Jack Harley, Therapeutic Neuroscience at Oxford University
reviewed by Dr Michael Yapko
Monday, July 6, 2020
Jack Harley, Therapeutic Neuroscience at Oxford University
Monday, July 6, 2020

Anxiety and Diarrhea - Whats the Cause and How to Stop it?


Anxiety causes activation of the ‘fight or flight’ response – which can be a good thing, prompting us to take extra precautions. However, when these feelings persist in when there is no threat, they may take a toll on our physical health and cause diarrhea. Understanding this link may help you avoid symptoms and feel well again.

Can anxiety cause diarrhea?

The gut-brain connection is strong one. Anxiety can take a toll on the digestive system and cause diarrhea. When you are anxious, hormones and signals from the brain enter the digestive tract, causing a chemical imbalance that can interfere with digestion causing diarrhea and other gastrointestinal (GI) symptoms. For those with IBS or other gut-related conditions it may even trigger a flare-up.

If you are experiencing both anxiety and diarrhea, it's a good idea to speak to your doctor about your symptoms. They will be able to diagnose your gut symptoms and find out the root cause. While it may solely be related to anxiety, it's important to check for conditions such as:

  • Inflammatory Bowel Diseases – ulcerative colitis and Crohn’s disease
  • Diabetes
  • Overactive thyroid (hyperthyroidism)
  • Poor absorption of certain nutrients (malabsorption)
  • Irritable Bowel Syndrome

Why does stress and anxiety cause diarrhea?

There are a few ways anxiety can trigger diarrhea. The first is part of the body's stress response.

Anxiety prepares us to confront a crisis by putting the body on alert (sometimes called fight-or-flight mode), and nerve signals from the brain travel through the body in this response. This causes blood flow to be diverted away from the abdominal organs. This, unfortunately, may cause nausea and diarrhea.

By voiding the bowels in diarrhea, the body prepares for survival. The digestive system suspends to provide more blood flow to parts of the body such as the skeletal muscles and although useful in ancient times, is an unnecessary response in today’s modern world.

Another cause relates specifically to IBS. One study found that people with IBS-D (diarrhea) had higher levels of inflammatories that could affect the way the digestive tract absorbs the water in stools. More stress, can lead to higher amounts of this compound, which in turn stops the body from absorbing water, eventually leading to wet, loose stool.

If you also experience abdominal pain with diarrhea, it might also be irritable bowel syndrome (IBS).

Calm your IBS in just 6 weeks with Nerva

Start Now
Self-guided gut hypnotherapy
Developed by doctors
89% of users report improved gut symptoms

Take control of how you think, feel & act with Mindset

Try for free
Self-guided hypnosis app
Developed by world-experts
Courses on anxiety, negative thinking, achieving goals & more

Self-manage menopause & hot flashes naturally

Learn more
Evidence-based hypnotherapy
Menopause education
Symptom tracking & more!

Irritable bowel syndrome

Irritable bowel syndrome (IBS) is a gastrointestinal disorder. It is ‘functional’ meaning it is not life-threatening and has no underlying physical disease, and is essentially a disorder of the gut-brain connection. It is very commonly seen in those with anxiety disorder and depression.  However, this is not to underestimate the symptoms of IBS, which may be very real and distressing and include:  

• Diarrhea or constipation

• Abdominal pain, often relieved with passing a bowel motion or wind

• Abdominal bloating

• Cramping

IBS is extremely common, affecting 1 in 7 individuals globally and is more common women. The cause of IBS is not known, but environmental factors such as emotional stress and change of routine may trigger an attack. Studies show that anxiety is strongly associated with IBS – both onset and worsening of symptoms.

Diagnosis of IBS

IBS is diagnosed by the Rome-IV criteria:

Recurrent abdominal pain at least one day per week in the last three months that is associated with two or more of the following:

  • Related to defecation
  • Associated with a change in frequency of stool
  • Associated with a change in form (appearance) of stool.

While IBS is one of the common links between diarrhea and anxiety, it is not the only one, so be sure to talk to your doctor for a diagnosis.

Types of IBS

There are three main types of IBS categories, depending on the types of symptoms you are experiencing. If your anxiety is triggering diarrhea, it is possible you have diarrhea-predominant IBS (IBS-D), the most common form of IBS.

  • Diarrhea-predominant IBS (IBS-D): this person experiences diarrhea, first thing in the morning or after eating.
  • Constipation-predominant IBS (IBS-C): this person experiences constipation, and abdominal pain and cramping are commonly triggered by eating.
  • Mixed IBS (IBS-M): this person experiences alternating periods of diarrhea and constipation.

Is diarrhea common with anxiety & stress?

Diarrhea can be a big part of life for people dealing with daily anxiety and stress. In fact, people with anxiety are more than twice as likely to experience diarrhea than the general population. And studies show that 40 to 60% of those with irritable bowel syndrome (IBS) have generalized anxiety disorder.

The gut-brain link

Whether or not you have IBS, anxiety disorders are linked with diarrhea by the ‘gut-brain axis’. This is the two-way connection between brain and bowels that involves nerves, hormones, and gut bacteria, and a key component of the gut-brain axis is the enteric nervous system (ENS).

