Over a quarter (28%) of the UK population has suffered from nervous tension diarrhoea¹, especially before events such as an interview, examination or having to talk in public. Other environmental stresses such as marital difficulties, problems with children or parents and worries related to business or career are shown to be common causes². Nervous diarrhoea also appears to be more common in women (around 40% have suffered)¹.

The action of the smooth muscle in the intestines (or ‘peristalsis’) is controlled by the specialised enteric nervous system, which is also connected to the central nervous system (brain)².

When you are nervous, your body produces adrenaline - a hormone that is referred to as the ‘fight, flight, fright’ hormone - as well as other powerful chemicals. These affect your central nervous system, which then has the effect of speeding everything up in your body, including your intestines via the enteric nervous system.

If normal intestinal motility (movement) is upset, the intestines absorb less fluid than normal and your stools become more frequent and watery, known as an attack of diarrhoea. Just a 1% reduction in the amount of fluid absorbed by the intestines can lead to an attack of diarrhoea³.

1. Adopt a healthy lifestyle.
   If we eat a healthy diet, exercise regularly and ensure we get adequate rest, our body is better able to cope with stress should it occur.
2. Know your limitations and do not take on too much.
   We cause ourselves a great deal of stress because we do not like to say no to people. We like people to like us and do not want to let people down. We then end up doing more than we should. Learn to be assertive and how to say no without upsetting or offending people.
3. Avoid unnecessary conflict.
   Don’t be too argumentative. Is it really worth the stress? Look for win - win situations. Look for a solution to a dispute where both parties can achieve a positive outcome.
4. Learn to manage your time more effectively.
   We waste a lot of time doing unimportant tasks. Prioritise your day and do the important jobs first. The unimportant ones can wait, and often they will disappear completely leaving you time to do other things. Also do not put off the unpleasant tasks. Every time we think about them we cause ourselves stress. Give an unpleasant task a high priority and do it first.
5. Take time out to relax and recharge your batteries.
   You will perform much better after a break and easily make up the time you used relaxing.
6. Accept the things you cannot change.
   When things cause us stress, try to change the situation. Sometimes however, this is not possible. If this proves to be the case recognise this and accept things as they are.
7. Try to see things differently.
   If something is bothering you try to see it differently. Talk over your problem with somebody before it gets out of proportion. Often, talking to somebody else will help you see things from a different and less stressful perspective. Try to see the funny side of a situation. Laughter is a great stress reducer.
8. Avoid alcohol, nicotine and caffeine as coping mechanisms.
   Long term, these faulty coping mechanisms will just add to the problem. For example, caffeine is a stimulant and our body reacts to this with the stress response.
9. Find time to meet friends.
   Friends help us see things in a different way. The activities we engage in with friends usually help us relax and we will often have a good laugh. Laughter is a great stress reducer. It boosts the immune system which is often depleted during stress.
10. If you do become stressed engage in some form of physical activity and relaxation technique.
    Physical activity will work off the biochemical and physical changes that occur within your body due to stress. Relaxation helps your body return to its normal healthy state. Good relaxation techniques include breathing exercises, massage and a variety of complementary therapies.