Stomach ache - Stress as a cause

Stomach aches from stress are something many people recognize. A "stomach-wrenching" experience, "butterflies in the stomach" or a lump that won't let go. These aren't just metaphors - the gut is incredibly sensitive to our emotional life. Research shows that the gut and brain are closely linked and that stress can be one of the strongest factors influencing this interaction.

But why does this happen? And how can stomach problems in turn create more stress?

Stress is the body's way of dealing with a challenge and can be healthy for us at the right time. However, many of us stress too much over a long period of time and it is this stress that can ultimately affect us, not only mentally but also physically.

There is a strong connection between the stomach and the intestine that researchers often call the gut-brain axis. This is a complex communication pathway where signals between the central nervous system and the gastrointestinal tract occur via several different channels, nerves, hormones and immune cells. One of the most important communication conductors in this network is the vagus nerve. The vagus nerve extends from the brain stem all the way down to the large intestine and functions as a two-way communication: it sends information from the brain to the intestine, but also information from the intestine back to the brain.

In the stomach is an extensive network of nerve cells called the enteric nervous system. This system is so complex that researchers often describe it as the body's "second brain." It consists of more than a hundred million nerve cells and controls virtually the entire digestive process, from how food moves through the intestine to how nutrients are absorbed. Despite its independence, the enteric nervous system is in constant contact with the brain via, among other things, the vagus nerve. Through this communication, the gut can quickly respond to how we feel, and the brain can be just as quickly affected by what is happening in the gut.

The intestines also contain a huge ecosystem of bacteria and microorganisms, the so-called microbiota. These microbes do not just live passively in the intestines, but produce substances that affect both the immune system, the hormonal system and the nervous system. They can create neurotransmitters and their building blocks, can affect inflammation levels and participate in the regulation of the stress system. Therefore, the microbiota can affect how both the intestines and the brain function.

This complex two-way interaction has led researchers to see the gut as more than just a digestive organ. It sends signals up to the brain that can affect our mood, our stress levels and our psychological balance. In the same way, we can experience everything from worry and sadness to joy and anger directly in our stomach. This means that both mental and physical stress can be felt in the gut – but also that the gut can affect how we feel emotionally.

When we get stressed, the sympathetic nervous system, the body's emergency response system that is often described as "fight-or-flight," is activated. It is a system that is designed to help us deal with danger, but in today's society, it is often turned on by things like deadlines, performance demands, or worries about the future. When the sympathetic nervous system takes over, heart rate and blood pressure increase, muscles tense, and the body releases stress hormones like adrenaline and cortisol. At the same time, blood flow is redirected away from the stomach to the brain and muscles, as the body prioritizes us being able to think quickly and act, not digest food.

This directly affects digestion. Bowel movements can either slow down or speed up, which can lead to constipation or diarrhea. Stomach acid can change, causing nausea or acid reflux. The nervous system of the gut can become more sensitive, causing subtle bowel movements to feel like pain or discomfort. If the stress is short-lived, the gut usually recovers quickly, but if the stress is long-term, the body can be constantly on alert, which increases the risk of recurring stomach problems, such as IBS. The digestive system is then not given the opportunity to recover and the signals between the brain and the gut are disrupted.

The parasympathetic nervous system, the body’s “rest-and-digest” system, helps restore balance. The vagus nerve activates the parasympathetic nervous system and essentially acts as a button you can press to reduce stress. When we feel safe and relaxed, bowel movements increase, heart rate decreases, gastric juices are produced, and nutrient absorption works better. This also leads to mental balance.

Both of these systems are constantly active, but to different degrees. You can think of it as a switch where one pulls more than the other depending on the situation. Which of these systems is dominated is largely determined by how we feel mentally. By strengthening the parasympathetic nervous system, you can often break the negative spiral where stress affects the stomach, and vice versa. Deep breathing, mindfulness, physical touch, presence in nature, and light physical movement are effective ways to reduce stress.

