Dear HealthyWomen,

My digestive system seems to go off the rails every time I get stressed, annoyed or frightened. The emotions start firing, and then so does my stomach, with stomach cramps and, worse, diarrhea. Sometimes I get so nervous that I won’t get to the bathroom in time, which only makes things spiral downward.

Is it the stress that’s causing diarrhea, or is it the other way around?

Signed,

Stressed Out Stomach

Dear SOS,

It’s not your imagination. There’s a big connection between your emotions and your gut. Just like your brain is full of nerves, so is your gut; in fact, they share many of the same nerve connections.

And when you think about it, you can see the relationship: Butterflies in your stomach when you get nervous before a big speech. Cramps that make your belly feel like it’s tied up in knots when you’ve just had a big blow-up with your spouse. A jumping sensation in your gut when an angry driver cuts you off.

Chronic worry, upset or a single stressful event can make your stomach react. And it’s this reaction that releases hormones and chemicals into your digestive tract, where they go to work at upsetting its balance.

Learn more: Is It Stress or Anxiety?

In addition to causing diarrhea, stress may lead to conditions like nausea, indigestion, constipation, a loss of appetite or an increase in appetite. Find out about Stress Symptoms You Should Never Ignore.

The stress of diarrhea can also become a source of anxiety and exacerbate the problem. So, when you’re feeling stressed and it results in diarrhea, having diarrhea can lead to more stress. So say many experts, including those at Harvard Medical School: “The relationship between environmental or psychological stress and gastrointestinal distress is complex and bidirectional: stress can trigger and worsen gastrointestinal pain and other symptoms, and vice versa.”

Here are some ways to manage your stress to reduce its impact on your gut:

• Learn to say no. Being a “people pleaser” can cause you to take on too much, which leads to stress. Remember that “no” is a complete sentence.
  
  
• Learn to breathe. Yes, we all breathe, but taking a short voluntary break and practicing a minute of quiet, deep breathing can dissipate stress before it gets unmanageable.
  
  
• Try exercise, yoga, meditation or any other physical activity. These activities signal your body to release chemicals (endorphins) which produce a feeling of calm throughout your body.

• If you can’t change a situation, work on changing your reaction. By reframing your reaction to a situation, you can feel more in control.

• Examine your diet. Are you eating foods that might contribute to stomach irritation? For some people, these may include alcohol, caffeine, fatty or fried foods, fruit juice and acidic foods like tomatoes and some fruits like lemons, limes, oranges and grapefruit.

• Finally, don’t ignore the role of psychotherapy. Scientific evidence shows that therapies such as cognitive behavioral therapy, relaxation therapy and hypnosis can help you manage your gastrointestinal distress.