Exploring The Link Between Irritable Bowel Syndrome (IBS) And Anxiety
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Anxiety is most commonly thought of as a feeling or diagnosable condition that affects a person mentally, but it can also have physical symptoms. For instance, some people who have anxiety and irritable bowel syndrome (IBS) notice that the two seem to be correlated, with IBS symptoms flaring up during times of more intense worry or stress. If you’ve noticed that your IBS symptoms seem to occur or worsen in response to elevated anxiety, addressing the root of the anxiety may offer relief.
What is irritable bowel syndrome (IBS)?
IBS stands for irritable bowel syndrome, sometimes referred to as spastic colon. It’s a relatively common medical condition that affects the lower intestine. The most common signs of IBS include constipation, gas, bloating, diarrhea, abdominal pain, cramping, and visceral hypersensitivity. However, these symptoms can also occur without IBS, so you'll usually need to get a diagnosis from a doctor to determine whether or not you have this condition. Generally speaking, if problems like these are chronic, you should seek medical treatment.
Shifting to a healthy lifestyle can help manage irritable bowel syndrome symptoms
The exact cause of irritable bowel syndrome is not yet entirely known, but both physical and psychological factors seem to play a role due to the gut-brain axis. Shifting your eating patterns and making other healthy lifestyle choices typically helps control symptoms in irritable bowel syndrome (IBS) patients. Some individuals also benefit from dietary changes like a low FODMAP diet, which may help regulate bowel movements and reduce discomfort. Finding ways to manage stress levels and address anxiety and depression comorbidities, such as through psychological therapies or CBT treatment, relaxation training, and other methods, may also help reduce symptom severity or flare-ups. These strategies can potentially enhance mental health, alleviate pain, and promote overall GI tract health.
Diagnosing irritable bowel syndrome (IBS)
In general, there is no single test that proves you have irritable bowel syndrome, so it can be a bit challenging to diagnose. To make a diagnosis or rule out other conditions, your doctor might order a flexible sigmoidoscopy, which involves an examination of the lower part of the colon with a camera attached to a flexible tube or, they might opt for a colonoscopy, where they look at the entire length of your colon with a small, flexible tube. They might also do a CT scan or an X-ray of your pelvis and abdomen. If none of these tests reveal anything definitive, then your doctor may also want to do a stool test, an upper endoscopy, or a breath test for bacterial overgrowth.
Treatment options for irritable bowel syndrome
There’s currently no cure for this condition, but making certain lifestyle changes can be effective in reducing symptoms for many people with IBS. For example, your doctor might recommend that you alter your eating habits to incorporate more green, leafy vegetables, legumes, and whole grains, and avoid highly processed and high-fat foods. Medication may also be prescribed for IBS in some cases.
Consult with your doctor
Be sure to consult with a doctor or nutritionist before making significant changes to your eating patterns—especially because adjusting your eating habits to reduce IBS symptoms could result in insufficient nutrition or even eating disorders if not done carefully. Improper dietary changes may also affect the GI tract and disrupt normal biological processes, potentially leading to other health concerns. Consult with a doctor before starting, stopping, or changing any medication or supplement, as doing so without supervision could exacerbate symptoms or interfere with other treatments.
The connection between irritable bowel syndrome (IBS) and anxiety
Research also suggests that maintaining other types of healthy routines could be helpful in improving bowel habits for IBS patients. For example, you may be able to reduce symptoms by exercising regularly, getting enough sleep, and avoiding foods high in fat or sugar levels and alcohol intake. Following a diet low in fermentable carbs, such as the low FODMAP diet, may also help manage symptoms. Reducing stress levels may reduce symptoms, too, which is where a discussion of the connection between IBS and anxiety comes in. These conditions often co-occur and may contribute to pain perception and discomfort, especially in individuals with underlying psychiatric disorders or other mental disorders.
What is the link between IBS symptoms & anxiety symptoms?
In addition to improving your habits around eating, exercise, and sleep, reducing or better managing stress in your life seems to have something to do with IBS management. It's also possible that anxiety and irritable bowel syndrome (IBS) might not only stem from current stressors in one’s life, but from past stressors too. Some researchers believe that traumatic life events experienced during childhood, such as emotional or sexual abuse, can continue to affect a person into adulthood, potentially manifesting as IBS or other physical ailments.
