Anxiety can manifest in numerous physical ways, but perhaps none is as common or distressing as stomach pain. If you've ever felt your stomach "drop" during a stressful moment or experienced persistent digestive discomfort during anxious periods, you're not alone. Understanding what anxiety-induced stomach pain feels like and why it occurs can help you recognize these symptoms and find effective ways to manage them.
Key Takeaways
Stress and anxiety commonly produce GI symptoms.
The pain results from the gut-brain connection, where stress hormones like cortisol affect digestion, alter gut motility, increase stomach acid production, and cause muscle tension, creating a direct pathway between emotional stress and physical stomach symptoms.
Effective management combines immediate relief and long-term strategies, including breathing exercises, heat therapy, dietary modifications, stress management techniques, and professional treatment when symptoms persist or interfere with daily life.
Anxiety and Stomach Pain
Anxiety stomach pain refers to abdominal discomfort, cramping, or other digestive symptoms that result from psychological stress rather than underlying gastrointestinal disease.
Ever wonder why you get "butterflies" in your stomach before doing something stressful, or why you feel like your stomach is "tied in knots" after an argument? Stomach problems are one of the most common symptoms of stress and anxiety.
When you experience anxiety, your body activates its fight-or-flight response, releasing stress hormones that directly affect your digestive system. This creates a cascade of physical sensations that can range from mild discomfort to severe pain.
The Brain-Gut Connection
The relationship between anxiety and stomach pain is rooted in the powerful connection between your brain and digestive system.
Researchers have identified a powerful connection between the gut and the brain. The gut has its own extensive nervous system (the enteric nervous system) — sometimes called the ‘second brain’ — and communicates bidirectionally with the central nervous system, so emotional stress can alter gut function.
This connection means that when your brain experiences a state of stress, it can communicate that distress to your digestive system and trigger gut-based symptoms like cramping, bloating, or an upset stomach. The part of the central nervous system that serves the GI tract, called the enteric nervous system, makes a direct connection between the brain and GI system.
What Anxiety Stomach Pain Actually Feels Like
Anxiety-related stomach pain can manifest in various ways, and the experience often differs from person to person. Just as everyone experiences stress differently, they may experience the stomach discomfort it causes differently. People with stress- or anxiety-related stomach pain most often complain of a knotted feeling, cramping, churning, bloating, indigestion, nausea, or diarrhea.
Common Physical Sensations
Butterflies in the Stomach: The classic "butterflies" sensation is one of the most recognizable forms of anxiety stomach pain. A nervous stomach can give someone "butterflies" in their stomach or even make them feel as though they need to vomit. This fluttering feeling typically occurs in the upper abdomen and is caused by reduced blood flow to the stomach during the stress response.
Stomach butterflies, also known as nervous stomach, refer to a fluttering sensation in the abdomen, often associated with anxiety and nervousness. This feeling is caused by the body's response to stress, which involves the autonomic nervous system.
Knots and Cramping: Many people describe anxiety stomach pain as feeling like their stomach is "tied in knots." This cramping sensation can range from mild discomfort to intense, persistent pain. knotted sensation in their stomachs, often referred to as butterflies in the stomach. This cramping can be mild or intense and persistent, depending on the severity of the stress or anxiety.
Sharp or Stabbing Pains: Some people experience sharp, localized pains that come and go. This is similar to an irritable bowel syndrome (IBS) flare-up. These pains may feel like stabbing and jabbing sensations and are often linked to spasms in the gastrointestinal muscles caused by stress.
Stomach Aches and General Discomfort: Stress and anxiety may cause a dull, aching pain in the abdominal area. This can feel like a sense of heaviness or pressure in the stomach, similar to the feeling you might get after overeating.
Specific Types of Anxiety Stomach Pain
Research and clinical experience have identified several distinct patterns of anxiety-related digestive discomfort:
Abdominal Tension: Stress can cause great tension in the abdominal region. This tension can tire out abdominal muscles and lead to a recurring feeling of discomfort. This type of pain often feels like a tight band around your midsection or constant muscle strain.
