Is Stress the Reason You’ve Been So *Ahem* Backed Up Lately?

It's not in your head: Stress is a well-known cause of constipation, which is defined as having fewer than three bowel movements per week, according to the National Institute of Diabetes and Digestive and Kidney Diseases. It may also cause hard, dry, or painful stools that require straining while you "go," or a feeling that you haven't passed all the stool in your system.

Why does this happen, exactly? There are actually a few reasons. Learn more about the brain-gut connection here, plus expert-backed tips to relieve constipation from stress.

Related Stories

{{ truncate(post.title, 12) }}

{{post.sponsorText}}

How does stress cause constipation?

"Stress can set off a complex series of body responses," says Deborah Gilman, PhD, licensed psychologist and owner of Fox Chapel Psychological Services. This includes changes in your nervous system, a release of certain hormones, and changes in the gut-brain axis.

Activation of the parasympathetic nervous system

The sympathetic nervous system is often called the “fight or flight” response, per the Cleveland Clinic. “When the body perceives stress, the sympathetic nervous system becomes dominant, leading to changes in various bodily functions, including digestion,” Gilman says.

In particular, stress can inhibit the activity of the parasympathetic nervous system, which is responsible for rest and digestion. By slowing this system down, gastrointestinal motility (the movement of food through the GI tract) also slows down, leading to a reduced frequency of bowel movements, she adds.

Release of stress hormones

When the body is under stress, certain hormones are released, Gilman says. Two of these hormones are cortisol and adrenaline¹. While these hormones can be helpful when dealing with perceived threats or danger, they are not always helpful in day-to-day life. In fact, too much cortisol can affect many different parts of your body, including your heart, immunity, reproductive organs, and yes, your gut, per the Cleveland Clinic.

This is especially true if you're chronically stressed, which can lead to an imbalance of these hormones and cause a dysregulated nervous system, she adds.

"Cortisol has been shown to alter intestinal motility and sensitivity, contributing to constipation," Gilman says.

Changes in the gut-brain axis

Along with changing hormone levels, stress affects the communication between the gut and the brain, Gilman says. The gut is often called the “second brain” because it has an extensive network of neurons known as the enteric nervous system, according to a September 2023 review in the Journal of Physiology.

“This intricate network of nerves communicates bidirectionally with the central nervous system, forming the gut-brain axis,” Gilman says. Studies have shown that stress-induced changes in the gut-brain axis can affect gastrointestinal transit time, resulting in less frequent or irregular bowel movements, she adds.

Changes to eating behaviors

Stress can also lead to changes in eating habits and behaviors, says Sarah Robbins, MD, gastroenterologist and founder of Well Sunday Health Corporation. This could include reduced appetite, changes in diet, or irregular eating patterns—all of which can contribute to constipation.

For example, eating less fiber-rich foods or drinking less water during times of stress can result in harder poop that is difficult to pass, she adds.

Other causes of constipation

Besides stress, there are other reasons people get constipation. Those most at risk include the following, per the NIDDK:

• Women, particularly while pregnant or after childbirth
• Older adults
• People who don’t eat enough fiber
• People who don’t drink enough liquids
• People taking certain medications or supplements, such as antacids, seizure medications, iron supplements, or narcotic pain medicines
• People with certain health problems, such as irritable bowel syndrome (IBS)
• People who frequently ignore the urge to have a bowel movement

Can stress make other GI conditions worse?

Irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) are two GI conditions that can be worsened by stress, says Dr. Robbins.

Stress and IBS

“The relationship between stress and IBS is well-documented,” says Dr. Robbins. IBS is a functional gastrointestinal disorder that includes symptoms like abdominal pain, bloating, and altered bowel habits (diarrhea, constipation, or both), she explains. Stress and IBS can be linked in the following ways, according to Dr. Robbins.

