What Does Anxiety Stomach Pain Feel Like?

The relationship between anxiety and stomach pain is a complicated one. It’s not always obvious how or why mental and physical health relate to each other in such complex ways (this is sometimes termed the mind-body connection).

You might have heard the digestive system or gut described as ‘the second brain.’ and for good reason. The nervous system in our gut shares many of the same features as the brain, containing 500 million neurons and 40 neurotransmitters. Production of the neurotransmitter dopamine (responsible for reward and motivation) is split 50/50 between brain and gut, and the gut actually produces 95% of all serotonin, the mood stabilizing neurotransmitter that also impacts our sleep.

While studies dating back to the 19th and early 20th century^[1] showed that the brain and our emotional state can influence the function of the gastrointestinal tract, it’s only more recently that scientists have begun to research how and why the reverse might also be true.

It’s now widely understood that the gut can act autonomously, influencing behavior by sending messages to the brain via the vagus nerve. Many studies now are exploring the role of the gut in mental health issues such as anxiety and depression.

Why does anxiety cause stomach pain?

Let’s rewind a little.

If you’ve ever felt nervous or excited then you’ll already know the stomach responds to these emotions. The language we use to describe this is highly evocative – we might say we have a knot in our stomach or that we have ‘butterflies.’ (Likewise, we might talk about a ‘gut feeling’ or relying on our ‘gut instinct’ to make decisions.)

These physical feelings are one of the ways in which the sympathetic nervous system responds to perceived threats or danger, also known as ‘fight or flight.’ It’s an involuntary response designed to keep us alive by flooding our bodies with adrenaline, the stress hormone that prepares us for mental and physical activity.

Our heart beats faster, pumping more blood through our bodies. Breathing speeds up to increase the amount of oxygen in our lungs and brain. The gut slows down, however, as digestion is not vital to survival in dangerous situations. This all happens instantaneously, sometimes before we’ve even registered there is a threat.^[2]

Usually, this process is countered by the parasympathetic nervous system, which resets us back to calmness where our breathing and heart rate slow to a steady and balanced baseline.

For some people, the stress response can be triggered when perceived dangers are not life threatening. For others, that calming reset doesn’t happen, and the sympathetic nervous system remains switched on, causing these feelings almost constantly. This can be a result of trauma, although this isn’t always the case.

If you have experienced trauma or PTSD (Post Traumatic Stress Disorder) and would like to explore treatment options, The Center • A Place of HOPE has experienced specialists that can help you.

What does anxiety stomach pain feel like?

As you’d imagine, this can vary from person to person, but stomach problems are one of the most common symptoms of anxiety. Aside from the other symptoms of anxiety, stomach issues related to anxiety can feel particularly strong and even alarming.

Typical symptoms of anxiety stomach pain include:

• • A sudden feeling of nervousness or unease in the stomach
  • Queasiness
  • ‘Butterflies’ in your stomach or a fluttery feeling
  • Tightness in the stomach
  • Nausea
  • Retching or gagging
  • Vomiting
  • Loss of appetite
  • Stomach pains
  • Twitching muscles
  • Indigestion
  • Bloating
  • Cramps
  • Constipation
  • Diarrhea
  • Flatulence

How do I know my stomach pain is related to anxiety?

If it’s not obvious you’re experiencing anxiety-related stomach pain, you might need to play detective. The following steps will help you to get a clearer picture of what is happening.

1. Check if you have any other symptoms of anxiety

First, take our anxiety test to get a benchmark of your likely level of anxiety. If you don’t know much about anxiety as a condition, it’s worth reading up on what anxiety is, what anxiety feels like, and the different types of anxiety.

Think about your life and whether there are any factors you’re finding particularly stressful. This could be anything from work stress, money worries, family issues, or any other situations that cause you worry and stress.

2. Identify the triggers

Keep a diary of when your stomach feels painful, including days and times, what you’ve eaten (including food, caffeine, alcohol), any medications, your mood, and any particularly difficult, scary or important things that are happening for you.

