The Link Between Gastric Disorders and Anxiety

  • May 17th 2025
  • Est. 6 minutes read

The term “gut-brain-axis” refers to the communication between the central nervous system and the gut microbiome. Because of this communication, gastric disorders may be related to anxiety[1].

What Is the Gut-Brain Connection?

Before diving into the relationship between gut health and anxiety, it’s helpful to understand the gut-brain connection. Also called the gut-brain axis, this term refers to the communication that occurs between the gut microbiome and the central nervous system[1].

This connection exists because of the neuroendocrine system, the immune system, and metabolic pathways that allow for bidirectional communication. Because of the connection, changes to bacteria in the gut affect brain physiology and cognitive functioning, which explains the relationship between anxiety and stomach issues[2].

The gut-brain connection can have a powerful impact on emotions. In one study, the diversity of bacteria in the gut was related to emotion regulation[3]. So, alterations in the gut bacteria may lead to difficulties with emotion regulation, including anxiety.

Because of this, a healthy balance of gut bacteria is essential for emotional regulation, whereas disturbances in these bacteria can lead to psychiatric disturbances.[4].

Common Gastric Disorders Linked to Anxiety

The link between the gut and the brain has been established, so it would be reasonable to conclude that gastric disorders increase the risk of anxiety. Research assessing the specific stomach issues that cause anxiety is discussed in more detail below.

Irritable Bowel Syndrome (IBS)

A strong link between IBS and anxiety has been established. According to a review of 73 different studies, people with IBS are three times as likely to experience anxiety symptoms. The authors of the review concluded that the higher risk of anxiety in IBS patients is a result of the brain-gut connection[5].

Gastroesophageal Reflux Disease (GERD)

Research has also shown that individuals with GERD tend to have elevated anxiety levels. As researchers have explained, the functioning of one’s gastrointestinal system can affect emotions. This could explain elevated anxiety levels in those with GERD. It’s also possible that stress and emotions could negatively affect gastrointestinal functioning[6].

Crohn’s Disease

Crohn’s disease is also linked to anxiety. In one study of patients with Crohn’s disease, 61.7% of participants had anxiety, depression, or both, with anxiety the more common of the two.[7]. Disturbances in the gut microbiome contribute to Crohn’s disease, and because of the gut-brain axis, these disturbances can also cause anxiety[8].

Can Stress and Anxiety Cause Gastric Disorders?

It’s well-established that there is a connection between the gut and the brain, which can cause gastrointestinal symptoms of anxiety. However, research indicates it works both ways and that stress and anxiety may directly cause gastric disorders. For example, research suggests that psychological stress negatively impacts gut functioning[8].

Researchers have also found that psychological conditions like anxiety may directly cause symptoms of GERD. Anxiety can reduce the pressure in the lower esophageal sphincter, which causes reflux[6]. Other research suggests anxiety might play a role in inflammatory bowel diseases[8].

Stress and anxiety can cause gastric disorders, as both disrupt the nervous system in the brain and intestinal tract. This can lead to changes in the gut microbiome, which can cause symptoms of conditions like IBS[9].

Some studies suggest, however, that it’s anxiety treatments rather than anxiety itself that cause gastric problems. For instance, taking medications for anxiety can lead to inflammatory bowel diseases[8]. Regardless of the specific mechanism by which anxiety is linked to gastric disorders, the bottom line is that the two are connected, and the gut-brain axis explains this connection, at least partially[2].

How to Manage Gut Health to Reduce Anxiety

Gut health and anxiety are strongly related, and the community of bacteria in the gut can potentially affect mental health. Since the central nervous system can communicate with the nervous system in the gut, the bacteria in the gut can affect mental health[10]. Based on these facts, promoting a healthy balance of bacteria in the gut could reduce anxiety.

So, what can be done to promote gut health?

