Can Stress Cause Constipation? Find Out Here

Promoting a healthy digestive system involves more than just eating the right food. As with many aspects of our health, there is a mind and body connection, in which stress hormones may contribute to disturbed bowel functions, including constipation. Read on to learn more about the gut-brain connection of stress and constipation, as well as tips to relieve stress for the benefit of your gastrointestinal tract.

Can stress cause constipation?

The short answer is yes. Stress — for reasons, which will be discussed in more detail below — is known to cause changes in your bowel habits, including constipation. Constipation is a condition in which stool moves too slowly through the large intestine. The signs of constipation may include:

• Hard, dry stools
• Difficulty or pain passing bowel movements
• Having fewer than three bowel movements in a week
• Stomach pain, abdominal fullness

When under stress, your brain's hypothalamus, as part of what's called your hypothalamus-pituitary-adrenal (HPA) axis, stimulates the release of stress hormones like cortisol to prepare your body for a 'fight or flight' response. This increases the blood flow to certain vital organs like those within your cardiovascular system but also slows down other 'non-essential' systems in 'fight or flight' mode such as digestion.

Specifically, when cortisol acts on the digestive system, it decreases gut motility, meaning you will pass the waste more infrequently and your colon will also have additional time to absorb water, forming harder and more dry stools.

Other potential effects of cortisol are increased intestinal permeability and changes to your gut microbiome — both of which may contribute to constipation issues, increasing the risk incidence of stomach pain, bloating, and indigestion.

Another relationship of the gut-brain axis is nerve and muscle function, which is important since passing a bowel movement involves the tightening, relaxation, and coordination of various pelvic floor muscles. Think of when you're stressed and may feel tension in your head, neck, or shoulders. The same is true for how your nervous system affects the pelvic floor. Chronic stress or anxiety may create pelvic floor tension — making it more difficult to pass stool.

Stress that contributes to constipation can be physical or emotional and acute or chronic. The scientific literature referenced above also indicates an association between specific mental health conditions such as anxiety disorders or depression and constipation.

Other causes of constipation

While stress is certainly a contributing factor, there can be other reasons why someone may experience constipation. Diet, especially one that is low in fiber, can lead to constipation, as can poor hydration. A sedentary lifestyle that includes less exercise may contribute to reduced intestinal motility. Additionally, certain medications or supplements like opioids, calcium antacids, or iron may contribute to constipation.

If you have concerns about your bowel habits, be sure to talk with your healthcare provider. They can also rule out any chronic digestive tract conditions like irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD).

Symptoms of stress-induced constipation

The best way to identify whether it is stress causing constipation is to pay attention to other stress-related changes. Likely, if you are experiencing both constipation and other symptoms associated with high stress levels, stress may be the main contributing factor.

Be on the lookout for these signs that your nervous system is on high alert:

• Difficulty falling asleep and/or disturbed sleep
• Changes in appetite
• Forgetfulness, difficulty concentrating
• Racing heart, headaches, muscle tension, sensitive gut
• Irritability, mood swings
• Behaviors such as biting nails, grinding teeth, increased alcohol consumption

How to manage stress-induced constipation

If you think stress is an underlying cause of your digestive issues, it makes sense to focus on reducing your stress levels to relieve constipation. Eating a diet rich in fiber, staying hydrated, and getting regular exercise are also great strategies to promote a healthy digestive process while simultaneously supporting mental health.

Explore our list of tips to help cope with psychological stress and stress-induced constipation, and leave a comment below with your individual techniques to reduce stress.

Stress management techniques

We cannot always control the stressor itself, but we can control how we react to it. The key, therefore, is finding techniques that also support a healthy lifestyle and overall well-being. For instance, some people resort to alcohol as a strategy to manage stress. However, turning to alcohol to continuously cope with stress increases the risk for alcohol use disorder, which comes with its own set of physical and mental health risks.