Indigestion and Bloating: Stress and anxiety can affect hormone levels, and hormones play a crucial role in digestion. If you are stressed out, it can result in abdominal imbalance that results in indigestion and accompanying symptoms such as bloating, intestinal pain, and others. Bloating or fullness: Anxiety and stress can lead to digestive symptoms like bloating, which can feel like an uncomfortable fullness or tightness in the stomach.
Churning and Gurgling: Many people experience a churning sensation, as if their stomach contents are constantly moving around. This may be accompanied by audible gurgling sounds and can create feelings of nausea or unease.
How Long Does Anxiety Stomach Pain Last?
The duration of anxiety stomach pain varies depending on several factors:
Acute Episodes
For immediate stress responses, stomach pain typically lasts for the duration of the stressful event plus recovery time.
It shouldn't last more than a few hours and should go away when the stressful situation ends. If your upset stomach lasts more than a day, it's possible that something other than stress is causing your stomach pain and you should contact your doctor.
Chronic Patterns
However, chronic stress and anxiety can take a toll on the digestive system and could lead to more serious, long-term stomach problems. When anxiety becomes ongoing, digestive symptoms may persist or occur frequently, creating a cycle where worry about stomach pain actually increases anxiety.
Where Do You Feel Anxiety Stomach Pain?
Anxiety stomach pain can occur in different areas of the abdomen:
Upper Abdomen
Just below the ribcage (epigastric region)
Common location for "butterflies" and nausea
May feel like heartburn or acid reflux
Central Abdomen
Around the belly button area
Often described as cramping or knotting
May be accompanied by churning sensations
Lower Abdomen
Below the belly button
Often associated with bowel changes
May signal stress-related IBS symptoms
Generalized Pain Some people experience diffuse discomfort throughout the entire abdominal area, making it difficult to pinpoint a specific location.
Accompanying Symptoms
Anxiety stomach pain rarely occurs in isolation. Common accompanying symptoms include:
Digestive Symptoms
Nausea or feeling queasy
Changes in appetite (increased or decreased)
Diarrhea or constipation
Increased urination frequency
Acid reflux or heartburn
They can react by quickly pushing waste through your system, causing nausea, cramping, bloating or diarrhea.
Physical Symptoms Beyond the Stomach
Rapid heartbeat or palpitations
Sweating or feeling hot
Trembling or shaking
Muscle tension, especially in shoulders and neck
Headaches
Dizziness or lightheadedness
Emotional and Cognitive Symptoms
Racing thoughts or difficulty concentrating
Feeling on edge or irritable
Fear of having more stomach pain
Worry about underlying health problems
Sleep difficulties
Why Does Anxiety Cause Stomach Pain?
Understanding the mechanisms behind anxiety stomach pain can help you recognize and address these symptoms more effectively.
Stress Hormone Release
When you are anxious, some of the hormones and chemicals released by your body enter your digestive tract, where they interfere with digestion. Anxiety releases a stress hormone called cortisol, which can cause the body to produce excess stomach acid, but the effect varies by person and context. This acidity can irritate the esophagus lining, leading to belly pain, nausea, vomiting, and in severe cases, stress-induced ulcers.
Altered Gut Motility
When you experience stress, your body releases hormones and neurotransmitters, which travel to the gut and affect how your stomach and intestines transfer waste through the body, known as gut motility. This can lead to either slowed digestion (causing bloating and constipation) or accelerated transit (causing diarrhea and cramping).
Muscle Tension and Spasms
Stress tends to cause a great deal of abdominal tension. That tension can tire out abdominal muscles and cause an internal feeling of discomfort. This muscle tension can also lead to spasms in the gastrointestinal tract, creating sharp, cramping pains.
Increased Sensitivity
In stressful or anxiety-provoking situations, it can cause normal physiologic processes to be interpreted as painful. Stress and anxiety can make the gastrointestinal system more sensitive, amplifying pain signals that might normally go unnoticed.
Common Anxiety-Related Stomach Conditions
Chronic anxiety can contribute to or exacerbate several digestive conditions:
Irritable Bowel Syndrome (IBS)
Anxiety is strongly associated with IBS: people with IBS have higher rates of anxiety and depression, and anxiety can worsen IBS symptoms. Evidence supports a bidirectional relationship rather than a simple one-way causal link.