The ENS is often referred to as the ‘second brain’ due to its complexity and consists of millions of neurons that surround the digestive tract and control digestion. The ENS connects to the central nervous system, the brain, and spinal cord, and is literally affected by processes in your brain.

When diarrhea occurs with anxiety or in IBS, the ENS is malfunctioning. There is a disruption to signals controlling motility – the speed of transit of material through the intestines – that may lead to an urgent need to defecate. Hence anxiety may lead to physical digestive symptoms such as diarrhea.

How to stop anxiety diarrhea

If you are experiencing sustained diarrhea (even without anxiety), you should seek immediate medical help if you have:

  • Blood in stools
  • Rectal bleeding
  • Fever lasting three days or more
  • Severe abdominal pain
  • Vomiting
  • Rapid weight loss
  • Bowel movements do not relieve pain.

If you do not suffer the above symptoms, treatments for diarrhea and stress-management strategies may improve symptoms. You may still wish to consult your doctor to confirm which treatment is right for you.

Treatments for diarrhea

There are treatments to manage the symptoms of anxiety-related diarhhea as well as treatments, or management programs to treat the root cause.

Treatments to manage the diarrhea symptoms largely involve rehydrating the body. These include:  

  • Rehydration. This is important to counteract the dehydration in diarrhea.
  • Oral rehydration. To replace lost salts and minerals from diarrhea.
  • Medications. Such as antibiotics if the cause is an infection or anti-diarrheal medications.
  • Avoiding exercise. As strenuous exercise may further contribute to dehydration.
  • Treating disease. If there is a physical basis, such as inflammatory bowel disease.
  • Fluid IV replacement. In severe cases to rehydrate the body.

These will ensure your body can recover from periods of dehydration associated with diarrhea. You should consult your doctor to confirm the best treatment for your condition.


As well as diarrhea treatments, stress management strategies may help relieve stress & anxiety, which may be at the root cause of symptoms. Stress management techniques prevent the body from easily being triggered by outside stressors. These include:

  • Cognitive-Behavioural Therapy (CBT). This therapy involves a cognitive aspect in helping patients identify thoughts that generate anxiety and a behavioral part teaching them to respond differently to anxiety-provoking situations. These techniques help to lessen anxiety and improve gastrointestinal symptoms.
  • Hypnotherapy. The patient first undergoes hypnotic induction, then suggestions are made to address the patterns of thought associated with anxiety. This form of therapy has been shown at least as effective as CBT for treating anxiety disorders, and IBS. It's possible to try hypnotherapy through a mobile app like Nerva or with your local hypnotherapist.
  • Mindfulness meditation. This practice of focusing awareness on the present moment has been shown to reduce anxiety and stress scores. IBS symptoms such as abdominal pain and bloating may particularly benefit.
  • Yoga. Has been shown to relieve stress and also specific symptoms of IBS that is diarrhea-predominant. Research has shown yoga more effective than anti-diarrheal medication in relieving symptoms.

Lifestyle adjustments

Over a longer period, lifestyle adjustments that may prevent symptoms of diarrhea and include:

Recent insights into anxiety and diarrhea

Science has recently illuminated some fascinating links between the brain and the gut. These insights are helping us to understand the connection between diarrhea and anxiety.

Anxiety increases the speed of transit of food through the gut.

One study showed that generalized anxiety disorder (GAD) causes physical changes to the digestive system. The transit of food from the mouth to rectum was found to be 14 hours, on average, in anxiety patients – much faster than the 42 hour-average in controls. Anxiety was therefore shown to physically alter speed of transit through the intestines, explaining the link between diarrhea and anxiety.

Remote hypnotherapy reduces symptoms of IBS.

Researchers showed that symptoms of IBS improved in 65% of subjects who received hypnotherapy delivered online over Skype, compared to 76% with face-to-face treatment. Although slightly lower, the significant rate of Skype hypnotherapy means access to this form of IBS treatment could be greatly expanded.

The Wrap Up

The nervous system and stomach are intimately linked. It is possible that experiencing anxiety can trigger a flare-up of diarrhea. Anxiety and diarrhea may also be a sign of irritable bowel syndrome. If you experience diarrhea or other IBS symptoms and mental health conditions such as anxiety disorder, there are treatments available to help you manage stressful situations and improve your anxious stomach.  Relaxation techniques may help to improve GI symptoms and improve your upset stomach, with hypnotherapy through apps like Nerva being especially helpful.

Self-hypnosis app for sleep, anxiety & depression

Try the Mindset app
Self-guided hypnosis app
Developed by world-experts
Courses on anxiety, negative thinking, achieving goals & more

Calm your IBS in just 6 weeks with Nerva

Start Now
Self-guided gut hypnotherapy
Developed by doctors
89% of users report improved gut symptoms

Manage hot flashes naturally, at home

Learn more
Evidence-based hypnotherapy
Menopause education
Symptom tracking & more!

Our Sources

Mindset Health only uses high-quality sources, including peer-reviewed research, to support our articles. We work with experts to ensure our content is helpful, accurate and trustworthy.

