Your question: How do I know if my stomach ache is anxiety?

My reply:

Hi, I hope this message finds you well. My name is Cesar Guedez, a psychologist trained in cognitive behavioral therapy. Through this blog I will explain why you can often confuse stomach pain with anxiety, highlighting the link the two share and giving you some suggestions on how to cope with this problem.

Anxiety generates a whole world of symptoms. Usually people believe that having anxiety only refers to being worried, uneasy or frightened about a particular event. There is a whole physical symptomatology associated with anxiety, from tachycardia, through the sensation of urinary incontinence to specific pains, headaches, joint and stomach.

In order to determine whether a persistent physical symptom is related to anxiety, or any other psychological issue, it is always necessary to see your primary care physician. The doctor will be able to determine if the origin of the stomach pain is physical, related to medical conditions of the digestive system. If you have been to the doctor and everything is fine, we may be talking about somatization due to anxiety.

How do your body and mind relate?

Somatization is the expression of psychological or emotional factors as physical (somatic) symptoms. So defined, it is neither a disorder nor a diagnostic category but a generic term for a set of experimental, cognitive, and behavioral characteristics of patients who complain of physical symptoms in the absence of relevant medical findings (1).

Anxiety works in a complex way, as each person experiences it in different ways. If for you the physical symptom associated with anxiety is a stomach ache, for another person it will be a headache or numbness, and for another person it will be all of these symptoms at once. Therefore, to address these physical symptoms that do not have a medical origin, you must work on the psychological part that is causing the symptom, in this case, anxiety.

What is the relationship between stomach pain and anxiety?

Anxiety deregulates our body because it is an exhaustion response to external pressures. Whether it is work, studies or relationships that cause anxiety, they cause an emotional and physical imbalance in the body through hormones and neurotransmitters that are released during episodes of anxiety.

A 2013 study of hospitalized patients revealed that patients with gastrointestinal problems had higher anxiety and depression symptoms than patients with other types of medical conditions (2).

The explanations for this are varied. First, we must keep in mind that in episodes of anxiety and stress the balance of bacteria in our intestine is affected. Also, people with anxiety, stress and depression tend to have unhealthy eating habits that aggravate stomach pain and gastric problems in general.

How can you deal with this?

There are several things you can do to alleviate the physical and psychological symptoms related to stomach pain and anxiety.


Modifying your eating habits is important to decrease stomach pain or any other gastrointestinal problems. Fruits, vegetables, grains and plenty of hydration have proven to be allies of the digestive system.

Know your body

Before going to the doctor for the stomach pain you associate with anxiety, it is effective to write down specifically what the painful sensation you are experiencing is like. Whether it is a burning, stabbing or throbbing pain. It also helps if each time you experience stomach pain you write down how intense it is on a scale of 1 to 10.

Know your mind

In addition to this, you can write down under what circumstances this stomach ache occurs. You may identify that the uncomfortable feeling in your stomach starts right when you arrive at work, when you go to study for an exam or when you have a conversation with a stressful person. Depending on your case, writing it down and then telling your doctor or therapist about it will be effective, as it will guide your treatment in the most specific way possible.

Relieve your anxiety

Diaphragmatic breathing has been shown to be effective for patients with gastrointestinal problems(3). Centering the breath is an effective way to encourage the body to relax. When practicing diaphragmatic breathing, the stomach, rather than the chest, moves with each breath, expanding as you inhale and contracting as you exhale. Deliberately paying attention to each breath serves to distract and quiet the mind. 

You do this by sitting or lying down in a comfortable place with your eyes closed. Resting one hand on your chest and the other on your abdomen. You will take slow 4 second breaths, inhaling 2 seconds and exhaling 2 seconds. Take your time to find your rhythm and while doing so, try to visualize a relaxing scenario.

In my experience…

Stomach pain is one of the most common physical symptoms associated with anxiety, so it is completely normal to confuse the two. Through my suggestions and seeking professional help from both a physician and a psychologist to help you deal with these symptoms, you can gradually improve.

I hope that with these suggestions you can improve. I recognize and applaud you for seeking professional counseling, because it shows that you want to feel better and you are on the right path to change the things that make you feel bad. 

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