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More frequent bellyaches? What’s normal and what’s not

Stress can have a huge impact on the physical body. But what if the stomachaches you’re having are caused by something other than stress or diet? Digestive diseases specialist Lynn Connolly, MD, shares her insights about when you might need to worry about belly pain.

The relationship between stress and abdominal pain

“One thing that is underappreciated is how dramatically people’s lifestyles have changed since the pandemic started,” says Dr. Connolly. “People are no longer walking to and from their cars, or even leaving the house. They are more sedentary and their sleep is disrupted. And many of us are eating more pantry staples and fewer fruits and veggies.”

All of these changes can make a big impact on the digestive system. Here’s how:

  • Your belly has millions of nerve cells that constantly communicate with the brain. Stress impacts the brain-belly communication loop and makes minor discomforts more pronounced.
  • When you’re under stress your threshold for pain drops, so you may perceive usual discomfort as being more intense.
  • Stress can cause muscle spasms in the intestine, which can be uncomfortable. Spasms also impact how fast or slow food moves through the digestive system. The result could be a bout of diarrhea or constipation.
  • Eating more or less than normal because of stress can cause you to experience an uptick in heartburn, and may contribute to weight gain or loss.
  • Using alcohol as a coping tool can also contribute to acid reflux.
  • How well your body absorbs nutrients may be impacted by stress. You may experience more gas than normal, which could lead to painful bloating.

How do you know if your stomach pain is related to stress or something more?

Dr. Connolly says an important question to ask is whether your bellyaches are new to you, or whether they’ve been around for a while.

“If you’re experiencing new gastrointestinal symptoms, it is worth a call to your provider,” she says. “More longstanding or vague abdominal discomfort or cramping is often related to diet or other changes, including stress. It’s still a good idea to bring these up when you speak with your provider.”

Dr. Connolly recommends contacting your provider if you experience any of these symptoms:

  • Blood in the stool: Red or black, tarry blood evident in the stool or on toilet paper
  • Distended belly: Hard, swollen belly and an inability to pass gas or stool
  • Extreme pain: Difficulty moving side to side or intense pain in the chest, abdomen or pelvis
  • Extreme lightheadedness: Incredible dizziness, feeling like you are going to pass out or very low blood pressure
  • Change in bowel habits: Looser stools or constipation that linger for a week or two
  • Flu-like symptoms: Throwing up, fever, difficulty breathing or extreme fatigue
  • Weight changes: Significant, unexplained increase or decrease in weight

Is telemedicine a good way to diagnose or treat stomachaches?

“Health care providers do not want COVID to be a reason for delaying care,” says Dr. Connolly. “If you’re having questionable symptoms, you can start with telehealth to find out if you should be seen in the clinic.”

Dr. Connolly says in-person physical exams are the best way to diagnose problems of the digestive system. It is challenging to distinguish some conditions, such as bloating versus an obstruction, without a physical exam. If your provider remains concerned after a telehealth visit, you likely will be advised to come into the clinic for a full evaluation.

How to manage mild to moderate belly pain

If you’re experiencing minor belly discomforts, you may find relief with some lifestyle adjustments. Dr. Connolly recommends you:

  • Emphasize nutrition: Eat a predominately plant-based, high-fiber diet. Skip the processed foods and drink less alcohol.
  • Exercise more: Be more active to keep your body in better working order.
  • Sleep better: Get enough high-quality sleep.  
  • Stress less: Whether you get relief through exercise or incorporate meditation, dialing down your stress level will improve how you feel.

If you’re experiencing worrisome stomach pains, contact your primary care physician.


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