Most of us think of an agitated emotional state or mental strain when we hear of stress. This is known as psychological stress. However, the body can also undergo physical stress like with a severe disease, major surgery and extensive inury. This is known as physiological stress. It is now known that psychological stress is not isolated to just emotional or mental symptoms. Sometimes psychological stress can lead to physical symptoms, like diarrhea.
What is stress diarrhea?
Stress can refer to either physiological or psychological stress. However, since most people associate “stress” with mental and emotional strain, the focus for this article is diarrhea due to psychological stress. Diarrhea is an alteration in bowel habit where a person passes stool more than three times in a day. Most of the time the stool is watery in consistency or entirely liquid.
Diarrhea can at times occur during periods of psychological stress yet may not be due to the stress itself. Most of the time diarrhea is acute meaning that it arises suddenly and lasts for a short period of time. These acute episodes of diarrhea are often due to infections with viruses, bacteria or protozoa, or the toxins produced by these agents. Certain foods are a common cause of non-infectious diarrhea and once again may be unrelated to stress.
Read more on signs of stress.
Can Stress Cause Diarrhea?
Psychological stress can cause a host of disturbances in the body. Some of these effects are well understood while others are less so. The deterimental effect of long term psychological stress is better understood these days but even in the short term, stress can affect the body in many different ways. Diarrhea is one possible consequence of psychological stress as is seen in anxiety-induced diarrhea.
It is important to note that diarrhea may not be associated with psychological stress when it arises along with other symptoms like fever. Although there can be symptoms like unintentional weight loss with periods of stress, it is important to consider colorectal cancer as a possible cause of diarrhea when this weight loss is also associated with symptoms like rectal bleeding.
How Does Stress Cause Diarrhea?
One of the mechanisms by which stress causes diarrhea is that it affects the movement through the bowels. This is known as bowel motility. Stress hormones like adrenaline may stimulate the nerves that control the muscles in the bowel wall which results in faster bowel motility. With faster movement, food may not be fully digested and water may not be properly absorbed. The undigested food can also draw out more water into the bowels. As a result, diarrhea may occur.
However, it is important to differentiate between diarrhea that is caused by psychological stress and diarrhea that is due to some other condition which is aggravated by psychological stress. Several conditions, particularly chronic diarrheal conditions, may be exacerbated with stress. Furthermore in many of these conditions, there are little to no symptoms until acute episodes (flareups) arise where diarrhea may be one of the symptoms.
Causes of Stress Diarrhea
Apart from the direct effects of psychological stress on bowel motility, stress can also lead to diarrhea for other reasons. Some of these possible reasons have been discussed below. However, it is important to have diarrhea assessed by a medical professional especially if it is persistent or worsening. Diarrhea can lead to dehyration which has a host of adverse effects and can even become life threatening if not promptly treated.
Read more on persistent diarrhea.
Dietary habits may change during periods of psychological stress. Some people may eat less while others may eat more. Comfort eating is one way that many people use to cope with periods of stress. Increased food consumption can therefore contribute to more frequent bowel movements. The consumption or excess consumption of certain foods that are normally not part of the daily diet can also contribute to digestive disturbances like diarrhea.
Overuse of Stimulants
Another change in habits during periods of psychological stress is the use, and often the overuse, of stimulants like caffeine and nicotine. While caffeine is a widely used stimulant and may not cause a digestive problem for many users, when consumed it excess it may lead to symptoms like diarrhea. Tobacco users who may increase consumption may also experience symptoms like diarrhea due to the higher levels of nicotine in the body.
The use and abuse of other substances may also occur as a consequence of psychological stress. This may include alcohol, over-the-counter (OTC) and prescription medication, as well as illicit drugs. Depending on the substance, it may give rise to symptoms like diarrhea. Abuse of laxatives may also occur in people with an existing or previous history of eating disorders which leads to diarrhea.
Irritable Bowel Syndrome
Irritable bowel syndrome or IBS is one of the conditions that is often aggravated by stress. A person who has IBS-D (irritable bowel syndrome with diarrhea) may find that the diarrhea is triggered or worsened during periods of psychological stress. IBS is not a disease but a syndrome where symptoms like abdominal pain and alterations in bowel habit occur despite the absence of any disease. Therefore it is known as a functional bowel disorder.
Inflammatory Bowel Disease
Inflammatory bowel disease (IBD) is an autoimmune disorder where the immune system attacks the digestive tract thereby causing inflammation. The exact cause is unknown although a combination of genetic and environmental causes appear to play a role. It is a chronic condition marked by periods of remission and flareups. Psychological stress may be one of the possible triggers of these acute flareups in IBD but is not the cause of the condition.
Celiac disease is another immune-mediated condition where the bowels become inflamed after making contact with gluten, a protein that is abundant in foods like wheat. Although the exact cause is unknown, there appears to be several possible triggers. Major emotional stress appears to be one of the possible triggers where the condition becomes active for the first time or becomes worse. Once again, psychological stress is not the cause.