Hey Doc,
I get so nervous before I sing that I literally feel like I’m going to poo my pants. Once I’m into the song this goes away but it’s an excruciating and terribly uncomfortable feeling before hand. What can I do to keep my stomach in check?
-Bill
Dear Bill,
What you are describing, in your own charming way, is a case of stage fright. The need to evacuate your bowels and bladder in times of high anxiety is so common, that during World War I, a favorite send-off to pilots who were heading off on a bombing mission was “Keep a tight asshole!” So, this is not new.
My suggestion, first, is to go to the bathroom before going on stage. If you do experience stage fright, you may wish to consider a low dose of Inderal (generic name is propanolol), a beta blocker which can reduce both your heart rate and your general anxiety level. Other ways of managing stage fright abound, most importantly good preparation of your material, meditation, and visualization.
But propanolol has stood the test of time, with the proviso that it might actually make you too calm, and take away some of the excitement of your performance. So, good luck, and bombs away!
-Anthony F. Jahn, MD, FACS, FRCS(C)
This discussion is for general information and not to be construed as specific medical advice that you should obtain from your own physician.

Dr. Jahn is an internationally renowned otolaryngologist based in Manhattan with a sub-specialty interest in the professional voice. His practice includes classical and popular singers. He holds academic appointments at Mount Sinai School of Medicine and Westminster Choir College in Princeton. He is Medical Director at Jazz at Lincoln Center, and former Director of Medical Services at the Metropolitan Opera in New York. Dr. Jahn has published several books for vocalists, including “Vocal Heath for Singers” (Singdaptive) and “The Singer’s Guide to Complete Health” (Oxford University Press).