Make Time for Exercise

Most people know getting enough exercise is important, but it can specifically benefit gut health. Research suggests that regular exercise improves the composition of the gut bacteria. Exercise can increase the number of beneficial bacteria and enhance the diversity of your gut microbiome, which is beneficial for health[11].

Follow a Healthy Diet

Dietary factors are also linked to gut health. More specifically, a high-fat, low-fiber Western diet may harm gut health and lead to inflammation, whereas a diet rich in omega-3 fatty acids can be beneficial.

The Mediterranean diet, which emphasizes consuming fish, fruits, vegetables, unrefined grains, beans, and olive oil, while limiting sugar and red meats, may also promote gut health[12].

Consider a Probiotic

There is some evidence that probiotics may help promote gut health, at least in the short term. A review of the research shows that probiotics can improve the concentration of gut bacteria, improve the immune system, and enhance stool consistency[13]. However, probiotics may not be the answer for everyone, so it is important to discuss them with a doctor.

Practice Healthy Stress Management

As stress harms gut health[8], managing this can be essential for reducing the anxiety associated with gut problems. Scientists have found that stress management interventions can reduce bowel and mental health problems in those with IBS, at least over the short term, but more research is needed[15].

Seek Medical Treatment

Sometimes, medical treatment is warranted to treat gastric problems. Over-the-counter and prescription medications are available to treat various gastrointestinal ailments. For instance, antacids like Tums or Imodium can reduce stomach complaints.

Your doctor may also recommend H2 blockers or proton pump inhibitors or prescribe a form of these medications to reduce upset stomach[14]. For inflammatory bowel diseases like Crohn’s disease, prescription medications such as immunomodulators and biologics can provide relief[16].

Anxiety and gut health seem to be related. Fortunately, you can take steps to protect gut health and reduce the risk of anxiety. Positive lifestyle habits can go a long way, but if you’re struggling with anxiety and/or gastrointestinal distress, it’s essential to see a physician to determine if medical treatment is warranted. Talk therapy may also help teach ways to manage anxiety[14].

