Can Stress Cause Diarrhea?

All bodies process stress differently. Some people may have headaches, trouble sleeping, or body aches when they’re under stress. 

Others may experience depression, anxiety, or allergy symptoms. Stomach trouble, including diarrhea, is another common symptom of acute or chronic stress. 

In this article, I’ll explain the link between stress and diarrhea. I’ll also explain how stress impacts the body and other causes of diarrhea. Then I’ll share how to treat diarrhea at home and when to see a medical provider.

What’s the Link Between Stress and Diarrhea?

Stress is known to cause bowel dysfunction. During the beginning stages of a stress response, the body releases a hormone called corticotropin releasing factor (CRF), which ultimately affects GI motility. 

Studies performed on rats found that CRF released during stress reduced gut transit time of the stomach and small intestines and increased the motility of the large intestine.It also increased stool output and transit speed.

Research suggests that stress promotes a similar response in humans by decreasing gastric emptying and accelerating colonic transit. 

When contents move through the digestive system too quickly, the intestines don’t have enough time to absorb the fluids. That can lead to diarrhea. 

What the research says

Chronic stress can alter the functioning of the gastrointestinal (GI) system. Specifically, research shows that the effects of stress on the GI system can be classified into six different actions:

1. GI movement disorders
2. Increased visceral irritability
3. Altered rate and extent of GI secretions
4. Modified permeability of the intestinal barrier
5. Negative effects on blood flow to the GI tract
6. Increased intestinal bacteria counts

Some of the ways these effects can present in the body include: 

• Diarrhea
• Upset stomach
• Stomach pain
• Heartburn
• Nausea
• Constipation
• Stomach ulcer
• Trigger flares of medical conditions such as Crohn’s disease and irritable bowel syndrome (IBS)

How Stress Can Impact the Body

It’s common to experience stress from time to time. When experienced in short bursts, stress can help us meet work deadlines and avoid potentially dangerous or life-threatening situations. 

But chronic stress can have damaging effects on our health, weakening many of the body’s functions, including our digestive tract.One of the main ways stress impacts the body is by triggering our “fight-or-flight” response. 

During fight-or-flight, several bodily resources get redirected toward survival. 

Some of these changes include:

• Increased cortisol production
• Increased heart rate
• Increased blood flow to the muscles
• Increased muscle tension
• Increased respiratory rate
• Elevated blood pressure

Over time, chronic stress can lead to physical illness, mental illness, or disease. Chronic stress can also aggravate and exacerbate pre-existing conditions, including acne, type 2 diabetes, and high blood pressure. 

Other Causes of Diarrhea

Stress is one of many possible causes of diarrhea.

Other common causes of acute and persistent diarrhea are: 

• Viral, bacterial, or parasitic infections: You may need to speak with a medical provider about prescription medication to treat the underlying infection.

• Traveler’s diarrhea: This is caused by eating food or drinking water that is contaminated while traveling (particularly to developing countries). 

• Medication side effects: Some antibiotics, antacids, cancer medications, and other medications may cause diarrhea.

Causes of chronic diarrhea include:

• Food allergies or intolerances: Allergies to dairy, cereal grains, eggs, and seafood

• Medical conditions: Digestive tract problems, including celiac disease, Crohn’s disease, irritable bowel syndrome (IBS), and ulcerative colitis

• Abdominal surgery: Surgeries performed on the appendix, gallbladder, large intestine, liver, pancreas, small intestine, spleen, or stomach

• Long-term use of medicines: Some medications can disrupt the balance of flora in your gut and increase the risk of developing a Clostridioides difficile infection

Treating Diarrhea

Many cases of diarrhea go away on their own after four days. 

But there are still things you can do at home to support your recovery. If you don’t see an improvement in your bowel movements after four days, contact your medical provider to determine whether additional treatments or testing is necessary. 

Stay hydrated

Diarrhea can lead to dehydration, so staying hydrated is key. 

Drinking water or drinks with added electrolytes can help to replenish fluid and electrolyte loss. Try to avoid caffeinated and alcoholic beverages during this time, as these can dehydrate you even further.   

Eat a BRAT diet

A BRAT diet emphasizes bland foods that are well tolerated and can support your digestive system when you’re having diarrhea. BRAT stands for bananas, rice, applesauce, and toast. Other foods included in this diet include oatmeal, soup, and broths. 

Though you don’t have to restrict your diet to only these foods while you’re having diarrhea, they may help to improve your symptoms. Most importantly, it’s a good idea to avoid foods that are high in fiber when you have diarrhea. 

Foods that are high in fiber include beans and legumes, whole-wheat grains, cruciferous vegetables (like brussel sprouts, broccoli, and cauliflower), and chia and flax seeds. 

Avoid rich or spicy foods

Like foods that are high in fiber, rich and spicy foods can worsen symptoms of diarrhea. For that reason, it’s a good idea to avoid fried foods, foods cooked in butter or large amounts of olive oil, and spicy foods.  

Medications

Some over-the-counter (OTC) medications like loperamide (Imodium) and bismuth subsalicylate (Pepto-Bismol) can help reduce the frequency of stools. 

However, you should not take these medications if you have a fever or bloody diarrhea, as these are usually signs of an intestinal infection, and OTC medications can worsen these infections. 

When to See a Medical Provider

Diarrhea that resolves on its own after a few days is rarely cause for concern. However, if you have diarrhea for four days or more, contact your medical provider. 

And if you experience any of the below symptoms, seek emergency care:

• Bloody diarrhea
• Black or tar-colored stools
• High fever and/or chills
• Lightheadedness or dizziness
• Frequent vomiting
• Dark-colored urine
• Sunken eyes or cheeks
• Loose, greasy, or foul-smelling bowel movements
• Six or more loose stools in 24 hours 
• Severe pain in the abdomen or rectum 

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