Stomach ache? Try our Lactic Acid Bacteria

Anxiety can cause stomach pain because the body responds to psychological stress with the same physiological systems as it does to physical danger. When we become anxious, the sympathetic nervous system is activated and the body goes into a state of alert. Blood flow is diverted away from the stomach, muscles tense, and the brain signals the intestines to slow down or change their rhythm. This imbalance can create stomach cramps, nausea, or a feeling that the stomach is “locking up.”

Anxiety also affects breathing. Many people start to breathe faster and more shallowly, which makes them swallow more air and become more bloated. At the same time, the gut becomes more sensitive during psychological stress: signals that would not normally be perceived as unpleasant can then be experienced as pain. This is why even small changes in the gut can feel intense when you are worried or anxious.

This interaction easily creates a vicious cycle. The stomach reacts to anxiety – and the unpleasant stomach sensations in turn amplify the anxiety. For some, the stomach then becomes one of the first places where psychological stress is felt, and the symptoms can in turn make you even more aware of your body, which further increases anxiety.

The body also releases stress hormones like adrenaline and cortisol when anxious, and these hormones alter blood flow to the digestive system and can disrupt its rhythm. The result is often stomach cramps, nausea, diarrhea, or constipation.

Anxiety and stress can also affect eating habits. When you feel unwell, many people eat less healthily, which can lead to dysbiosis, an imbalance between good and bad bacteria in the gut. Dysbiosis can affect hunger, stress levels, mood and immune system. In this way, poor gut health can create a vicious cycle, where stress and gut problems reinforce each other.

Taking care of your stomach through healthy eating habits, lactic acid bacteria, physical activity and stress management can therefore positively affect both your stomach health and your mental well-being.

People with IBS (Irritable Bowel Syndrome) are often extra sensitive to stress, as their gut reacts more strongly to both emotional and physiological signals. In IBS, the gut's nervous system is more irritable, and the communication between the gut and the brain is overactive. Stress hormones, worry and anxiety can therefore trigger symptoms such as diarrhea, bloating, constipation and cramps much more easily than in others. Since the microbiota of many people with IBS is out of balance, stress can further amplify this imbalance, making the symptoms even more pronounced.

At the same time, research shows that treatments that target the brain – such as stress management, therapy, relaxation, breathing exercises and physical activity – often provide as good symptom relief as dietary changes. This underlines how strongly the gut and psyche are connected in IBS, and how important a holistic view is to break the negative spiral.

Want to read more about IBS? See our guide

To support the gut, especially during stressful periods, certain dietary supplements can be helpful. They do not replace a balanced diet, but can act as a complement to restore the balance of the intestinal flora and facilitate digestion.

Lactic acid bacteria - Lactic acid bacteria can help strengthen intestinal flora and restore microbial balance, which can reduce both bloating and irregular bowel movements.

Enzymes - Digestive enzymes can be helpful if digestion is impaired during stress. They help break down food and can reduce discomfort such as gas and bloating.

Ashwagandha - Ashwagandha is an adaptogen that can help balance the body's stress response.

Magnesium – An important mineral that can help relax muscles, including the muscles of the intestines, which can relieve constipation and stomach tension.

Chamomile and lemon balm - Herbs traditionally used to calm the stomach and mind.

Diet and digestive health during stress

Diet is one of the strongest factors influencing the composition of the gut flora. The food we eat determines which bacteria thrive in the gut, and these bacteria play a crucial role in digestion, immune function and mental well-being.

During periods of high stress, it is common for digestion to worsen. Many people notice that they become bloated more easily, have stomach cramps or feel “heavy in the stomach” even after small meals. In such cases, it is important to be kind to yourself and your stomach. Easily digestible foods such as rice, bananas, yogurt and phyllo can be gentle when the intestines feel overloaded. At the same time, it may be wise to temporarily avoid foods that are difficult to digest, a lot of fat, strong spices, alcohol and large amounts of caffeine, which can trigger further problems.

