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How To Tell If Your Stomach Pain Is Caused By Stress Or Indigestion

Woman with Stomach Pain
Image by LaylaBird / iStock
April 18, 2020

Stomach pain, at the minimum, is unpleasant and uncomfortable. At its worst, stomachaches can be quite debilitating—making it difficult to eat, move, or sleep well. If your diet and overall health haven't changed, but you're experiencing more stomach pain lately, it might be a symptom of stress. 

We consulted experts in integrative medicine and psychology to explain why stress can manifest physically and how to differentiate indigestion from stress-induced stomach pain. 

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Can stress cause stomach pain? 

Stomach pain has many causes, and stress can be one of them. It can interfere with digestion because of the gut-brain connection via the vagus nerve. "Our stomach and intestines have their own unique nervous system called the enteric nervous system," holistic psychologist Nicole Lippman-Barile, Ph.D., tells mbg. "These nerves respond to the same stress hormones and neurotransmitters that our brains do."

Meaning, the hormones you release when you're stressed can enter into the digestive system and disrupt the process of digestion, causing stomach pain. 

While stress can cause abdominal pain, integrative medicine physician Aditi Nerurkar, M.D., MPH, says it's critical to rule out any underlying etiology before naming stress as the cause. This ensures doctors and patients don't overlook any serious medical issues. 

How can you distinguish stress-induced pain from indigestion?

It can be difficult to differentiate stress-related abdominal pain from other forms of abdominal pain, according to Nerurkar. "They often present as the same symptoms, with the same intensity." And they can be connected.

If you have common digestive or food-related issues, Wendie Trubow, M.D., MBA, says taking probiotic supplements can help manage symptoms.* She also recommends slowing down while you eat, chewing your food completely, and opting for easy-to-digest foods. Once your digestion is optimized, it will be easier to tell if stress is creating your stomach pain or simply elevating symptoms.

"Stomach pain can be a combination of normal indigestion as well as stress because of the connection between your mind and your gut," Lippman-Barile says. The gut microbiome is an important piece of this connection. "There are three to five times more serotonin receptors in the gut1 than the brain," according to Nerurkar. "This may be why the gut microbiome is intimately linked to our mood state."  So even if it starts as a physical ailment, stress can worsen any pre-existing stomach pain. 

Another way to narrow down what your main triggers are is by creating a daily pain diary with your doctor, says Nerurkar. When you start to experience stomach pain, write down the time of day, what foods you've consumed, what kind of physical activity you've participated in, and your current emotional state. Also, be sure to describe the pain (Sharp, dull? Where is it located?), plus record stool consistency and patterns. "All of these points can help your doctor figure out why you may be having pain."

It's also important to keep in mind that stress typically affects the whole body—not just digestion—and can lead to rapid breathing, a general feeling of nervousness, and racing thoughts, Lippman-Barile says.

"Stomach pain frequently manifests in some clear time frame after the stressor happens," Trubow says. "For some people it's immediate, and for others it's a little delayed." If you're able to name the stressor—whether it's physical or emotional—responsible for your pain, you may be able to manage it before it becomes problematic. 

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How can you manage stress-related stomach pain?

If you suspect stress is the trigger, "One of the best ways to quell anxiety- or stress-induced stomach pain is to practice deep breathing techniques," Lippman-Barile suggests. "It allows our gut and brain to communicate with each other and tells it to start slowing down." She also recommends exercising to help reduce stress.

Bottom line.

Whether your stomach pain is caused by indigestion or stress, it's important to pay attention to your body and what it's trying to tell you. "The more you are aware of the triggers and what causes it, the better able you are to understand what you need to do in order to reduce these feelings and manage them in a healthy way," says Lippman-Barile. If you experience frequent or debilitating stomach pain, be sure to speak with your doctor to get to the root of the issue and determine the best course of action.