Link between IBS and anxiety, and strategies for management
Irritable Bowel Syndrome (IBS) is a common digestive disorder, characterised by abdominal pain, bloating, and changes in bowel habits. Recent research has uncovered a significant connection between IBS and anxiety, suggesting that the two conditions may be intertwined.
IBS can manifest in three primary forms: IBS-C, which is characterised by pain accompanied by constipation; IBS-D, where pain is associated with diarrhoea; and IBS-M, a combination of both constipation and diarrhoea.
There is a strong scientific basis for a bidirectional link between IBS and anxiety. Anxiety can trigger and exacerbate IBS symptoms, while IBS can worsen anxiety.
Anxiety can affect IBS symptoms through several mechanisms. Stress hormones like adrenaline and corticotropin-releasing hormone, released during anxiety episodes, can act directly on intestinal nerves and muscles, speeding up colon transit and causing urgent diarrhoea. They also heighten visceral sensitivity, making normal gut sensations feel painful, and can lead to rapid, uncoordinated intestinal muscle spasms, causing sharp pain. Furthermore, anxiety can reduce blood flow to the gut, impairing digestion and promoting gas and bloating.
Approximately 60% of IBS patients also have anxiety or other psychiatric conditions. Conversely, IBS itself can worsen anxiety through gut microbiota imbalances, which alter gut-brain signalling, leading to inflammation and disrupted neurotransmitter production affecting mood regulation.
This relationship between anxiety and IBS is further supported by longitudinal studies. Patients with severe anxiety have about a 2.7-fold higher risk of developing IBS later, demonstrating anxiety’s role as a risk factor for IBS onset.
Experts often describe anxiety and IBS as creating a "vicious cycle" where each one worsens the other. Anxiety can trigger IBS flare-ups rapidly, and IBS symptoms can feed back to worsen anxiety.
Understanding this connection between anxiety and IBS has important implications for managing both conditions. Integrated psychological and gastrointestinal care may be necessary to effectively treat these interconnected disorders.
It is crucial for a person with anxiety to speak with a healthcare professional if they experience uncontrollable fear or worry that may interfere with work, school, or social events, or if they develop abdominal pain along with diarrhoea or constipation. Similarly, a person with IBS may want to talk with a healthcare professional if they experience fear, worry, or similar feelings related to their IBS symptoms.
Treatment for anxiety can include mindfulness training, Cognitive Behavioural Therapy (CBT), beta-blockers, relaxation techniques, anxiety medications, acceptance and commitment therapy (ACT), antidepressants, and support groups. Treatment for IBS can include lifestyle changes like eating more fibre, eating foods high in probiotics, getting more exercise, avoiding gluten, getting enough sleep, following a low FODMAP diet, reducing stress, and seeking mental health treatment.
While the exact cause of IBS is still unknown, experts suggest that gastrointestinal issues may result from communication issues between the gut and the brain. Research suggests that treatments for anxiety, such as CBT, may overlap with treatments for IBS.
Furthermore, anxiety and IBS may share a genetic link, according to a study reviewing the diagnoses of 53,000 people with IBS. Certain health conditions, such as thyroid disorders, may worsen anxiety in some people.
An increase in mast cells and eosinophils was found in the GI systems of youths with IBS, which are important in the immune system's inflammatory response. People with depression and anxiety have a higher chance of developing IBS compared with those who do not have either condition.
Researchers continue to explore the complex relationship between anxiety and IBS, with the hope of finding new and effective treatment strategies. For those affected by both conditions, understanding this connection can provide valuable insight into their symptoms and potential paths to relief.
- The connection between Irritable Bowel Syndrome (IBS) and anxiety is significant, as recent research suggests that the two conditions may be intertwined, with anxiety potentially triggering and exacerbating IBS symptoms.
- Approximately 60% of IBS patients also have anxiety or other psychiatric conditions, demonstrating a strong link between these chronic-diseases and mental-health issues.
- Anxiety can affect IBS symptoms through several mechanisms, such as stimulating intestinal nerves and muscles, increasing visceral sensitivity, and reducing blood flow to the gut, all of which can contribute to constipation, diarrhea, pain, gas, and bloating.
- Understanding the health-and-wellness implications of this connection between anxiety and IBS is crucial, as integrated psychological and gastrointestinal care may be necessary to effectively treat these interconnected disorders.
- Seeking medical-attention is essential for those experiencing uncontrollable fear or worry that may interfere with work, school, or social events, or for individuals who develop abdominal pain along with diarrhea or constipation, as both conditions may share a genetic link and require comprehensive treatment approaches.
