Anxiety, Stress, and Stomachaches

“Mommy, I have a tummy ache.”

Where would childhood be without this vague refrain? As adults we may not use the same woebegone words, but who hasn’t had a nervous stomach, a butterfly belly, or a case of anxiety that sent us to the bathroom, nauseous, sweating, and near to vomiting?

Lots of things can leave us queasy or give us a stomachache. Viruses and bacteria are major physical causes of nausea and vomiting. But so are our emotions, especially anxiety, stress, and excitement. Consider:

• Social anxiety. We’ve all had this in certain situations. Maybe it’s attending a fancy party where we don’t know anyone, or heading out for the first day of school or a new job.
• Performance anxiety. It could be giving an important talk at a meeting, or preparing for the biggest game of the season.
• Stress or fear. Maybe it’s mortgage payment worries, a child moving across country to attend college, or a bully at school.
• Over-excitement. Here’s a “good” reason for tummy upsets. Think a great big wedding, maybe graduation day, or a much-anticipated vacation.

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How Emotions Affect Our Body

Why do our feelings sometimes make us sick?

“Our lives are filled with emotions, from anger to shame, fear to delight,” says Tracy A. Dennis, PhD, associate professor in the department of psychology at Hunter College, the City University of New York.

Each of these emotions causes complex physical responses. When we’re angry, for example, our heart rate increases, adrenaline flows, blood pressure spikes, and we “see red,” Dennis says.

“These physiological and neuroendocrine changes associated with emotion influence all aspects of our body, including the digestive system,” Dennis tells WebMD. “These physical responses can start and stop quite suddenly and be very intense.”

Dennis says it’s the intensity of emotions that can send our body into overdrive, producing immediate gastrointestinal distress -- stomachaches, nausea, vomiting, diarrhea. (Over the long-run, these same neuroendocrine responses can raise our risks of high blood pressure or cardiovascular disease.)

Stress, Anxiety, Vomiting, and Stomachache: What You Can Do

If you or your child suffers frequent stomachaches or nausea, first see a doctor to rule out any physical cause. Physical causes -- bacteria, a virus, acid reflux, lactose intolerance, constipation -- are usually behind the stomachaches and vomiting of younger children.

“It’s beyond toddlerhood when you tend to get into the stress-triggered abdominal complaints,” says Chris Tolcher, MD, FAAP, a pediatrician and clinical assistant professor of pediatrics at the University of Southern California School of Medicine.

Once you’ve ruled out physical causes, take a close look at how you or your child react to stressful situations.

“We all know that our mind influences our body, and vice versa. The science of emotion and stress is starting to catch up with our intuitive understanding of this,” Dennis says.

Therapy can help children and adults. But, often there’s no need for a therapist. Learning how to regulate emotions more effectively also helps.

“The key may be to learn how to ‘look for the silver lining’ in each emotionally challenging situation before we have an emotional reaction,” Dennis says.

For example, perhaps an upcoming job interview or school test would normally make you or your child anxiously fear failure. This fear leads to a cascade of negative emotions, stress, and physical distress. Instead, try to see the situation in a more positive light: An opportunity to share your expertise or enthusiasm, or to learn.

“Like anything, this takes practice,” Dennis says.

To help your body influence -- and soothe -- your mind, these coping tips can be a big help.

Managing Stress, Anxiety, and Over-Excitement

• Breathe deep. Close your eyes and take a deep breath, then another. Let each breath out slowly. Repeat as needed.
• Light exercise. Walking and stretching can soothe a stressed-out body or an over-excited mind.
• Meditate. Focus on your breathing and what’s happening around you right now.
• Take a time out. Distract yourself with something you enjoy, like TV, gardening, playing with pets, or a visit with friends.
• Visualize. Picture yourself facing and conquering fears. For example, see yourself succeeding in that meeting.
• Get support. Call up a sympathetic friend or family member and talk.
• Make a plan. Just thinking about how you’ll handle a problem can help you begin to feel in control.
• Eat and drink right. Alcohol can make stress and anxiety worse. Overeating can pile guilt and nausea onto an already overwrought situation.
• Rest up. Whether it’s stress, anxiety, or excitement taking your body on a roller-coaster ride, the unchangeable fact is you need to rest and recharge. So daydream. Take naps. And, always get a good night’s sleep.

Sometimes you need a little more assistance to manage the stomachache, nausea, or other physical symptoms of stress, anxiety, and excitement. Here’s a few expert tips that may help.

• Stay hydrated. If stress or over-excitement has caused you or the kids to vomit, it’s important to stay hydrated, but do wait 30 to 60 minutes after vomiting before putting anything in your stomach, says Scott Cohen, MD, FAAP, an attending physician at Cedars Sinai Medical Center and a pediatrician. Then take it very slowly, sipping one teaspoon of fluids at a time. Steer clear of solid foods until it’s been six hours since the last time you vomited.
• Food and drinks. Many swear that peppermint tea or ginger soothe a nervous stomach or foil nausea. Ginger can be a hard sell for kids though, and the more popular remedy, ginger-ale, usually “isn’t made with real ginger, it’s really liquid candy, and we don’t recommend it,” Tolcher tells WebMD. Chances are good you already know what helps calm stomachache in you or your kids. It could be soup, seltzer, crackers, toast, or some other comfort food.
• Medications: Some help. Others don’t. Many over-the-counter medications can help you deal with vomiting or one or more of the side effects of a nervous stomach, like nausea, diarrhea, or acidity, including Alka-Seltzer, Emetrol, Mylanta, Pepto-Bismal, Similac, or Tums. To know which medication is most appropriate for your symptom, talk to your doctor. If you’re trying to mellow a stomachache by popping medicines with ibuprofen (Advil, Motrin), don’t. Ibuprofen generally won’t help, and can sometimes make a stomachache worse.
• Avoid strong odors. If your tummy is queasy or you feel like you’re going to vomit, steer clear of strong odors like cooking smells, smoke, and perfumes, they can help tip you from “almost” to “definitely.”
• Lifestyle changes. Constipation can also be a symptom of stress in kids or adults, “and for that we use things like dietary changes, fiber supplements or laxatives,” says Tolcher. If diarrhea is the problem fiber supplements and probiotics (like those found in yogurt, or in some supplements) might help relieve stress-triggered bowel pain.

These are just a few ways to get your body and mind back in balance. If anxiety and stress become overwhelming and you’re dealing with the physical pain of that pressure daily, be sure to reach out and get help.