Emotional challenges like anxiety and depression or digestive disorders can cause individuals to experience a nervous stomach. Can knowing common symptoms, what causes them, and when to see a healthcare provider help manage the disorder?

Nervous Stomach

A nervous stomach is usually nothing to worry about, but it can happen occasionally as a reaction to a new environment, groups of people, foods, stress, and anxiety. Symptoms include indigestion, fluttering stomach/butterflies, or a gut-wrenching feeling. (Anxiety and Depression Association of America. 2023) Causes include underlying psychological and physical health conditions, certain medications, and lifestyle factors. Individuals experiencing chronic or ongoing symptoms should speak with a healthcare provider about their full range of symptoms. Treatments include medication, therapy, and lifestyle changes.

Symptoms

Nervous stomach symptoms can vary. Stress and anxiety can lead to physical symptoms, and physical symptoms may also lead to stress and anxiety. This is because the brain and gut connection communicates which hormones and neurotransmitters will be released and when. Common symptoms include: (Anxiety and Depression Association of America. 2023)

• Loss of appetite
• Butterflies or fluttering feeling in the stomach
• Upset stomach
• Indigestion
• Bloating
• Flatulence
• Gut-wrenching feeling
• Cramping
• Nausea, dry heaving
• Increased need to urinate or have bowel movements
• Constipation
• Diarrhea
• Out-of-sync hunger cues

Causes

In most cases, a nervous stomach will come and go. However, it can also be caused by disorders such as anxiety disorder, depression, or gastrointestinal and digestive disorders. Brain health contributes to gut health, and vice versa. The brain is always communicating with the digestive system, and the digestive system is always sending information back to the brain. (Foster, J. A., and McVey Neufeld, K. A. 2013) (University of Chicago Medical Center, 2024) Common causes of a nervous stomach include: (Anxiety and Depression Association of America. 2023)

• Stress
• Anxiety
• Depression
• Depressive disorders
• Schizophrenia (Fadgyas-Stanculete, M. et al., 2014)
• Irritable bowel syndrome
• Inflammatory bowel disease
• Lifestyle factors like smoking, drinking coffee, and alcohol use can upset the stomach lining. (Ness-Jensen, E., and Lagergren, J. 2017)
• Peptic ulcers can contribute to and be a cause of symptoms and a result of an untreated nervous stomach. (Anxiety and Depression Association of America. 2023)

Medications

Over-the-counter and prescription medications can cause a nervous stomach as a side effect. This can happen when taking a single medication or more than one simultaneously. It can also occur in those with food sensitivities or other medical conditions. (Johns Hopkins Medicine, 2024) This is why consulting and updating a healthcare provider on the current list of prescribed and over-the-counter medications is important. Some meds can irritate the stomach, while others can cause constipation or diarrhea, leading to discomfort and nervous stomach symptoms. Common medications that may cause stomach side effect symptoms include: (Johns Hopkins Medicine, 2024)

• NSAIDs – non-steroidal anti-inflammatory drugs such as ibuprofen can weaken the stomach lining.
• Iron, antacids, and pain meds can cause constipation.
• Antibiotics can cause diarrhea.

Home Treatment

Treatment depends on the severity and cause/s. An infrequently nervous stomach may benefit from over-the-counter therapies to calm it and/or lifestyle changes to reduce stress. Tips for reducing stress and anxiety include (Anxiety and Depression Association of America. 2023)

• More frequent short breaks during the day
• Practicing slow and deep breathing
• Listening to guided meditations for stress-relief
• Adding exercise to the daily routine
• Realizing that stomach problems are part of anxiety and worrying about symptoms may make them worse.

Medical Treatment

Individuals may benefit from additional support treatment options with a healthcare provider (Johns Hopkins Medicine, 2024)

• Antidepressant treatment for nervous stomach and/or irritable bowel syndrome.
• Cognitive behavioral therapy for stress relief and learning how to manage anxiety.
• Medical hypnotherapy
• If symptoms are a side effect of medication or certain foods, a healthcare provider can develop an effective treatment plan that includes using another medication that is easier on the stomach or seeing a dietician.

Complications

Left untreated, a nervous stomach can contribute to further symptoms and other health problems. One study looked at the relationship between irritable bowel syndrome and certain psychiatric disorders. (Fadgyas-Stanculete, M. et al., 2014) This does not mean that a psychiatric disorder causes a nervous stomach or that a nervous stomach causes a psychiatric disorder. It is more likely that a combination of chemicals released when stressed can hurt gut health. This creates imbalances known to be risk factors for digestive disorders and conditions. (Anxiety and Depression Association of America. 2023)

Seeing a Healthcare Provider

Most nervous stomach symptoms resolve on their own. However, certain signs and symptoms can indicate that it is time to see a healthcare provider. Discuss symptoms with a healthcare provider who will order lab tests to check for underlying causes like anemia. See a healthcare provider immediately if you notice the following (University of Chicago Medical Center, 2024)

• Symptoms are making work and/or normal life challenging.
• Chronic or unresolved gastrointestinal issues like heartburn.
• Unexplained weight reduction – losing weight without exercising or diet changes.
• Blood in stool or blackish, tarry stools.
• Vomiting

If there is a medical history of digestive disorders or cancers such as stomach cancer or colon cancer, this will help a healthcare provider. Depending on overall symptoms and family medical history, individuals may be referred to a gastroenterologist and/or a mental healthcare provider, like a counselor or psychiatrist. At Injury Medical Chiropractic and Functional Medicine Clinic, we treat injuries and chronic pain syndromes by developing personalized treatment plans and specialized clinical services focused on injuries and the complete recovery process. We work with primary healthcare providers and specialists to develop an optimal health and wellness solution through an integrated approach to treating injuries and chronic pain syndromes, improving flexibility, mobility, and agility programs to relieve pain and help individuals return to optimal health. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.

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Root Causes of Gut Dysfunction Part 3

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References

Anxiety and Depression Association of America. (2023). How to calm an anxious stomach: The brain-gut connection. Anxiety and Depression Association of America.
Triumphing Through Science, Treatment, and Education. adaa.org/learn-from-us/from-the-experts/blog-posts/consumer/how-calm-anxious-stomach-brain-gut-connection

Foster, J. A., & McVey Neufeld, K. A. (2013). Gut-brain axis: how the microbiome influences anxiety and depression. Trends in neurosciences, 36(5), 305–312. doi.org/10.1016/j.tins.2013.01.005

University of Chicago Medical Center. (2024). Stress and stomach pain: When should you see a specialist? Forefront. www.uchicagomedicine.org/forefront/gastrointestinal-articles/2024/january/stress-stomach-pain-when-to-see-a-doctor

Fadgyas-Stanculete, M., Buga, A. M., Popa-Wagner, A., & Dumitrascu, D. L. (2014). The relationship between irritable bowel syndrome and psychiatric disorders: from molecular changes to clinical manifestations. Journal of molecular psychiatry, 2(1), 4. doi.org/10.1186/2049-9256-2-4

Ness-Jensen, E., & Lagergren, J. (2017). Tobacco smoking, alcohol consumption and gastro-oesophageal reflux disease. Best practice & research. Clinical gastroenterology, 31(5), 501–508. doi.org/10.1016/j.bpg.2017.09.004

Johns Hopkins Medicine. (2024). Medicines and the digestive system. Health. www.hopkinsmedicine.org/health/conditions-and-diseases/medicines-and-the-digestive-system