How to Curb Anxiety-Induced Stomach Pains, According to a Gastroenterologist and Psychologist

stomach pain


For most of your life, you’ve probably observed how your emotions physically manifest in your body. You’ve likely gotten “butterflies” when you spotted your crush in high school, and a “gut feeling” about a decision or a person. Perhaps you’ve felt “sick to your stomach” when you hear some bad news, or experienced digestive issues—like constipation, abdominal tension, or diarrhea—during a stressful time. 

Abdominal Tension

Abdominal tension is the sensation of your stomach muscles tightening, much like cramps. It can be caused by a number of factors such as overeating, smoking and alcohol, anxiety, or certain medications.

While it’s not exactly comfortable, it’s actually completely normal to have stomach symptoms when you’re under stress or experiencing anxiety. And luckily, there are some ways to assuage these uncomfortable issues. We went to experts in mental health and gastroenterology to find out what’s really going on, why it’s happening, and how you can work on soothing an anxious stomach.

The Gut-Brain Connection

Even though the gut and the brain appear far apart, they’re actually closely connected. "The brain and the gut work in conjunction with each other, and they are very much connected by nerves and millions upon millions of neurons sending signals back and forth through the nervous system," explains Dr Niket Sonpal MD, a New York-based gastroenterologist and internist.

These two areas of the body are connected by chemicals known as neurotransmitters, and the processes happening within each organ can affect the other, Sonpal says. First, your nutrition and gut microbiome (the bacteria inside your gut) play a role in optimizing your brain power and even regulating your mental health. 

Interestingly, 90% of the body's serotonin—known as the “feel-good neurotransmitter” that contributes to happiness and well-being—is produced in the gut. Kellie Ziegler, a certified applied positive psychology practitioner in Atlanta agrees, explaining that what’s going on in your gut can play a huge role in your mental health (and vice versa).

Meet the Expert

  • Dr Niket Sonpal MD is a New York-based gastroenterologist, internist, and adjunct professor at Touro College with over 10 years in the field. He was chosen as one of the top ten national residents for the Medelita-Dupont Honoring Excellent Resident Observations (or the H.E.R.O. Campaign).
  • Kellie Ziegler is a certified applied positive psychology practitioner in Atlanta. She has a certificate in Applied Positive Psychology and Applied Positive Psychology Coaching which is certified by the International Coaching Federation.

On the other hand, the state of your brain affects how well your digestive system is flowing. Translation: If your brain is stressed or anxious, it’s very possible that you’ll feel some not-so-happy effects in your gut.

Possible Causes of Abdominal Tension

As with most things in the health and wellness world, there’s not one set answer why you’re experiencing discomfort in your stomach since everyone’s body is different. 

For many of us, "when we are stressed or uncomfortable, this will trigger a response in our gut,” Sonpal says. Stress can cause symptoms in the gut such as belly aches, constipation, bowel movements, tension in the stomach, or contractions (cramps). 

Similarly, when you’re nervous or anxious, neurotransmitters can filter into your gut, causing you to feel nauseous, hungry, or just have a general feeling of discomfort or abdominal tension.

Whether this manifests for you as abdominal tension, diarrhea, or any of the above, it’s a sign from your brain to your gut to communicate danger. Interesting fact: Back in prehistoric times, when humans were living on the plains, this danger was more likely to be a potential predator, although today, it’s more likely to be a looming presentation at work, a difficult relationship issue, or another rough patch. 

If you’re absolutely certain your stomach issues aren’t due to stress or anxiety, then a physical reason might be to blame, such as indigestion, irritable bowel syndrome, gastritis, food poisoning, or even pregnancy. Definitely check in with your doctor if you suspect any of these causes. 

How to Soothe an Anxious Stomach

If you’re regularly experiencing stomach issues that stem back to stress or anxiety, there are several ways to tackle them.

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Practice Mindfulness

For a short-term (but effective) solution, mindfulness exercises can provide fast relief. To start, Ziegler recommends a simple rhythmic breathing exercise to stimulate the relaxation response in the body. “As a general rule, to calm the body, you want the exhale to be longer than the inhale,” she notes. Inhale for a count of 4, exhale for a count of 6. Do this for one minute, which should be 6 breath cycles. “You might feel calm after one minute or it may take up to 10 minutes of this type of breathing to calm the anxious feeling in your stomach,” she says. Note that this type of breathing can make you feel very sleepy, so it’s best not to do it before a big presentation at work or an exam.

You can also bring more calmness into your mind (as well as your stomach!) by practicing mindfulness throughout your days. "Mindfulness is simply a state of being open and aware of the present moment without judgment of your thoughts or feelings, and it has been shown to reduce anxiety and stress," Ziegler says. 

The easiest way to start: Set a timer for 5 minutes and take in everything in your surroundings. "Allow yourself to become aware of everything, to notice how it physically feels to be in your body," Ziegler says. "Ask yourself: What do you smell? What do you see? What do you hear?” Remember to observe without judgment, and without labeling anything as 'good' or 'bad'—they simply 'are.'"

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Ready to take it to the next level? Try meditation. And again, it doesn’t have to be too complex. "The absolute easiest way to get started with meditation is to just sit for 2-3 minutes in silence," Ziegler recommends. Remember, meditation isn't about not having any thoughts; it's about allowing those thoughts to come and go without judgment. If sitting in silence isn't appealing, there are many meditation apps that have guided meditations or even free meditations you can tune into on YouTube.

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Consider Therapy

As a long-term solution, particularly if the discomfort has been extremely uncomfortable and longstanding, consider mental health therapy, suggests Kahina A. Louis, PsyD., a licensed psychologist. "There may be some stressors you haven’t fully acknowledged or deeper concerns that have gone unaddressed," she explains. "Without some extra intervention, it is rather likely that the symptoms will continue."

Article Sources
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  1. Cleveland Clinic. Abdominal pain: possible causes. Updated March 20, 2016.

  2. Thomas C. Fung, Helen E. Vuong, Cristopher D. G. Luna, Geoffrey N. Pronovost, Antoniya A. Aleksandrova, Noah G. Riley, Anastasia Vavilina, Julianne McGinn, Tomiko Rendon, Lucy R. Forrest, Elaine Y. Hsiao. Intestinal serotonin and fluoxetine exposure modulate bacterial colonization in the gutNature Microbiology, 2019; DOI: 10.1038/s41564-019-0540-4

  3. Mittal R, Debs LH, Patel AP, et al. Neurotransmitters: the critical modulators regulating gut-brain axisJ Cell Physiol. 2017;232(9):2359-2372. doi:10.1002/jcp.25518

  4. Cleveland Clinic. Nausea and vomiting: possible causes. Updated July 23, 2019.

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