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This Is What Stress Does to the Gut

You know that what you eat can affect your gut (hello, probiotics!), but did you know that your mental health is also connected to your gut? It makes sense when you consider that bacteria in your gut are responsible for producing and regulating hormones. In fact, more than 90 percent of the body’s serotonin—a hormone that affects your mood—is synthesized in the gut.

You’ve probably felt the connection before: “Just think about how many times you’ve ‘gone with your gut’ to make a difficult decision or felt ‘butterflies in your stomach’ when you were nervous about a new opportunity,” says Peyton Berookim, M.D., director of the Gastroenterology Institute of Southern California.

The gut—officially called the enteric nervous system—has such a complex nervous system of its own that it’s sometimes called the second brain. “Since the enteric system connects to the big brain, or central nervous system, the mind-gut connection definitely plays a role in diagnosis and treatment processes in my practice,” Berookim says.

Your gut microbiome is a delicate balance of bacteria. It’s important to maintain levels of good bacteria; when the balance is disrupted, you may encounter a range of issues, both physical and mental. Stress can upend your bacteria’s balance, negatively affecting your microbiome, disrupting your digestive process, and decreasing production of antibodies that protect the body.
When you’re stressed, it affects your body, mainly through the regulation of hormones like serotonin and cortisol. Serotonin, in addition to regulating your mood, happiness, and anxiety, plays a role in your bowel movements. And, Berookim says, “Altered levels of peripheral serotonin have been linked to diseases such as irritable bowel syndrome, cardiovascular disease, and osteoporosis.” Meanwhile, cortisol—which is often called the stress hormone—helps regulate the metabolism and reduce inflammation. However, having cortisol levels that are too high or low can cause physical and mental health issues.

“We know that in people with irritable bowel syndrome, stress exacerbates symptoms,” says Rabia de Latour, M.D., a gastroenterologist and therapeutic endoscopist at NYU Langone Health in New York. On the flip side, “now we’re understanding that irritation in the gastrointestinal tract can send signals to the central nervous system (i.e. brain) that cause mood changes,” Berookim says.

Of course, there’s a difference between a nervous stomach—i.e., you need to hit the bathroom three times before speaking in public—and a more serious gastrointestinal disorder. “If someone’s been having GI symptoms, we want to know if they’ve experienced a large amount of weight loss, if they’re waking up in the middle of the night with symptoms, and if they have a family history of severe diseases,” de Latour says. Those red flags mean it could be more a physical issue than a mental one. If you’re experiencing these symptoms, your doctor can help you get to the bottom of the problem. And if the issue is mental, don’t let that mess with your immune system and throw off your microbiome. “Your GI tract is one of your first defenses in your immunity. It does a wonderful job of not letting bad bacteria be systemically absorbed,” de Latour says. To support your GI tract—and your immune system—a supplement like Emergen-C Probiotics+, which contains two billion live active cultures that are good for your gut and 250 milligrams of vitamin C, can help. “One of the main functions of vitamin C is to regulate the immune system,” Berookim says.

Otherwise, managing stress can help keep your mind and gut in harmony. One meta-analysis looking at data from over 2,000 people found that psychological therapies had a significant impact on GI problems among adults with IBS. So next time you’re feeling stressed—and have the stomach issues to prove it—try finding your zen. Maybe all that nervous stomach needs is a little deep breathing.


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