Have you had anxiety which triggers bouts of IBS (Irritable Bowel Syndrome)?
Or did you develop IBS and as a result you started feeling anxious about when and where you might get symptoms?
Either way, IBS and anxiety are strongly related and they can both be the cause and effect of each other – so understanding this relationship is vital to managing your symptoms.
What is Anxiety?
Anxiety is the most common mental health condition in Australia; on average, one in four people will experience anxiety at some stage in their life.
Everyone experiences some degree of anxiety or fear as it is a normal response to a stressful situation. However, anxiety becomes problematic when the fear is out of proportion to the problem; it persists well before or after the stress; or if it is interfering in your everyday life.
While anxiety impacts everybody differently, some common symptoms include:
- Physical: panic attacks, hot and cold flushes, racing heart, tightening of the chest, quick breathing, restlessness, or feeling tense, wound up and edgy;
- Psychological: excessive fear, worry, catastrophizing, or obsessive thinking;
- Behavioural: avoidance of situations that make you feel anxious which can impact on study, work or social life.
What is IBS?
Irritable Bowel Syndrome is a functional gastrointestinal disorder that is characterised by one or a combination of symptoms, including abdominal pain or discomfort; diarrhoea and/or constipation; abdominal bloating; mucous in the faeces; and nausea.
In people with IBS, the process of digestion is altered. If food moves through the digestive system too slowly, it causes IBS with constipation (IBS-C), and if it moves through too quickly it causes IBS with diarrhea (IBS-D).
There is a third subtype of IBS which is IBS-M – a combination of constipation and diarrhea.
IBS is a common disorder affecting approximately 1 in 5 Australians. The triggers can vary which is part of the challenge in identifying the root cause of the symptoms in each individual. The most common triggers are:
- Food: This is different for everyone, but some common trigger foods are high fibre foods, foods high in FODMAPs, caffeine, fatty foods, fructose, dairy, spicy foods, artificial sweeteners;
- Hormones: Changes in hormones are likely to impact on your gut function. This is most common for women, and it is common for women to have more issues with IBS during their menstrual cycle and when pregnant;
- Stress: For many people, stress can be a trigger for symptoms. This might be a change in routine like a new job, financial stress or during exam periods;
- Other illnesses/medications: Other GI illnesses such as gastroenteritis can trigger IBS but so can medications from non-related illnesses, such as some anti-nausea and pain relief medications.
The Relationship between IBS and Anxiety
IBS and anxiety are common co-morbidities – around 70-90% of IBS sufferers who seek treatment have psychological disorders.
There has been significant research on this topic and recent systematic reviews found that anxiety and depression provided a two-fold risk for IBS onset, and that patients with IBS had higher levels of anxiety and depression.
As mentioned earlier, stress is a common trigger for Irritable Bowel Syndrome, so a person with anxiety would be experiencing regular high levels of stress thereby at risk of triggering their IBS more often.
However, looking at it from a different perspective, for some people IBS may be the trigger for anxiety. The constant fear that you might eat something that doesn’t agree with you and always having to be aware of where the closest toilet it, is enough to make you anxious.
As it is so common in people with IBS, monitoring anxiety levels should be done regularly. Psychological factors such as anxiety and stress can have significant effects on symptoms of IBS and can impact treatment, therefore it is important if you are experiencing both of these conditions that you seek treatment for both.
For some, IBS might be a brief and transient condition as a result of medication or an illness, subsiding on its own.
However for most people, IBS isn’t the sort of condition that can be “cured” – however it is possible to manage the severity and frequency of your symptoms.
The first and most important step is to identify your triggers, which can be done by keeping a food/symptoms diary. This involves keeping track of all foods you eat, your bowel movements, and any other symptoms, and the timing of both.
Once you have identified your triggers, you can then work on eliminating them. This is simpler if you are just triggered by food, but if your triggers include stress or anxiety then it is important to seek help.
If you are having trouble identifying triggers or need help managing them, you can make an appointment with me and I can help you through it.
Author: Ashleigh Hamilton, BHlthSc (Nutr & Diet), MSc (Diet), APD.
Accredited Practicing Dietitian and Nutritionist, Ashleigh Hamilton, is passionate about a whole of body approach to health which encompasses both physical and mental aspects. She works with people to make lifestyle changes that will benefit their health for the future, using a range of counselling techniques including aspects of cognitive behavioural therapy, mindfulness and person-centred therapy.
To make an appointment with Brisbane Dietitian and Nutritionist, Ashleigh Hamilton, try Online Booking – Mt Gravatt or call Vision Psychology (Mt Gravatt) on (07) 3088 5422.
- Sibelli, A., et al. “A systematic review with meta-analysis of the role of anxiety and depression in irritable bowel syndrome onset.” Psychological Medicine 46.15 (2016): 3065-3080.
- Fond, Guillaume, et al. “Anxiety and depression comorbidities in irritable bowel syndrome (IBS): a systematic review and meta-analysis.” European archives of psychiatry and clinical neuroscience 264.8 (2014): 651-660.