms of stress

We may not realise the impact that stress is having on our bodies, and we may not even realise that we are suffering from stress or anxiety. These are generally recognised as the most common physical symptoms of stress and anxiety:

  • Digestive problems such as indigestion, heart burn, constipation, diarrhoea or nausea.
  • Problems sleeping.
  • Fatigue.
  • Shallow breath or hyperventilating.
  • Headaches.

Digestive problems caused by stress

In the short-term, stress can cause a number of digestive issues, including:

  • Indigestion and heartburn due to the build-up of acid in the stomach.
  • Stomach pains due to cramping of the stomach muscles.
  • Diarrhoea and constipation due to changes in the speed of digestion.

In the long-term, stress can exacerbate existing conditions, including:

  • Irritable Bowel Syndrome (IBS), which is characterised by stomach cramps, bloating, constipation and/or diarrhoea;
  • indigestion – stomach growls, aches and burns, often accompanied by feelings of bloating, vomiting or nausea;
  • heartburn – when stomach acid rises up the oesophagus (food pipe) and throat and causes a burning pain;
  • stomach ulcers – these aren’t directly caused by stress, but stress could make the stomach more susceptible to infection.

Tips on ways to reduce stress

  • Understand what makes you stressed. It may be your home or work life (e.g. overworking, unrealistic deadlines, etc.) that makes you stressed, but try to identify the triggers that cause your stress and anxiety levels to rise. Once you identify the problem, you can start to find a solution.
  • Talk. Don’t suffer in silence but talk to friends, family or managers about what is making you stressed.
  • Eat well. Eat a healthy well balanced diet and avoid smoking and alcohol. Eat plenty of fruit and vegetables and look at the fibre in your diet. Research the best diets for your specific digestive problems – high fibre diets can be good for some conditions but bad for others.
  • Exercise. Getting out and exercising is fundamental to our health and happiness. Exercising for 30 minutes, five times a week, will make you fitter and improve your digestion.
  • Take breaks and don’t overdo it at the office. Remember to take your lunch breaks and holidays and try to leave the office on time.
  • Make changes. Step out of your normal routine by trying new activities or hobbies. Think of something you have always wanted to do but have never had enough time for. Think about volunteering in your community – giving your time to worthy causes will make you feel good about yourself, teach you new skills and help you to meet new people.


Fit for Work offers free, online, work-related health advice and guidance to anyone looking for advice and support about an existing case of sickness absence, or about issues that may result in sickness absence. Visit the Fit for Work website or call the free telephone advice line on 0800 032 6235 (English) or 0800 032 6233 (Welsh). There is a separate service running in Scotland (0800 019 2211).

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