Can Stress Cause Constipation? Here’s What You Need to Know

Your boss has heaped a whole lot of work in your lap, the daycare just called to tell you that your toddler has a runny nose and has to be picked up, you’ve run out of milk and toilet paper at home, and you’re stuck in rush hour traffic. Oh, and to add insult to injury, you have an uncomfortable fullness in your gut because you haven’t had a BM in days. So, can stress cause constipation? We spoke to a medical expert for the full scoop on whether or not your hectic life might be responsible for backing up your bowels. (Spoiler: It’s entirely possible.)

Meet the Expert

Dr. Vicente Mera is the head of Internal Medicine at the SHA Wellness Clinic in Altea, Spain. Earning a medical degree from the University of Seville with a specialization in Internal Medicine, Mera has 25 years of experience as an internist at renowned institutions, including the Virgen Macarena hospital in Seville and the Reina Sofía hospital in Córdoba.

Per Dr. Mera, constipation—a condition that occurs when stool passes too slowly through the digestive tract, causing it to dry and harden—has many possible causes, including blockages in the colon or rectum, small tears around the anus, obstructions in the intestines, colon cancer, narrowing of the colon, problems with the pelvic muscles…and the list goes on. Another possible cause (and one that’s particularly relevant to the question at hand)? “Any condition that affects hormones in the body,” the medical expert tells us. So let’s talk about stress, baby.

As previously mentioned, hormones play a significant role in regulating the digestive system. If you’re wondering whether stress can cause constipation, the answer is yes. Stress hormones, in particular, can directly affect bodily processes that contribute to bowel movements, explains Dr. Mera. “Stressful situations trigger the release of a hormone called epinephrine from the adrenal glands, which plays a role in the body’s fight-or-flight response,” the doctor explains. This matters because when the fight-or-flight response kicks in, blood flow is directed to vital organs like the heart and brain, thus slowing down digestion. “Furthermore, stress increases the presence of corticotropin-releasing factor (CRF) in the bowels, which can lead to increased intestinal permeability [and] may alter the healthy bacteria in the gut, impacting normal bowel movements.”

Indeed, a 2014 study published in the journal Expert Review of Gastroenterology and Hepatology concludes that CRF release can cause constipation by acting directly on the bowels as well as through the central nervous system (CNS), and is associated with dysfunctional motility, permeability and inflammation in the gastrointestinal tract. You probably get the picture, but that dysfunction is a recipe for backed up bowels. What’s more, Dr. Mera points out that stress is also associated with lifestyle factors that can contribute to constipation—namely that “people tend to have a poor diet, drink less water, and exercise less when stressed.”

You’re stressed, your boss is stressed, your mother’s stressed and all the stress is making you so much more stressed that you only just realized it’s been days since you had a satisfying BM. (A stressful realization.)  There are a few things you can do to get some relief, depending on whether or not the constipation problem is chronic. First, the expert recommends making healthy lifestyle changes in terms of diet and physical exercise and getting enough sleep, which can help manage both constipation and the stress that may or may not be causing it.

Looking for a faster fix? “Occasional constipation can be treated with over-the-counter laxatives,” says Dr. Mera. If your constipation is chronic, you’re going to want to see a doctor to determine the cause and possibly get a prescription-strength solution. (The expert says Lubiprostone is an FDA-approved medication for IBS and certain forms of chronic constipation that works by increasing bowel fluid to ease stool passage.)

That said, if you and your doctor suspect that stress is the cause of your chronic constipation, you would be wise to focus on your mental health instead of just treating the somatic symptoms. “In cases of anxiety or depression, seeking help from a therapist or cognitive behavior therapist is essential,” says Dr. Mera, adding that “low-dose antidepressants such as selective serotonin reuptake inhibitors and tricyclic antidepressants can help reduce anxiety that causes constipation by affecting neurotransmitters in the brain and gut.”

An occasional bout of constipation is no big deal, but if it becomes a recurring or chronic issue Dr. Mera recommends a thorough medical evaluation to rule out other underlying issues, even if chronic stress is also evident.