IBS and Anxiety: Understanding the Connection
Anxiety doesn’t cause IBS, but you can experience anxiety-related IBS flare-ups
Medically reviewed by Kumkum S. Patel MD, MPH
Irritable bowel syndrome (IBS) causes symptoms such as abdominal pain, bloating, and diarrhea and/or constipation. It is considered a disorder of gut-brain interaction, meaning that there is a disconnect in the communication between the gut and the brain. While mood disorders do not cause IBS, people with IBS may be more likely to experience anxiety or depression.
This article will discuss the connection between IBS and anxiety, including what the symptoms are and how to manage both at the same time.
Verywell / Theresa Chiechi
What’s the Link Between IBS and Anxiety?
IBS is a common condition that's thought to affect between 5% and 10% of all people, though its occurrence varies among geographic areas. People with IBS may be three times more likely to deal with anxiety or depression than the general population.
It’s thought that there is a link between anxiety and IBS, but the reasons why it happens are not well understood. One theory is that both conditions may be caused by the same mechanisms.
Common IBS and Anxiety Symptoms
The symptoms of IBS have a significant impact on quality of life. Some of the more common symptoms that could occur with IBS include:
Abdominal pain and/or cramping
Bloating/distension
Urgent bowel movements
Symptoms of an anxiety disorder can be uncontrollable or intense. They may include feelings of:
Anxiety
Fear
Panic
Worry
Related: Anxiety and Anxiety Disorder Symptoms
Why IBS Can Worsen Anxiety
IBS and anxiety may share common causes in the body, including some genes. The two don’t always go together, but anxiety is one of the more common additional diagnoses for people who live with IBS.
IBS can be unpredictable, and the symptoms can make daily tasks difficult. This can result in having anxiety about symptoms coming on. It can turn into a circular pattern, in which anxiety fuels digestive symptoms and worry or anxiety surrounding digestive symptoms can lead to having digestive symptoms.
Why Anxiety Can Worsen IBS
People who have IBS and also symptoms of anxiety may have IBS symptoms that are more severe.
In one study, pain and diarrhea were found to be worse when patients also had symptoms of mood disorders. Transit time (how long it takes for digested food to move through the colon) and constipation and diarrhea were also shown to be linked. These symptoms were worsened when psychological symptoms accompanied them.
Related: How Stress and Anxiety Cause Diarrhea
Triggers and Causes of IBS and Anxiety
IBS symptoms have many potential triggers. These situations or stressors may lead to a worsening of IBS symptoms. Every person with IBS will have a different response to the factors in their diet or in their life that may have an effect on their symptoms.
Altered Gut Microbiota
The microbiome of the gut (the balance of microbes that live in the intestinal tract) may be important in the development and management of many digestive disorders, including IBS.
How changes in the gut microbiome affect IBS isn’t well understood. Some of the things that can change the microbiome dramatically include antibiotics or a gut infection.
Hypersensitivity of the Gut-Brain Axis
IBS is considered a disorder of the gut-brain axis. The gut and the brain work together to regulate digestion and the central nervous system. In IBS, this pathway might respond strongly to changes in anything from diet to mood.
This could mean that there are more IBS symptoms in response to even small changes in the environment or the diet that affect the gut-brain axis. This is called visceral hypersensitivity.
Psychological Factors
It’s thought that having IBS could lead to developing psychological symptoms. Chronic stress, low energy, fatigue, sexual dysfunction, and sleep problems might all affect people with IBS. In some people, these problems could even become more of an issue than the IBS.
Stress
A review paper of 37 studies could not conclude if the stress people with IBS experience is because of the symptoms or whether it is a separate issue. However, it did determine that stressful life events can worsen symptoms of IBS worse.
Related: What Causes IBS?
Treatment for IBS and Anxiety
Treatments for IBS are of several different types, ranging from lifestyle changes to prescription medication. What will be helpful will be different for each person and will also be guided by their main symptoms or their IBS type. Some people may need to try different types of treatments separately or together in order to get the desired results.
Antidepressants
Antidepressants are prescribed to treat certain people with IBS. These drugs might help because they treat pain in a variety of different ways. If someone is also experiencing anxiety or depression alongside their IBS, these medications might help with those symptoms as well.
Cognitive Behavioral Therapy (CBT)
CBT is a type of psychological treatment that may be used to treat many types of conditions. A mental health provider helps a person understand a distorted thought pattern and learn how to use problem-solving to change it.
Exercise
For those who have IBS that presents with more constipation or pain, exercise might be a potential treatment. Between 20 to 60 minutes of exercise such as walking, aerobics, biking, or yoga, that’s done three to five times a week may help with IBS symptoms. Physical exercise is also helpful in managing anxiety and anxiety disorders.
Hypnotherapy
Hypnosis is a valid and potentially effective treatment for symptoms of IBS. It could be that accessing the unconscious brain helps to manage dysregulation in the gut-brain axis. Many studies show that hypnosis that a licensed practitioner delivers is a valid treatment option.
Low-FODMAP Diet for IBS
A diet that restricts foods that are low in certain types of carbohydrates, called fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs), may be used to alleviate IBS symptoms. This diet is not easy to follow without help, so working with a dietitian is usually recommended.
How to Manage IBS and Anxiety At Home
Managing IBS and/or anxiety might include one or more of the strategies above, many of which will involve the guidance of a healthcare provider. There’s no single treatment alone that gets results for everyone. For that reason, it may be a journey of trial and error to find what works.
At home, people with IBS may want to try some management techniques on their own. Reducing the symptoms of IBS may also have an effect on anxiety. This can include:
Adding fiber or fiber supplements to the diet
A trial of probiotics (beneficial bacteria for gut health)
Avoiding fatty and spicy foods
Avoiding carbonated drinks and caffeine
Using over-the-counter (OTC, nonprescription) laxatives for constipation
Using antidiarrheal medications for diarrhea
As for anxiety, there are some techniques that can be used at home in addition to working with a healthcare provider that may help in managing the symptoms. These include:
Exercise
Getting enough sleep
Joining a support group
When to Contact a Healthcare Provider
IBS symptoms include a change in bowel habits. This can include going to the bathroom more or less frequently and/or having pain with bowel movements. It's important to keep track of these changes and discuss them with a healthcare provider.
Many people may try to treat symptoms at home with lifestyle and diet changes. This is reasonable, and for some people, it may help. However, adopting overly restrictive diets (such as gluten-free that eliminates a protein common in wheat plants) is not proven to help IBS and can lead to nutritional deficiencies.
Talking to a healthcare provider is also a good idea if symptoms of anxiety or IBS have gotten to the point where they are negatively impacting life. For example, avoiding going out in public because of the fear of needing a bathroom is one warning sign that it's time to get treatment.
Gastrointestinal symptoms that are never a sign of IBS but are a reason to get medical attention include:
Chronic diarrhea
Going to the bathroom an excessive number of times each day
Bowel movements that stop altogether
Help for Anxiety
If you or a loved one is struggling with anxiety, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 800-662-4357 for information on support and treatment facilities in your area.
Summary
IBS and anxiety often occur in the same person and may be caused by similar disease pathways in the body. It’s not well understood how these two conditions affect one another, but it is clear that, at least in some people, they do.
Addressing the symptoms of either may help the symptoms of the other because they tend to form a vicious circle. There are plenty of options for treatment both at home and with the help of healthcare providers such as a mental health professional.
Read the original article on Verywell Health.
