Are you surprised to learn that more than 50 percent of patients who suffer from Irritable Bowel Syndrome (IBS) also experience anxiety? IBS, a condition affecting the lowest portion of the digestive tract (the large intestine and the colon), is characterized by stomach pain, bloating, and bowel irregularities like diarrhea and constipation. While there were many theories that IBS was caused by a mental disorder, it was not until the 1990s that formal publications suggested anxiety was directly related to IBS. It is now clear that IBS and anxiety are related, yet we still can't explain why that is.

IBS is a common problem; Around 10-15% of the population in the United States suffers from it, according to the National Digestive Diseases Information Clearinghouse.

Common symptoms of IBS include:

  • Constipation
  • Diarrhea
  • Feeling that bowel movement is not complete
  • Cramping
  • Stomachaches and pains
  • Bloating
  • Gas
  • Mucus in the stool

Less common symptoms of IBS include:

  • Tiredness
  • Backache
  • Urinary frequency
  • Poor sleep

To diagnose IBS, a health care provider will consider a patient's medical history and conduct several routine tests such as: a blood test, scan, endoscopy, and stool test. Other symptoms such as blood in the stool, unexplainable weight loss, and loss of appetite may require more tests to exclude the possibility of other, more serious, conditions.

Treat Anxiety, Treat IBS

Due to the close association between anxiety and IBS, techniques currently being implemented to treat anxiety might in fact help lessen the symptoms of IBS. Reducing stress can help also reduce the severity and frequency of IBS symptoms.

A recent study published by the Archives of Medical Science revealed that medical treatment in combination with psychological treatment was more effective for reducing symptoms of IBS than just medical treatment alone.

Other stress management techniques that can be helpful for IBS include:

  • Meditation
  • Yoga or Tai Chi
  • Regular exercise
  • Hypnotherapy
  • Cognitive Behavioral Therapy
  • Tricyclic Antidepressants
  • Serotonin Reuptake Inhibitors

What Studies Show

Although there are many other possible factors that can lead to IBS, there is a strong association with IBS and anxiety that even current research has failed to understand. One possible explanation for the high prevalence of anxiety among patients with IBS is something called the brain-gut interaction. This theory suggests that brain and nerve patterns during periods of stress amplify the input signals to the gut and change bowel habits or increase discomfort.

How IBS Complicates the Matter

Recent studies have been able to establish a link between anxiety and IBS, but the exact cause of IBS remains unknown. If the cause and effect relationship was better understood then preventative measures could perhaps be taken in order to avoid or decrease symptoms.

The relationship between anxiety and IBS is difficult to establish because there are many different physical and mental health problems that can lead to IBS. Other factors that can lead to IBS development include:

  • Bacterial overgrowth
  • Harmful bacteria in the gut
  • Food intolerances
  • Abnormal nervous system
  • Sensitive nerves in the colon
  • Other abnormalities in the colon

IBS affects people of all ages, but it is more common in people between the ages of 20 and 30. Most people who suffer from IBS experience mild symptoms and do not need medical treatment. However, the symptoms associated with IBS can cause discomfort and inconvenience.

More on the Studies

A study conducted at the University of Southampton, UK, investigated how psychological factors like anxiety affected the development of IBS. The study began with 620 participants who had confirmed gastroenteritis, a known trigger of IBS that is caused by a bacterial infection. None of the participants had a history of IBS before the study began.

To determine their relationship with anxiety, the participants were asked to answer a questionnaire about their moods, daily stress levels, perfectionist attitudes, and illness-related beliefs and behaviors. After a period of three months and six months, the researchers checked the participants to see if they had developed IBS. Out of the 620 participants that were in the study, 49 had developed IBS. The study also revealed other interesting aspects about IBS:

  • Women were twice as likely to develop IBS than men.
  • Participants with IBS were twice as likely to have self-reported high levels of stress compared to those who had not developed IBS.

Another study carried out by Singapore General Hospital found similar results. 345 patients who suffered from IBS were tested for psychological disorders using questionnaires. The results from the study showed that more than half of IBS patients suffered from a psychological disorder. The most common disorder was anxiety.

Although the exact nature of the relationship between IBS and anxiety is unknown, anxiety relief techniques have proven to be an efficient method to manage symptoms of IBS. Hopefully future studies will provide more insight into the relationship between IBS and anxiety and help researchers discover preventative measures for symptoms of IBS.

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Michele Rosenthal
Eugene G. Lipov, M.D.
Katherine K. Dahlsgaard, Ph.D.
Maisha M. Syeda, MSc.
Herman R. Lukow II, Ph.D.

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Date of original publication:

Updated: September 12, 2019