• Stress as a symptom trigger: This could be because people with IBS have more sensitive guts that respond acutely to stress. Increased gut sensitivity to pain or discomfort is called visceral hypersensitivity, which would not likely affect a person without IBS, per the Cleveland Clinic.
• Gut-brain axis: Stress can affect the communication between the central and enteric nervous systems (i.e., the brain and gut). This can lead to changes in muscle contractions in the gut and alter the gut microbiota—both of which can contribute to IBS symptoms, per the Journal of Physiology review.
• Hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis: The HPA axis helps regulate stress in the body, per Michigan State University. The hypothalamus, pituitary glands, and adrenal glands are often hyperactive in people with IBS, which can lead to overproduction of stress hormones like cortisol. This can affect gut and immune function, and make IBS worse.
• Psychological co-morbidities: People with IBS-C (constipation) have a higher prevalence of psychological disorders like anxiety and depression, according to a January 2021 meta-analysis in BMC Gastroenterology.

Stress and IBD

The relationship between stress and IBD is complex. While stress does not cause IBD, it can significantly affect the course of the disease, says Dr. Robbins. Here are some ways that stress influences IBD, per Dr. Robbins:

• Exacerbation of symptoms: Stress is widely recognized to worsen IBD symptoms, with patients often reporting that stressful life events precede flare-ups, per Penn Medicine.
• Inflammatory responses: Stress can affect your body's inflammatory responses, which can contribute to inflammation in the gut.
• Gut-brain axis: Stress can affect your nervous system and communication between the gut and the brain. This can affect the immune response, which can influence IBD activity.

How to treat stress-induced constipation

While stress-induced constipation is frustrating, there are many different treatment strategies you can try at home.

Change up your diet

Dr. Robbins recommends making slight changes to your diet. This could mean incorporating foods to make you poop—like oats, whole grains, and fruits. Other changes you can make include:

• Upping your fiber intake
• Drinking plenty of water and fluids
• Drinking warm liquids in the morning to stimulate your digestive system
• Eating mindfully
• Adding prunes or prune juice to your daily routine, which are natural laxatives (aim to eat only a small number of prunes, especially when you’re first adding them to your diet, since they can lead to diarrhea if you overdo it)

Get an abdominal massage

"Gently massaging your abdomen can help stimulate your intestines to move stool along the GI tract," says Dr. Robbins. This can be done by lightly pressing on the lower right side of your abdomen and working in upward, circular motions until you've reached your right ribs, across to your left ribs, and down into the left side of your abdomen. Repeat that clockwise motion for about 10 minutes, per Michigan Medicine.

Going to get a professional abdominal massage, or other forms of massage therapy, can also help relieve stress-induced constipation, adds Dr. Robbins.

Establish a regular bathroom schedule

Dr. Robbins recommends trying to poop at the same time every day. This can help train your body to have regular bowel movements. Most people will find it's easiest to poop in the morning, especially after they've had a cup of coffee. Over time, your body will adapt to a schedule.

Another tip? Trying rocking back and forth to poop while on the toilet. The motion will help you "go" with ease.

Incorporate stress-management techniques

Completely avoiding stress may feel impossible, but there are ways to reduce its effects on your brain and your bowels. Gilman recommends trying things like deep breathing, progressive muscle relaxation, or meditation to reduce stress levels and promote relaxation throughout your entire body, including your GI tract.

"Mindfulness meditation, in particular, can help people cultivate present-moment awareness," Gilman adds. "This enables them to create non-judgmental attitudes toward everyday stressors, which may relieve tension and promote bowel regularity."

Another option? Cognitive behavioral therapy (CBT), Gilman notes. This specific type of therapy helps you challenge negative thought patterns, and it's actually been shown to help improve symptoms of IBS, according to a July 2017 review in Psychology Research and Behavior Management.

Keep a journal to track symptoms

If you feel like your constipation is caused by specific stressors or emotional triggers, keeping a journal can be a helpful way to track patterns and identify situations that exacerbate your symptoms, Gilman says.

From there, you can learn coping strategies like boundary setting, problem-solving skills, and relaxation techniques to help reduce stress and bowel issues, she adds.