1.    Schiller, L.R., 2000. Diarrhea. Medical Clinics of North America, 84(5), pp.1259-1274. Link

2.    Davis, M., 1992. The role of the amygdala in fear and anxiety. Annual review of neuroscience, 15(1),pp.353-375. Link

3.    Hudlicka, O., 1985. Regulation of muscle blood flow. Clinical physiology (Oxford,England), 5(3), pp.201-229. Link

4.    Chey, W.D.,Kurlander, J. and Eswaran, S., 2015. Irritable bowel syndrome: a clinical review. Jama, 313(9), pp.949-958. Link

5.    Fond, G., Loundou,A., Hamdani, N., Boukouaci, W., Dargel, A., Oliveira, J., Roger, M., Tamouza,R., Leboyer, M. and Boyer, L., 2014. Anxiety and depression comorbidities in irritable bowel syndrome (IBS): a systematic review and meta-analysis. European archives of psychiatry and clinical neuroscience, 264(8), pp.651-660. Link

6.    Schmulson, M.J. andDrossman, D.A., 2017. What is new in Rome IV. Journal of neurogastroenterology and motility, 23(2), p.151. Link

7.    Guilera, M., Balboa,A. and Mearin, F., 2005. Bowel habit subtypes and temporal patterns in irritable bowel syndrome: systematic review. The American journal of gastroenterology, 100(5), p.1174. Link

8.    Pimentel, M., 2018.Evidence-based management of irritable bowel syndrome with diarrhea. The American journal of managed care, 24(3 Suppl), pp.S35-S46. Link

9.    Haug, T.T., Mykletun,A. and Dahl, A.A., 2002. Are anxiety and depression related to gastrointestinal symptoms in the general population?. Scandinavian Journal ofGastroenterology, 37(3), pp.294-298. Link

10.  Walker, E.A., Katon, W.J., Jemelka, R.P. and Roy-Byrne, P.P., 1992.Comorbidity of gastrointestinal complaints, depression, and anxiety in the Epidemiologic Catchment Area (ECA) Study. The American journal of medicine, 92(1), pp.S26-S30. Link

11.  Cryan, J.F. and O’mahony, S.M., 2011. The microbiome‐gut‐brain axis:from bowel to behavior. Neurogastroenterology & Motility, 23(3),pp.187-192. Link

12.  Furness, J.B., 2006. The enteric nervous system. Link

13.  Farthing, M.J.G., 2000. Diarrhoea: a significant worldwide problem. International journal of antimicrobial agents, 14(1),pp.65-69. Link

14.  Gonsalkorale, W.M., Miller, V., Afzal, A. and Whorwell, P.J., 2003. Longterm benefits of hypnotherapy for irritable bowel syndrome. Gut, 52(11),pp.1623-1629. Link

15.  Tang, Q.L., Lin, G.Y. and Zhang, M.Q., 2013. Cognitive-behavioral therapy for the management of irritable bowel syndrome. World Journal ofGastroenterology: WJG, 19(46), p.8605. Link

16.  Gaylord, S.A., Palsson, O.S., Garland, E.L., Faurot, K.R., Coble, R.S.,Mann, J.D., Frey, W., Leniek, K. and Whitehead, W.E., 2011. Mindfulness training reduces the severity of irritable bowel syndrome in women: results of a randomized controlled trial. The American journal of gastroenterology, 106(9), p.1678. Link

17.  Kuttner, L., Chambers, C.T., Hardial, J., Israel, D.M., Jacobson, K. andEvans, K., 2006. A randomized trial of yoga for adolescents with irritable bowel syndrome. Pain Research and Management, 11(4), pp.217-224. Link

18.  Guandalini, S., 2011. Probiotics for prevention and treatment of diarrhea. Journal of Clinical Gastroenterology, 45, pp.S149-S153. Link

19.  Gorard, D.A., Gomborone, J.E., Libby, G.W. and Farthing, M.J., 1996.Intestinal transit in anxiety and depression. Gut, 39(4), pp.551-555. Link

20.  Hasan, S.S., Pearson, J.S., Morris, J. and Whorwell, P.J., 2019. Skype hypnotherapy for irritable bowel syndrome: effectiveness and comparison with face-to-face treatment. International Journal of Clinical and ExperimentalHypnosis, 67(1), pp.69-80. Link

  1. Gao J. Correlation between anxiety-depression status and cytokines in diarrhea-predominant irritable bowel syndrome. Exp Ther Med. 2013;6(1):93-96. doi:10.3892/etm.2013.1101
  2. Singh P, Agnihotri A, Pathak MK, et al. Psychiatric, somatic and other functional gastrointestinal disorders in patients with irritable bowel syndrome at a tertiary care center. J Neurogastroenterol Motil. 2012;18(3):324-331. doi:10.5056/jnm.2012.18.3.324

Similar Articles

What is Mindset?

We’re glad you asked! Mindset is a hypnotherapy app for mental health & positive thinking.

Personalized to you

Learn coping skills


Created by experts

Available 24/7

Loved by thousands

Take our free IBS quiz
Start now