Because trauma, stress, and anxiety seem to be so closely linked to IBS symptoms, a growing body of research suggests that talk therapy—particularly a type called cognitive behavioral therapy (CBT)—can be an effective treatment. A therapist can help you shift your thought patterns and learn grounding techniques to calm your central nervous system and reduce psychological distress associated with the stress response, which may reduce GI symptoms in turn.
Talk therapy for anxiety and irritable bowel syndrome patients
Again, it’s generally recommended that you consult with your doctor if you’re experiencing symptoms of a condition like irritable bowel syndrome (IBS). They may evaluate to rule out any other medical conditions that could be causing your symptoms and/or recommend treatment to reduce their severity. If you have IBS, it may also be helpful to meet with a mental health care professional. They can help you address past trauma and other cognitive factors and find healthy ways to cope with stress and anxiety—whether routine or as symptoms of an anxiety disorder—which may reduce IBS and other GI symptoms.
Online therapy for depression, anxiety, and IBS symptoms
If IBS makes it difficult for you to commute to a new place like a therapist’s office or you experience hospital anxiety related to healthcare facilities, you might find online therapy to be a more convenient alternative. Research like one 2017 systematic review and meta-analysis using healthy controls suggests that online therapy can be effective for treating psychiatric disorders like anxiety and depression, so seeking this type of treatment may have a positive impact on IBS symptoms, anxiety, and depressive symptoms as measured by evaluation and depression scales, and quality of life.
Takeaway
Research suggests a link between IBS and anxiety because of the gut-brain axis. If you’ve picked up on a potential correlation between your stress levels and symptoms of irritable bowel syndrome (IBS), treating your anxiety and any depression comorbidities may result in IBS relief as well. You can get started by connecting with a licensed therapist in your local area or online to seek treatment.
Is irritable bowel syndrome (IBS) related to anxiety?
There is some research to suggest there may be a relationship between irritable bowel syndrome and anxiety disorders. For example, in 2023, researchers analyzed a sample of over 1 million irritable bowel syndrome (IBS) patients who were hospitalized between 2016 and 2019. They found that nearly 40% of the irritable bowel syndrome patients also had anxiety. Many also experienced abdominal pain and other digestive symptoms, which are commonly reported in both conditions. Further research, including a 2014 epidemiological population-based study design with various healthy controls (e.g., those with anxiety but not IBS, and vice versa), may help elucidate the relationship and link between the two conditions. As of now, it appears that people with IBS have a significantly higher prevalence of anxiety compared to healthy individuals, supporting the role of the brain-gut axis in this interaction.
How do you control anxiety-related IBS symptoms?
Although the relationship between IBS and anxiety is not fully understood, people often find that stress and anxiety seem to make their IBS symptoms worse. This may be due to the brain-gut axis, which links emotional and digestive health. Elevated anxiety levels, especially during stressful life events, can trigger or worsen symptoms like bloating or discomfort. Finding ways to manage stress and reduce anxiety, especially in individuals who also experience anxiety or have comorbid depression, may help reduce symptoms of IBS and improve overall quality of life.
Strategies to help reduce anxiety and IBS symptoms
Some strategies that may be helpful include:
Doing relaxation training exercises, like box breathing and progressive muscle relaxation
Regularly meditating, doing yoga, or practicing mindfulness
Journaling about feelings, worries, and challenges
Getting regular exercise
Practicing good sleep hygiene
Making time for hobbies
Maintaining a healthy support network
Seek mental health support
If anxiety-related IBS symptoms are severely impacting your life, seeking professional support may also be helpful. Psychological treatments like mindfulness-based stress reduction, cognitive behavioral therapy (to assess cognitive factors), or medication may also help improve the quality of life for people with anxiety. The American College of Gastroenterology recommends CBT as a way to manage symptoms of both IBS and anxiety.
Is irritable bowel syndrome (IBS) a mental health condition?
According to the International Foundation for Gastrointestinal Disorders, the global prevalence of irritable bowel syndrome is between 5 and 10% of the general population worldwide. IBS is a digestive disorder that falls under the category of “functional gastrointestinal disorders,” which also includes conditions like GERD. It is not considered a mental health condition. IBS may be caused by a range of factors, such as changes in the immune system and gut bacteria.
That said, there may also be a link between IBS and psychiatric disorders like anxiety and depression. This may be due to the enteric nervous system, the part of the peripheral nervous system that controls the gastrointestinal (GI) tract. The enteric nervous system communicates back and forth with the central nervous system, a concept known as the “brain-gut axis.” Because the brain may influence the gut, and gut health may influence mental health, certain mental illnesses, like anxiety, may disrupt digestion. It may help to speak with a doctor about possible medical treatment. They may be able to answer questions about IBS, the body’s stress response, eating disorders, and visceral hypersensitivity. They may also refer you to a therapist, who may be able to help mitigate psychological distress related to IBS.
