Your mental health affects your physical health more than you may realize. Stress and anxiety can be to blame for numerous health problems, from insomnia to headaches. If you have unexplained gastrointestinal symptoms like diarrhea, upset stomach or heartburn, stress may be the culprit.

“I’ve been practicing medicine for 25 years, and I’ve seen many people with reflux disease who are hypersensitive to stress,” says gastroenterologist Howard Seeman, M.D. “They have profound symptoms, but we don’t see anything serious during an endoscopy.”

While stress does not necessarily cause digestive problems, it can make them worse in individuals predisposed to GI issues. Dr. Seeman says these people have severe reactions to normal digestive processes in the body, which can result from a lack of coping with stress.

“When people are under a lot of stress, we tend to see subclinical issues come to the surface,” he explains. “It can be conscious or unconscious stress. The person may be grieving, having relationship troubles, work stress, etc.”

Treatment options for stress and GI issues

Dr. Seeman recommends the following tactics to manage your stress levels and reduce the chances of exacerbating an underlying gastrointestinal condition:

• Get enough sleep. Most adults need seven to nine hours each night.
• Eat a healthy diet and limit processed foods. Eat plenty of fiber and stay well-hydrated to keep your bowel movements regular.
• Limit your caffeine and alcohol intake – both can increase stress and affect the digestive system.
• Exercise regularly, which can improve bowel motility, boost your metabolism and reduce stress.

If these lifestyle modifications do not improve your symptoms, talk to your doctor about over-the-counter medications for your specific symptoms. Prescription medications, like selective serotonin reuptake inhibitors (SSRIs), can also be used to treat underlying conditions that are magnified by stress.

When to see a doctor for gastrointestinal problems

“My line in the sand: if the symptoms persist consistently for three to six weeks without a change in frequency or intensity, or if you notice bowel changes at night, you need to see a doctor,” Dr. Seeman says. “He or she can help you break the cycle between stress and GI pain.”

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