"Once you recognize constipation is a common physiological response to stress, you can be more gentle with yourself."—Deborah Gilman, PhD, psychologist

Practice self-compassion

Another coping strategy is self-compassion. It's true: Treating yourself with kindness and grace during stressful times can help reduce GI flare-ups, Gilman says.

"Once you recognize that constipation is a common physiological response to stress, you can be more gentle with yourself as you navigate the experience," she adds.

Incorporate other healthy lifestyle changes

According to Gilman, there are several behavioral strategies you can use to manage stress, including:

• Getting enough exercise: The Centers for Disease Control and Prevention (CDC) recommends the average adult gets at least 150 minutes of moderate-intensity exercise per week. This equals about 30 minutes per day, which you can break up into several smaller chunks if that better suits your schedule.
• Getting enough sleep: The CDC recommends adults get anywhere from seven to nine hours of sleep per night.
• Setting realistic goals: Instead of focusing on big goals, break tasks into manageable steps and set realistic goals to reduce feelings of overwhelm. Celebrate small victories and progress toward your goals.
• Seeking social support: Finding IBS or anxiety support groups online or in-person can help you feel less alone in your experience and help empower you to take care of yourself.

Try over-the-counter (OTC) medications and supplements

If the above changes aren’t working for you, Dr. Robbins suggests using OTC treatments like fiber supplements, stool softeners, or mild laxatives. This can include products like Metamucil, Benefiber, Miralax, or Dulcolax.

Just keep in mind that laxatives should be considered a short-term solution. If your constipation lasts longer than a few days, it's best to see your doctor to make sure you can keep using them long term.

Preventing stress-induced constipation

Once you know your bowels well enough (and know how they respond to stress), you can anticipate constipation flares ahead of time and help mitigate them, says Dr. Robbins.

Start by keeping a journal (as mentioned above) to help track any patterns or daily habits. “Once you recognize the signs of stress affecting your bowel movements, you can work to prevent flares before they start,” she adds. You can implement the same treatment strategies listed above for prevention.

When to see a doctor

While constipation can be annoying and even uncomfortable at times, stress-induced constipation is usually harmless and will begin to dissipate once stress is relieved.

That said, if you develop any of the following symptoms alongside constipation, reach out to your doctor as soon as possible, per Dr. Robbins:

• Constipation that lasts for several weeks despite home treatment and lifestyle changes
• Blood in your stool
• Severe pain or discomfort that is not relieved by having a bowel movement
• Unexplained weight loss
• Sudden changes in bowel habits
• Difficulty passing stool
• Bloating and abdominal distention that does not improve
• Relying on laxatives to have a bowel movement
• Symptoms of anemia, such as fatigue, shortness or breath, or paleness
• Family history of colon conditions like colorectal cancer or IBD

Your doctor can help rule out or treat any serious underlying conditions that arise.

FAQ

How can I make my bowels move faster?

A great natural remedy for constipation that moves your bowels faster is prunes (or drinking prune juice), per Johns Hopkins Medicine. Both have sorbitol—a sugar alcohol that doesn't break down during digestion—which can help you poop faster, per the National Library of Medicine.

Taking a gentle OTC laxative can also help stimulate your bowels to move faster. Just check with your doctor before taking them to make sure they're right for you.

How long does stress constipation last?

Stress-constipation will last a different amount of time for each person. Factors like the intensity or duration of your stress, your coping skills, and underlying health conditions will play a role, Gilman says.

“For some people, constipation may resolve once the stressor is alleviated or managed, but for others, it may persist longer,” she adds. This is why it's important to keep track of your symptoms and note any patterns/habits that could be prolonging your constipation.

Can depression and stress cause constipation?

There's no denying that your mental health and gut health can play off of each other. This means it's quite possible to have gut symptoms like constipation or diarrhea while depressed or anxious. While there's no scientific evidence that depression directly causes constipation, there is some anecdotal evidence of people with depression undergoing changes in their bowel habits, per Dr. Robbins.

If you are dealing with depressive symptoms, reach out to your doctor or a therapist for support. They can suggest treatment options that could help relieve bowel issues, too.

—reviewed by Jennifer Logan, MD, MPH