As your stomach starts to settle, it's a good idea to gradually reintroduce fiber-rich foods such as vegetables, whole grains, and legumes. These help rebuild a healthy and diverse intestinal flora and nourish the good bacteria in your gut.

Prevent stomach upset

Stomach problems that arise in connection with stress and anxiety can often be prevented by giving the body the right conditions for recovery. Think about what makes you feel anxious and stressed. Maybe it is possible to change something that will reduce stress? For example, you can try to lower the demands on yourself and have fewer things planned in your everyday life. When we manage to activate the parasympathetic nervous system, digestion gets better rest and the stomach can return to its natural balance. By eating a nutrient-dense diet with fiber, protein and fat, we give the body good conditions to function optimally. Psychotherapeutic methods such as cognitive behavioral therapy or mindfulness-based therapy can be effective tools for reducing stress and anxiety and thereby also relieving stomach problems. Working long-term with stress management can make a big difference, not only for the stomach but for the entire body.

Learning to truly relax can do wonders for our mental health. Relaxation exercises don't have to be complicated and time-consuming. Learning simple tricks that you can use when you feel stress and anxiety creeping in can be very effective. At the same time, you get other well-known health benefits: lower blood pressure, better sleep and a stronger immune system. Just a few minutes of silence every day can make a big difference. Deep breathing, where you breathe slowly into your stomach, can reduce gas and cramps by releasing tension in the intestinal wall. Progressive muscle relaxation, where you consciously tense and relax different muscle groups, can also reduce that stress level. Some people find that yoga or slow walks help the intestines work more rhythmically.

The difference between acute and chronic stress

Acute stress – such as when you get nervous before a meeting or feel pressured by a deadline – can cause temporary stomach cramps or a diffuse feeling of unease in the stomach. When the short-term stress subsides, the body usually recovers quickly and the symptoms disappear.

Chronic stress, however, is a different story. When stress becomes prolonged, the sympathetic nervous system is constantly active, which can disrupt bowel movements, alter gut flora, and make pain more persistent. This makes it even more important to work on recovery, sleep, nutrition, and stress management to break the negative spiral.

If you have pain in the upper part of your stomach

Pain in the upper abdomen can be caused by acid reflux, gastritis, or the stomach becoming extra sensitive during stress. Many people describe it as a burning or tingling sensation just below the breastbone. Avoiding large, heavy meals, cutting down on caffeine and alcohol, and strong spices can help relieve the discomfort. It can also help to eat more slowly and allow your body to settle down before and after meals, as the stomach is especially sensitive to prolonged stress.

If you have pain in the lower abdomen

Pain or discomfort further down in the stomach is often related to bowel movements. Stress-induced constipation, diarrhea, IBS or periods of bloating and gas are common. Here, regular eating and toilet habits, enough fluids and physical activity can help the intestines to come into balance. Fiber can be helpful – but in the right amount and with gradual increase to avoid more gas.

It is also important to listen to your body's signals. Do you notice that your gut reacts when you are anxious or stressed? Then a combination of dietary adjustments and stress-reducing techniques may be the most effective way to reduce the discomfort. When both the body and nervous system are allowed to calm down, the lower stomach region also usually responds positively.

Although the stomach often reflects our emotions, this does not mean that the discomfort is “imaginary”. On the contrary – pain and discomfort are real bodily signals that deserve to be taken seriously. Understanding the connection between stress and the stomach can be the first step towards breaking a vicious cycle, but sometimes professional help is also needed. Seeking knowledge, making small changes in everyday life and daring to ask for support are important steps towards feeling better.

Then you should seek medical attention.

Our bodies are very good at healing themselves, and most stomach problems can be treated on their own. However, there are situations where you should always contact your healthcare provider. Seek help if you experience severe or sudden stomach pain, blood in your stool, unexplained weight loss, prolonged diarrhea, or if your symptoms worsen despite self-care. Getting a professional evaluation provides reassurance and can rule out serious causes.