IBS and anxiety: Is there a link?

IBS is an umbrella term for conditions with moderate to severe digestive symptoms that affect your bowel movements. Symptoms of anxiety and depression may be common among people living with IBS.

The cause of IBS is yet to be determined, but experts suspect that a combination of factors is at play. These include stress, viral infections, bacteria, and food sensitivities.

Living with symptoms of IBS may involve ongoing:

• constipation
• diarrhea
• bloating
• abdominal pain
• cramps
• flatulence

Socializing and going out can feel intimidating and uncomfortable for someone with IBS, particularly because symptoms may arise unexpectedly.

This article discusses the possible link between IBS and anxiety and how to manage when you live with symptoms of both.

The link between IBS and anxiety 

Although no causal relationship has been established, anxiety symptoms are more common among people with IBS.

A 2023 study found that among 1.2 million people living with irritable bowel syndrome in the United States, 38% of them lived with anxiety and 27% with depression.

Another study from 2017 also found that 44% of people living with IBS had received a diagnosis of anxiety disorders, compared to only 8% of those who did not have the condition.

Anxiety disorder is a group of conditions that manifest primarily with anxious thoughts and emotions. Conditions include social anxiety, phobias, and panic disorder.

Some researchers have theorized that the link is found in the gut-brain axis. This refers to the two-way communication system between the central and enteric nervous systems. In other words, it’s how your brain and your digestive system communicate with each other.

Your thoughts and emotions affect hormone production. These chemicals also affect your bowel movement. When you have anxious thoughts, you may feel them in your gut.

At the same time, challenges in your digestive health may affect the production of mood-related chemicals, such as dopamine. Low levels of dopamine may lead to symptoms of depression and anxiety.

Additionally, living with IBS may lead you to experience anticipatory anxiety. This is anxiety that comes from anticipating an event that has not happened.

Fearing that your symptoms may suddenly appear when there is limited access to a restroom, for example, may elicit anxious thoughts of anticipation. This anxiety, in turn, may trigger IBS symptoms like nausea and diarrhea.

How can I manage IBS anxiety? 

Anxiety is a treatable condition, regardless of what is causing it. Managing your digestive health may also help you reduce mood symptoms, including anxiety.

A mental health professional and a primary physician may be able to help you devise a plan that works for your specific case.

Modifying your eating habits, adding supplements, engaging in mental health therapy, and considering medications may be part of the plan.

Here is a brief overview of ways to manage IBS-related anxiety:

• Cognitive behavioral therapy (CBT): This is the leading non-pharmaceutical therapy to manage anxiety symptoms. CBT is a type of psychotherapy that helps you develop tools for assessing and managing negative thought patterns and anxiety-related behaviors.
• Gut-directed hypnotherapy: For gut-directed hypnotherapy, a certified hypnotherapist will use verbal commands and suggestions to help you manage your physical discomfort and mental focus on your IBS symptoms.
• Relaxation techniques: Techniques like meditation, deep breathing, and grounding exercises may help you manage your stress response and induce your body and mind to release tension and anxiety.
• Probiotics: Some evidence suggests that probiotics may help you improve symptoms of anxiety disorders and low mood. This may be due to the gut-brain axis and how improving digestive health may improve dopamine production.
• Eating habits: Managing digestive health is closely related to your eating habits. Consider working with a registered dietician or your health team to determine which changes in nutritional habits may improve your anxiety and IBS symptoms.
• Sleep hygiene: Research suggests that sleep quality and duration can support healthy gut bacteria. Getting 8 hours of daily sleep may also help you manage anxiety symptoms.
• Medications: In some cases where other types of therapy have not worked, pharmaceutical options may help. Consider discussing the use of medications to treat IBS symptoms and anxiety.
  • Clonazepam (Rivotril), alprazolam (Xanax), and lorazepam (Ativan) may be indicated for anxiety symptoms.
  • Alosetron (Lotronex), eluxadoline (Viberzi), and rifaximin (Xifaxan) may be provided for IBS symptoms.

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Summary

Symptoms of anxiety are common among people with IBS. In the same way, digestive symptoms are common among people who live with an anxiety disorder. The gut-brain axis, a communication system between your central and enteric nervous systems, may explain this two-way relationship.

If you live with IBS-related anxiety, consider adding probiotics to your routine, practicing daily relaxation techniques, and searching for a CBT therapist. Medically managing your IBS symptoms may also help reduce your chances of experiencing anxiety.

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