Nervous Stomach – Problems and Symptoms due to Anxiety, Stress

A nervous stomach is a general term to describe a number of gastrointestinal conditions that are triggered or aggravated by emotions. It can range from symptoms that are isolated to one part of the gastrointestinal tract, like the stomach, to disorders affecting the entire gut. However, it is commonly used to describe irritable bowel syndrome and less frequently,  non-ulcer or functional dyspepsia.

Nervous Stomach Causes

The gastrointestinal activity is under the control of the autonomic system which often operates by means of visceral reflexes (1). It does not exist in isolation and can be influenced by the limbic system and cerebral cortex. Under normal circumstances, the sympathetic stimulation as a result of the “fight-or-flight” (stress/alarm) response inhibits gastrointestinal activity and the same applies for the pain reflex. In a person with a functional bowel syndrome, the opposite reaction may also occur resulting in increased secretion of digestive enzymes (like gastric acid secretion), contractions (peristalsis) and defecation.

Nervous Stomach and Emotions

Certain emotions, memories and experiences can affect the gastrointestinal system in a number of ways due to sympathetic and parasympathetic stimulation and local reflexes. It is important to note that due to individual processing of various stimuli, each person may respond differently to a situation/event. The following emotions may elicit an altered activity of the gastrointestinal system.

  • anger
  • anxiety
  • excitement
  • fear
  • nervousness (anticipation)
  • sudden fright
  • stress
  • worry

Nervous Stomach and Pain

Severe pain may also affect gastrointestinal activity and this can be explained in part by the mass reflex reaction of the spinal cord. In this instance, pain as a stimulus causes excitation of large portions, if not all, of the spinal cord and triggers the reflexes of the gastrointestinal system – for example, activation of duodenocolic,  gastrocolic and/or defecation reflexes resulting in filling of the rectum with feces, urging and evacuation.

Nervous System and Functional Bowel Syndromes

With a nervous stomach, there is usually no clear indication of any pathology within the gut which could explain the cause of the signs and symptoms affecting a person. These are referred to as functional bowel syndromes and the two most common types are :

While the exact mechanism of action is still unclear, emotional stress tends to aggravate these conditions. This may be due to a direct effect by the cerebral cortex and limbic system upon the autonomic and/or enteric nervous system or smooth muscle hyperresponsiveness eliciting local reflexes.

Nervous Stomach Signs and Symptoms

Some of these symptoms include :

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