Anxiety and IBS Are Connected: Here’s How
Irritable bowel syndrome (IBS) affects about 12% of United States adults. This chronic disorder of the large intestine appears twice as frequently in women as in men, and it’s most common in people under 50-years-old.
Doctors don’t know the exact cause of IBS, but they do know it affects the way your brain and your intestines communicate, and that includes how you respond to anxiety and stress. However uncomfortable and distressing it may be, though, unlike diseases of the intestines such as ulcerative colitis, IBS doesn’t cause changes in intestinal tissue or increase your risk of colorectal cancer.
At GI Physicians Inc. in Lima, Ohio, Dr. Ven Kottapalli and his expert staff of gastroenterological specialists have years of experience dealing with the many forms of IBS. They also know anxiety and IBS can go hand-in-hand. They’ve put together this helpful guide so you can understand the reasons why.
Symptoms of IBS
IBS comes in three forms:
- IBS with constipation (IBS-C), produces hard, lumpy stools
- IBS with diarrhea (IBS-D), produces watery stools
- IBS with mixed bowel habits (IBS-M), shifts from one extreme to the other
Other common symptoms of all three types include abdominal pain and cramping, bloating, gas, and mucus in the stool.
Contributing factors to IBS
While the exact cause of IBS isn’t known, there are factors that contribute to its occurrence:
- Intestinal muscle contractions: Long, strong contractions lead to bloating, gas, and diarrhea; weak contractions lead to constipation
- Nervous system: Nerve abnormalities cause discomfort when your abdomen stretches from gas or stool; poorly coordinated signals between the brain and intestines cause an overreaction to normal processes
- Severe infection: Can develop after bacterial or viral gastroenteritis or bacterial overgrowth
- Early life stress: Exposure to stressful events, especially in childhood, leads to more IBS symptoms
- Changes in gut microbiome: Changes in native bacteria, fungi, and viruses can impact digestive health
The anxiety-IBS connection
Serotonin is a neurotransmitter that controls and stabilizes your mood in your brain. What’s interesting, though, is that serotonin is critical to proper digestive functioning, too. In fact, your gut produces about 95% of all the serotonin in your body, with the enteric nervous system — sometimes called your “second brain” — embedded in your GI tract from your esophagus to your anus.
Serotonin also plays a role in communication between the brain and the gut, with each structure affecting the other. That means if you’re anxious or depressed, your gut is going to pay a price, and if you’re struggling with IBS, you may become anxious or depressed.
Serotonin plays a role in much of your gut function, including:
- Motility
- How much fluid and mucus are secreted in your intestines
- How sensitive your intestines are to pain and fullness from eating
In addition, some nerve receptors send messages to your brain signaling GI events such as nausea, bloating, and pain, while others change how you respond to a distended or full intestine.
People with IBS-C often have lower levels of serotonin, and the muscles in their rectums are less reactive to it. Those with IBS-D have high levels of serotonin, and their rectal muscles are more reactive. According to a 2009 study, targeting serotonin receptors in your gut may help treat IBS.
Treatments for IBS and related anxiety
While fiber supplements, dietary changes, exercise, and antispasmodic medications may help the intestinal aspects of IBS, you also need to treat the related anxiety.
The British Society of Gastroenterology recommends psychotherapy to treat IBS when you have a history of anxiety, panic attacks, and/or depression along with gut problems. The American College of Gastroenterology concurs, indicating therapy can reduce both anxiety and IBS symptoms in some patients. Cognitive-behavioral therapy is a specific technique that teaches you to be more aware of your triggers and how to cope with them.
Self-help tips such as stress reduction and meditation are also useful in altering serotonin levels, but if you find you’re still having difficulty, your doctor may prescribe antidepressants to help manage your symptoms.
IBS and anxiety are definitely connected, but there’s no reason you need to suffer from either. Give GI Physicians Inc. a call at 419-419-5138, or schedule a consultation online, and let us help you manage your conditions so you can return to a normal life.