References
  1. Clapp, M., Aurora, N., Herrera, L., Bhatia, M., Wilen, E., & Wakefield, S. (2017). Gut microbiota’s effect on mental health: The gut-brain axis. Clinical Practice, 7(4), 987. https://www.mdpi.com/2039-7283/7/4/987
  2. Gwak, M.-G., & Chang, S.-Y. (2021). Gut-brain connection: Microbiome, gut barrier, and environmental sensors. Immune Network, 21(3), e20. https://immunenetwork.org/DOIx.php?id=10.4110/in.2021.21.e20
  3. Ke, S., Guimond, A.-J., Tworoger, S. S., Huang, T., Chan, A. T., Liu, Y.-Y., & Kubzansky, L. D. (2023). Gut feelings: Associations of emotions and emotion regulation with the gut microbiome in women. Psychological Medicine, 53(15). https://www.cambridge.org/core/journals/psychological-medicine/article/vaccinepreventable-hospitalisations-in-adult-mental-health-service-users-a-population-study/92E09C45AB557F6ECD586C9530B25FB0
  4. Yang, H., Liu, Y., Cai, R., Li, Y., & Gu, B. (2021). A narrative review of the relationship between gut microbiota and neuropsychiatric disorders: Mechanisms and clinical application of probiotics and prebiotics. Annals of Palliative Medicine, 10(2). https://pubmed.ncbi.nlm.nih.gov/33549028/
  5. 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. Aliment Pharmacol Ther, 50, 132–143. https://onlinelibrary.wiley.com/doi/10.1111/apt.15325
  6. Choi, J. M., Yang, J. I., Kang, S. J., Han, Y. M., Lee, J., Lee, C., Chung, S. J., Yoon, D. H., Park, B., & Kim, Y. S. (2018). Association between anxiety and depression and gastroesophageal reflux disease: Results from a large cross-sectional study. Journal of Neurogastroenterology and Motility, 24(4), 593–602. https://www.jnmjournal.org/journal/view.html?doi=10.5056/jnm18069
  7. Tomazoni, E. I., & Benvegnú, D. M. (2018). Symptoms of anxiety and depression, and quality of life of patients with Crohn’s disease. Arquivos de Gastroenterologia, 55(2). https://www.scielo.br/j/ag/a/HYK3jmGfZxwwdwzBrGDzGnr/?lang=en
  8. Abautret-Daly, Á., Dempsey, E., Parra-Blanco, A., Medina, C., & Harkin, A. (2017). Gut–brain actions underlying comorbid anxiety and depression associated with inflammatory bowel disease. Acta Neuropsychiatrica, 30(5). doi:10.1017/neu.2017.3
  9. Diao, Z., Xu, W., Guo, D., Zhang, J., Zhang, R., Liu, F., Hu, Y., & Ma, Y. (2023). Causal association between psycho-psychological factors, such as stress, anxiety, depression, and irritable bowel syndrome: Mendelian randomization. Medicine (Baltimore), 102(34), e34802. https://journals.lww.com/md-journal/fulltext/2023/08250/causal_association_between_psycho_psychological.13.aspx
  10. Peirce, J. M., & Alviña, K. (2019). The role of inflammation and the gut microbiome in depression and anxiety. Journal of Neuroscience Research, 97(10), 1223–1241. https://onlinelibrary.wiley.com/doi/10.1002/jnr.24476
  11. Monda, V., Villano, I., Messina, A., Valenzano, A., Esposito, T., Moscatelli, F., Viggiano, A., Cibelli, G., Chieffi, S., Monda, M., & Messina, G. (2017). Exercise modifies the gut microbiota with positive health effects. Oxidative Medicine and Cellular Longevity, 3831972. https://onlinelibrary.wiley.com/doi/10.1155/2017/3831972
  12. Nova, E., Gómez-Martinez, S., & González-Soltero, R. (2022). The influence of dietary factors on the gut microbiota. Microorganisms, 10(7), 1368. https://www.mdpi.com/2076-2607/10/7/1368
  13. Khalesi, S., Bellissimo, N., Vandelanotte, C., Williams, S., Stanley, D., & Irwin, C. (2019). A review of probiotic supplementation in healthy adults: Helpful or hype? European Journal of Clinical Nutrition, 73, 24–37. https://www.nature.com/articles/s41430-018-0135-9
  14. National Institute of Diabetes and Digestive and Kidney Diseases. (2016). Treatment of indigestion. https://www.niddk.nih.gov/health-information/digestive-diseases/indigestion-dyspepsia/treatment
  15. Horn, A., Stangl, S., Parisi, S., Bauer, N., Roll, J., Löffler, C., Gágyor, I., Haas, K., Heuschmann, P. U., Langhorst, J., & Keil, T. (2023). Systematic review with meta-analysis: Stress-management interventions for patients with irritable bowel syndrome. Stress and Health, 39(4), 694–707. https://onlinelibrary.wiley.com/doi/10.1002/smi.3226
  16. Cai, Z., Wang, S., & Li, J. (2021). Treatment of inflammatory bowel disease: A comprehensive review. Frontiers in Medicine, 8, 765474. https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.765474/full
Author Dr. Randi Fredricks, Ph.D. Writer

Dr. Randi Fredricks, Ph.D., is a therapist, researcher, and author with a Ph.D. in Psychology and a Doctorate in Naturopathy. Based in California, she is a licensed marriage and family therapist, as well as a certified clinical nutritionist, herbalist, hypnotherapist, and master NLP practitioner.

Published: May 17th 2025, Last updated: Jun 12th 2025

Morgan Blair
Medical Reviewer Morgan Blair MA, LPCC

Morgan Blair is a licensed therapist, writer and medical reviewer, holding a master’s degree in clinical mental health counseling from Northwestern University.

Content reviewed by a medical professional. Last reviewed: Jan 31st 2025
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