Activities that support your nervous system, specifically the vagus nerve, are proven to benefit your well-being and mental health:

• Aerobic exercise (brisk walking, jogging, swimming, biking, dancing)
• Stretching, yoga
• Deep breathing
• Mindfulness, meditation
• Laughing
• Singing
• Cold exposure, such as a cold bath, shower, or ice bath

Getting enough sleep, which may help regulate cortisol levels and cope with daily events, is also an important part of stress management.

Stress management devices

In the age of technology, there are also devices available that use touch therapy, vibrations, sound waves, and energy signals to try and stimulate the vagus nerve. Evaluation of these devices to see how effective they are in reducing stress is still ongoing, but it may be an appealing option for those looking for additional stress management techniques, especially people on the go since many devices are wearable.

As with any strategy, individual outcomes can vary, and it's important to check with your healthcare provider before starting something new.

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Dietary changes

When it comes to diet for constipation, adequate fiber intake and hydration are essential. Probiotics may also help regulate bowel function by supporting overall gut health and impacting the connection between the gut and the brain.

Adults, depending on their age and sex, are recommended between 22 and 34 grams of fiber per day, which can be obtained through foods such as:

• Whole grains
• Legumes
• Whole fruits and vegetables
• Nuts and seeds

Water is also important since it helps keep stools soft while fiber is creating bulk. Water also assists with the transit of stools through your intestines.

Estimating daily water needs can sometimes be tricky since needs vary by sex, activity, health, and environment (e.g., living somewhere with hot temperatures). However, the baseline Dietary Reference Intake for recommended daily water consumption is between 11 and 15 cups.

Lastly, the use of certain types of probiotics in healthy individuals may have benefits for potentially helping with cognitive functions, as well as supporting healthy gut microbiota.

Lifestyle changes

From these guidelines come a variety of lifestyle change suggestions that one can adopt to promote better stress management and support overall digestive health. It may be helpful to evaluate your current habits and consider where it makes sense to create some new goals. For example:

• Cutting down on alcohol or other substance use
• Increasing physical activity
• Incorporating more mindfulness into your day through meditation or journaling
• Connecting with people who make you laugh and help you engage in new activities
• Starting a new hobby
• Aiming to increase fiber intake through a healthy diet

Creating a balanced routine

Putting these strategies into action can take some practice and time. Start with one at a time — perhaps with the one you feel will make the largest impact on your stress-related constipation — and create a single goal around it. That may look like sneaking in a walk a few days per week on your lunch break, adding a vegetable to dinner, or starting your mornings with a gratitude journal.

If at any time it feels too difficult to find a balance, resources such as professional therapy or reaching out to your healthcare professional may help.

Medications

Several over-the-counter medications, including laxatives and stool softeners, are options some individuals may choose to help them manage occasional constipation. However, these often do not address the underlying cause of constipation, especially if it is stress-induced. Talk with your healthcare provider before taking any medications to relieve constipation, and consider lifestyle changes first, which can help address the root of your slow digestion.

When to seek professional help

Constipation can be common, but it's worth monitoring your symptoms to understand what your body is trying to tell you. If, after a prolonged period of trying some of the above strategies, you still do not experience relief, or if you have more serious symptoms such as blood in your stool or abdominal pain alongside constipation, it is encouraged that you speak with your healthcare provider.

Here are some additional signs to be on the lookout for:

• Constipation lasting longer than three weeks
• Severe constipation cramps or abdominal pain
• Bloody stool or blood when wiping
• Weight loss
• Fever
• Weakness

The connection between your brain and gut can mean gastrointestinal tract changes like constipation due to increased stress. To understand if stress is causing or making your constipation worse, look for patterns in stress-related signs to your mental and physical health, and then focus on incorporating stress-relieving activities into your day-to-day. In combination with lifestyle changes focusing on stress management, eating more fiber, and getting adequate fluid intake, you can support both your mental health and digestive health.