Let’s talk poop

You didn’t think I’d actually choose a poop picture for this blog, did you? Gaze on this lovely waterfall picture for sixty seconds and breathe slowly. It really helps sometimes.

I’m writing this today because I see so many people on the emetophobia support groups on Facebook really freaking out about poop. Mainly loose poop, which they often call “diarrhea.” The reason they get so anxious is because of course diarrhea and vomiting often go together. If you have norovirus (“stomach bug” or “stomach flu” – even though it’s not actually a “bug” or a “flu”) then you will normally get both. The virus multiplies so quickly and so much that it overwhelms your small intestine and then your stomach. As well, you stop digestion of food. So while technically norovirus is an intestinal virus, you often vomit a few times because the virus triggers a vomit mechanism in your brain to make sure you get as much of the virus out of your stomach and intestines as you can, while your immune system kills off the rest.

That being said, there is another, much more common reason for having loose or very loose poop: anxiety. I know that you’re probably very tired of well-meaning friends and relatives telling you that “it’s JUST anxiety” or “it’s all in your head” because these two things are often said with a tone of not-very-niceness to them. Like they’re fed up of you freaking out and complaining. I can well imagine my poor mother when I was a kid. I don’t know how many times in one day she’d have to explain to me what was actually wrong when I needled her with questions about poop or weird feelings in my digestive system (gas, bloating, acid, heartburn, upset stomach, butterflies, bowels just working properly, grumbling stomach, eating-too-little, eating-too-much, eating-too-many-sweets, eating-too-much-junk-food, not eating at all….).

The honest-to-God truth is, anxiety makes you have loose stool IMMEDIATELY. Like you know how someone is telling a funny story about someone jumping out at them and scaring them and they say “I almost shit myself!” Or I did. (I heard that story from one of my son’s friends once and I laughed so hard the tears ran down my legs.) Well, these aren’t just folklore – the stories are true. If you get a huge fright your bowels can loosen in an instant and then you really have to go.

Loose stool, and other digestive problems that often accompany anxiety, can happen because your brain and your gut are actually connected. And this works both ways. Your brain controls your gut, and your gut also has an effect on your brain. When you have emetophobia or some other anxiety disorders, this can cause what we call a “feedback loop.” So you get an anxious thought (which you may not even be aware of ) and your bowels loosen. The loose bowels make you anxious, so they loosen even more. And so on. Here’s an abstract from a 2013 scientific study:

Within the first few days of life, humans are colonized by commensal intestinal microbiota. Here, we review recent findings showing that microbiota are important innormal healthy brain function. We also discuss the relation between stress and microbiota, and how alterations in microbiota influence stress-related behaviors. New studies show that bacteria, including commensal, probiotic, and pathogenic bacteria, in the gastrointestinal (GI) tract can activate neural pathways and central nervous system (CNS) signaling systems. Ongoing and future animal and clinical studies aimed at understanding the microbiota–gut–brain axis may provide novel approaches for prevention and treatment of mental illness, including anxiety and depression.1

Dr Praveen Gupta, Director & HOD, Neurology, Fortis Memorial Research Institute (FMRI), Gurugram says: “The brain is responsible for sending signals to different parts of the body and hence, plays an important role in keeping all the systems of our body running smoothly. Now, the digestive system is no different. So, when you’re feeling anxious, your neuroendocrine system experiences changes, and this in turn causes changes in the enzymes of your digestive systems. This affects the mobility of the intestine. In fact, a lot of people who have anxiety also suffer from irritable bowel syndrome (IBS).”

Dr Gupta also says that once you’ve taken care of the root cause of your anxiety and feel more at peace mentally, your digestive system will also go back to functioning normally. That is until the next pang of anxiety hits you. All in all, your bowel movements and anxiety are interrelated
If you are experiencing anxiety, in all likelihood you can also end up suffering from digestion-related troubles such as acidity, stomach cramps, and in some cases, even constipation.2

What does all this mean for the person with emetophobia? It means, stop panicking about loose poop. It actually comes from panicking. So just let it happen, and carry on. Try to do some relaxation and breathing exercises to slow down the brain-gut reaction you’re having. You may not be able to, and that’s ok. If you actually contracted norovirus, the diarrhea would be quite severe, almost like you’ve just turned on a tap and water is pouring out. And it would be constant, even every half-hour or so. (So sorry for the TMI – I’m just trying to help.)

I hope at least some of you can find relief from your emetophobia through this blog!

  1. Jane A. Foster and Karen-Anne McVey Neufeld (2013). Gut–brain axis: how the microbiome influences anxiety and depression. Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
  2. From Healthshots (Feb 6, 2021) https://www.healthshots.com/mind/mental-health/wondering-why-your-anxiety-makes-you-poop-take-a-deep-breath-and-read-this/