By Michelle Pugle 

 Medically reviewed by Jay N. Yepuri, MD

A nervous stomach is a common problem that can be caused by emotional challenges such as anxiety and depression or by digestive disorders. It may include symptoms such as feeling "butterflies" in your stomach or experiencing a "gut-wrenching" feeling.1

Nervous stomach every now and then is no cause for concern. If you're experiencing ongoing symptoms, you may want to consider seeing a healthcare provider.

This article will explain common symptoms of nervous stomach, what causes it, and when to see a healthcare provider.

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Symptoms of Nervous Stomach

Nervous stomach symptoms can vary. When caused by stress and anxiety, it can lead to physical symptoms. Physical symptoms may also lead to stress and anxiety. This is because the brain and gut are closely connected and communicate about which hormones and neurotransmitters to release and when.1

Common nervous stomach symptoms:1

  • Upset stomach or indigestion

  • Bloating and flatulence

  • Cramping pain

  • "Butterflies" or unsettled feeling in the stomach

  • "Gut-wrenching" feeling

  • Diarrhea and/or constipation

  • Nausea, dry heaving, or feeling "sick to your stomach"

  • Loss of appetite or off-sync hunger cues

  • Increased need to urinate or have bowel movements

Causes of Nervous Stomach

Common causes of nervous stomach include emotional distress such as stress or anxiety. In most cases, a nervous stomach isn't anything to worry about. It will come and go.

Nervous stomach can also be caused by disorders or diseases such as anxiety disorder, depression, or gastrointestinal and digestive disorders. Brain health contributes to gut health, and gut health contributes to brain health. The brain is always sharing information with the digestive system, and the digestive system is always sharing information with the brain.23

Causes of nervous stomach include:1

  • Stress

  • Anxiety

  • Depression and depressive disorders such as bipolar disorder

  • Schizophrenia4

  • Irritable bowel syndrome

  • Inflammatory bowel disease

  • Certain lifestyle factors, including smoking, drinking coffee, and alcohol use which upset the stomach lining5

Peptic Ulcers

Peptic ulcers can be a cause of nervous stomach symptoms and a result of untreated nervous stomach.1

What Medications Can Cause Nervous Stomach?

Over-the-counter and prescription medications may cause a nervous stomach as a side effect. This can happen when taking a single medication or more than one medication simultaneously. It may also occur in people with ingredient sensitivities or other medical conditions.6 This is why it's always important to consult and update a healthcare provider on your current list of medications (including over-the-counter medications).

Some medications may irritate the stomach, while others can cause constipation or diarrhea leading to discomfort and nervous stomach symptoms.

Common medications that may cause stomach side effect symptoms include:6

  • Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen which can weaken the stomach lining.

  • Iron, antacids, and pain medications, particularly narcotics that cause constipation.

  • Antibiotics, which can cause diarrhea.

How to Treat Nervous Stomach

The method of treating nervous stomach will depend upon the cause. Nervous stomach that occurs infrequently may benefit from over-the-counter remedies to calm the stomach or lifestyle changes to reduce stress.

The following are tips for reducing stress and anxiety to help with nervous stomach:1

  • Take more frequent short breaks during the day

  • Practice slow and deep breathing

  • Work on saying "no"

  • Add exercise to your daily routine

  • Accept stomach problems as part of anxiety (ie., worrying about your stomach symptoms may make them worse)

  • Listen to guided meditations for lasting stress-relief

Medical Treatments for Nervous Stomach

If you or a loved one may benefit from additional support, you may want to discuss the following treatment options with a healthcare provider:6

  • Antidepressant treatment for nervous stomach or irritable bowel syndrome

  • Cognitive behavioral therapy (CBT) for stress-relief and learning how to cope with anxiety

  • Medical hypnotherapy

If nervous stomach is a side effect from medication or certain foods, your healthcare provider can make suggestions about effective treatment which may include transitioning to another medication option that is easier on the stomach or seeing a dietician.

Complications Associated With Nervous Stomach

Left untreated, symptoms of nervous stomach can contribute to future symptoms. One study demonstrated a relationship between irritable bowel syndrome and a range of psychiatric disorders.4 Bear in mind correlation is not the same as causation. So this is not the same as saying that nervous stomach is caused by psychiatric disorder or psychiatric disorder is caused by nervous stomach. It's much more likely a mix of both.

The Anxiety and Depression Association of America says the types of chemicals that are released when a person is stressed have a negative effect on gut health. This creates imbalances known to be risk factors for digestive conditions.1

When to See a Healthcare Provider

A nervous stomach may resolve on its own. But there are certain signs and symptoms that it's time to see a healthcare provider. If you discuss your symptoms, the healthcare provider may order routine lab tests to check for underlying causes like anemia.

See a healthcare provider for nervous stomach immediately if you notice the following:3

  • Unexplained weight reduction (ie., you lose weight without trying or knowing why)

  • Blood in stool or blackish, tarry stools

  • Chronic or unresolved gastrointestinal issues including heartburn

  • Vomiting

  • Your symptoms are causing work or social life challenges

If you have family history of digestive disorders or digestive cancers such as stomach cancer or colon cancer, this is helpful information for a healthcare provider.

You may be referred to a gastroenterologist (digestive disorder and disease specialist) and/or a mental healthcare provider such as a counselor or psychiatrist, depending on your overall symptoms and family medical history.

Summary

A nervous stomach is usually nothing to worry about. Symptoms include indigestion, feeling "butterflies" or a gut-wrenching feeling. Causes of nervous stomach include underlying psychological and physical health conditions and certain medications and lifestyle factors. If you experience chronic or ongoing symptoms, see a healthcare provider. Treatments include medication, therapy, and lifestyle changes.

Sources

Anxiety and Depression Association of America. How to calm an anxious stomach: The brain-gut connection.

Foster JA , McVey Neufeld. Gut-brain axis: How the microbiome influences anxiety and depression. Trends in Neurosciences. 2013;36(5):305-312. doi:10.1016/j.tins.2013.01.005

University of Chicago Medical Center. Stress and stomach pain: When should you see a specialist?

Fadgyas-Stanculete M, Buga AM, Popa-Wagner A, Dumitrascu DL. The relationship between irritable bowel syndrome and psychiatric disorders: From molecular changes to clinical manifestations. J Mol Psychiatry. 2014;2(1):4. doi:10.1186/2049-9256-2-4

Ness-Jensen E, Lagergren J. Tobacco smoking, alcohol consumption and gastro-oesophageal reflux disease. Best Practice & Research Clinical Gastroenterology. 2017;31(5):501-508. doi:10.1016/j.bpg.2017.09.004

Johns Hopkins Medicine. Medicines and the digestive system.

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By Michelle Pugle
Michelle Pugle, MA, MHFA is a freelance health writer as seen in Healthline, Health, Everyday Health, Psych Central, and Verywell.