Research shows that 39.1% of IBS patients had anxiety symptoms and 28.8% of them had depressive symptoms. Compared to healthy individuals, IBS patients were three times more likely to suffer from anxiety or depression.
Functional Dyspepsia
This condition involves chronic indigestion without an identifiable medical cause. Anxiety and depression are linked to functional abdominal pain, not only in subjects with IBS but also in otherwise healthy people with milder, subtle GI symptoms.
Gastroparesis
Stress can affect the nerves that control stomach muscles, potentially slowing gastric emptying and causing symptoms like early satiety, bloating, and nausea.
When to Seek Medical Attention
While anxiety stomach pain is generally not dangerous, certain symptoms warrant immediate medical evaluation:
Seek immediate medical attention if you experience:
Severe, sudden abdominal pain
Signs of dehydration (dizziness, dry mouth, little urination)
Blood in vomit or stool
High fever (over 101°F/38.3°C)
Severe difficulty breathing
Chest pain radiating to arm or jaw
Schedule an appointment with your healthcare provider if:
Stomach pain persists for more than a few days
Symptoms worsen over time
You experience unexplained weight loss
Pain interferes with daily activities
You develop new or concerning symptoms
Warning signs like weight loss, blood in the stool, black tarry stools or abnormal blood tests (that can reveal anemia) can indicate that something more serious is occurring.
Medical Disclaimer
This article is for educational purposes only and does not constitute medical advice. The information provided should not replace consultation with a qualified healthcare provider. Individual responses to medications can vary significantly, and what applies to one person may not be safe for another.
Always consult with your doctor or pharmacist before making any decisions about medication changes, discontinuation, or interactions with other substances. If you're experiencing concerning symptoms or side effects, please seek professional help from a healthcare provider. In case of a medical emergency, contact your local emergency services immediately or call 911. For mental health emergencies, contact the National Suicide Prevention Lifeline at 988.
References
Anxiety and Depression Association of America. (n.d.). How to calm an anxious stomach: The brain-gut connection. ADAA.
Canadian Digestive Health Foundation. (2025, January 14). Gut health and mental health: Alleviating anxiety symptoms. CDHF.
Cleveland Clinic. (2025, June 2). What to know about the gut-brain connection. Cleveland Clinic.
Cleveland Clinic. (2023, September 8). Irritable bowel syndrome (IBS): Symptoms, causes & treatment. Cleveland Clinic.
Harvard Health Publishing. (2023, July 18). The gut-brain connection. Harvard Medical School.
Harvard Health Publishing. (2023, July 26). Brain-gut connection explains why integrative treatments can help relieve digestive ailments. Harvard Health Blog.
Johns Hopkins Medicine. (2024, June 20). The brain-gut connection. Johns Hopkins Medicine.
Mayer, E. A. (2011). The brain-gut axis in abdominal pain syndromes. Annual Review of Medicine, 62, 381-396.
Nasirudeen, A. M. A., Isa, H. M., & Shafie, N. H. (2022). Studies on irritable bowel syndrome associated with anxiety or depression in the last 20 years: A bibliometric analysis. Frontiers in Public Health, 10, 947097.
Northwestern Medicine. (n.d.). Mind-gut connection. Northwestern Medicine.
Sibelli, A., Chalder, T., Everitt, H., Workman, P., Windgassen, S., & Moss-Morris, R. (2016). A systematic review with meta-analysis of the role of anxiety and depression in irritable bowel syndrome onset. Psychological Medicine, 46(15), 3065-3080.
University of Missouri School of Medicine. (2023, February 22). Irritable bowel syndrome patients suffer high rates of anxiety and depression. MU School of Medicine.
Zamani, M., Alizadeh-Tabari, S., & Zamani, V. (2019). Systematic review with meta-analysis: The prevalence of anxiety and depression in patients with irritable bowel syndrome. Alimentary Pharmacology & Therapeutics, 50(2), 132-143.