How long do IBS attacks last?
IBS attacks are periods of more intense symptoms, such as abdominal pain, bloating, diarrhea, and constipation. Although IBS is considered a chronic disorder, these flare-ups can come and go. An IBS attack can last anywhere from a few hours to more than a week.
Can anti-anxiety medication help manage IBS symptoms?
Anti-anxiety medications may be useful for managing the symptoms of both IBS and an anxiety disorder. They may help reduce pain and cramping, as well as provide relief from anxiety symptoms, which can worsen IBS for some patients. Research shows that selective serotonin reuptake inhibitors and tricyclic antidepressants improve IBS symptoms in some IBS patients, according to the National Institute of Health. These medications are often used in clinical medicine to target both anxiety and digestive issues. That said, the best treatments for both anxiety and IBS can depend on the person, especially if other conditions like depression or panic disorder are present.
How common is IBS anxiety?
Although exact numbers can vary, IBS often occurs alongside anxiety disorders. In a 2017 study, researchers looked at a sample of 50 patients with IBS and found that 44% also showed symptoms of anxiety. The authors declare no conflict of interest or bias that may have affected the results of the study.
There may be certain risk factors associated with developing IBS anxiety, including a family history of anxiety and depression or a history of trauma such as abuse. Certain personality traits can play a critical role as well.
How does IBS affect thinking and mental health?
Given the gut-brain axis, IBS can have a range of effects on thinking and mental health. Examples may include:
Trouble concentrating
Trouble remembering things
Confusion
Stress and irritability
Feelings of frustration or sadness
These symptoms may come as a direct result of IBS, but they may also be the indirect result of the challenges of living with the condition. That said, individual experiences can vary.
Individuals with severe symptoms of depression, mood disorders, and anxiety may need to see a mental health professional for treatment of these psychiatric conditions, especially if these symptoms are contributing to an impaired quality of life, such as school or work impairment. Treatment can play a central role in easing symptoms of both IBS and mental health issues. In some cases, IBS patients with long-term distress may also experience suicidal ideation, making early support essential. Clinical medicine and therapy can play a central role in easing symptoms of both IBS and mental health issues for affected patients.
How do you break an IBS cycle?
Because IBS is a chronic condition, it may not be possible to permanently stop flare-ups. However, people living with IBS may find self-care strategies helpful. Examples include:
Getting enough sleep
Exercising regularly
Using stress management techniques like meditation and deep breathing
Identifying and avoiding triggers
Drinking enough water
Being patient with yourself
Eating a high-fiber diet and practicing relaxation techniques may also help IBS patients manage both IBS and anxiety symptoms.
Consult a medical professional
It can be important to consult a medical professional if you have questions about treating IBS. A mental health specialist may also be able to provide advice on managing anxiety and stress related to the condition.
It could be necessary for your doctor to perform assessments and clinical tests to rule out other conditions, such as ulcerative colitis, and make a definitive diagnosis. They might ask you if you have a family history of digestive and kidney diseases, for example. They’ll also ask you about your gastrointestinal symptom severity, including stool frequency and other bowel symptoms. Depending on your IBS symptomatology, your doctor may make a formal diagnosis of IBS (irritable bowel syndrome).
Do probiotics help IBS?
Some people may find that probiotics are helpful for managing the symptoms of common IBS, although this can vary depending on the individual. Probiotics may support gut balance and influence the gut-brain axis, which plays a key role in communication between the gut and the brain. It can be important to check with your doctor before taking supplements or changing your diet, especially if you're following a low FODMAP diet or managing other psychiatric conditions alongside IBS patients’ care. Research published in the World Journal of Gastroenterology also suggests probiotics may benefit the GI tract by improving digestion and reducing discomfort in some individuals.
Why is there a connection between IBS and anxiety?
Irritable bowel syndrome and anxiety are two conditions that create a vicious cycle. The person’s central nervous system and gastrointestinal tract are intimately connected. Thus, a worried brain can cause digestive tract issues and vice versa. Research in clinical neuroscience and clinical medicine has shown that individuals with both conditions often experience significantly higher stress responses, which can intensify symptoms. In some cases, co-occurring conditions like depression or post-traumatic stress disorder may further complicate this connection and contribute to greater work impairment and reduced quality of life.
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