This can help you to notice any patterns (if there are any). Then, you can start to make some changes, one by one, and keep tracking your symptoms.

3. Get an expert opinion

Once you’ve spent time learning more about your particular stomach pain, it’s easier to know who to speak to about improving your symptoms.

For example, if you’ve figured out that your stomach is worse after eating specific food types, you might want to see a nutritionist. They can help you to understand what might be happening and to advise on a course of treatment or make dietary recommendations.

If you have connected your mental health to your symptoms, make an appointment with a therapist or book a call with The Center • A Place of HOPE where we offer whole person care to ensure you are well supported in every aspect of your treatment.

4. Is it a physical condition or is it anxiety stomach pain?

If you don’t appear to have any other symptoms of anxiety, nor any difficult life circumstances, it could be physical.

Speak to your doctor to rule out any other factors that might cause similar symptoms to anxiety stomach pain, such as:

• • • Irritable bowel syndrome (IBS)
    • Stomach ulcers
    • Inflammatory bowel disease
    • Celiac disease
    • Gallstones

Take the First Step Toward Healing

Anxiety and its physical effects, like stomach pain, can be overwhelming, but you don’t have to face them alone. Addressing the root causes of your anxiety is essential for both your mental and physical well-being.

At The Center • A Place of HOPE, we specialize in compassionate, comprehensive care to help you navigate life’s challenges. If anxiety stems from deeper issues like disordered eating or other mental health concerns, our world-renowned Eating Disorder Treatment Program offers personalized, holistic care to guide you toward recovery.

Take the first step today—explore our proven approach to lasting wellness and healing. Learn more here: Eating Disorder Treatment at The Center • A Place of HOPE.

[1] Cannon, W., 1909. The Influence Of Emotional States On The Functions Of The Alimentary Canal. The American Journal of the Medical Sciences, 137(4), pp.480-486.
[2] https://www.health.harvard.edu/staying-healthy/understanding-the-stress-response
[3] Andrea M. Harrington, Patrick A. Hughes, Christopher M. Martin, Jing Yang, Joel Castro, Nicole J. Isaacs, L. Ashley Blackshaw, Stuart M. Brierley, A novel role for TRPM8 in visceral afferent function,
PAIN®, Volume 152, Issue 7, 2011, Pages 1459-1468, ISSN 0304-3959, https://doi.org/10.1016/j.pain.2011.01.027.
[4] Hoge EA, Bui E, Marques L, Metcalf CA, Morris LK, Robinaugh DJ, Worthington JJ, Pollack MH, Simon NM. Randomized controlled trial of mindfulness meditation for generalized anxiety disorder: effects on anxiety and stress reactivity. J Clin Psychiatry. 2013 Aug;74(8):786-92. doi: 10.4088/JCP.12m08083. PMID: 23541163; PMCID: PMC3772979.
[5] Bercik, P., Park, A., Sinclair, D., Khoshdel, A., Lu, J., Huang, X., Deng, Y., Blennerhassett, P., Fahnestock, M., Moine, D., Berger, B., Huizinga, J., Kunze, W., McLean, P., Bergonzelli, G., Collins, S. and Verdu, E., 2011. The anxiolytic effect of Bifidobacterium longum NCC3001 involves vagal pathways for gut-brain communication. Neurogastroenterology & Motility, 23(12), pp.1132-1139.
[6] Sibelli, A., Chalder, T., Everitt, H., Workman, P., Windgassen, S., & Moss-Morris, R. (2016). A systematic review with meta-analysis of the role of anxiety and depression in irritable bowel syndrome onset. Psychological medicine, 1.
[7] Goodwin RD, Talley NJ, Hotopf M, Cowles RA, Galea S, Jacobi F. A link between physician-diagnosed ulcer and anxiety disorders among adults. Ann Epidemiol. 2013 Apr;23(4):189-92. doi: 10.1016/j.annepidem.2013.01.003. Epub 2013 Feb 28. PMID: 23453387.