They are so closely related that sometimes it can be hard to tell which one came first: the anxiety or the IBS (Irritable Bowel Syndrome).
Did the anxiety cause the IBS symptoms to develop – or once you had IBS, did you start to feel anxious about when symptoms might hit – if it might be embarrassing, inconvenient or worse?
In fact, they can both be the cause and effect of the other. It is as we begin to understand this relationship that we can take the first steps towards managing the symptoms.
As the name suggests, IBS – or Irritable Bowel Syndrome – affects the bowel habits. It is a disorder which affects digestion, and can cause one or a combination of the following symptoms:
- stomach pain and cramping;
- diarrhoea and/or constipation;
- bloating; and
- mucous in the faeces.
The symptoms vary, but 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).
Just to make things even more interesting, there is another type of IBS where sufferers can endure bouts of combination of constipation and diarrhea!
It is estimated that approximately 1 in 5 Australians suffers from the discomfort of IBS, and the triggers for symptoms can be as unique as the individual. This makes treatment more challenging, as it is only once these have been identified that the IBS can be treated effectively. Common triggers include:
- Food: This is different for everyone, but common culprits include caffeine, spicy foods, dairy, fatty foods, fructose, high fibre foods, artificial sweeteners, and foods high in FODMAPs.
- Hormones: Women tend to have more issues with IBS during their menstrual cycle and when pregnant, due to the changing hormones in the body.
- 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 gastrointestinal illnesses such as gastroenteritis can trigger IBS, but so can medications such as probiotics, anti-nausea, or pain relief medications.
What About Anxiety?
Meanwhile, 1 in 4 Australians will experience anxiety at some stage; it is the most common mental health condition.
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:
- panic attacks;
- hot and cold flushes;
- racing heart;
- tightening of the chest;
- rapid breathing;
- restlessness, or feeling tense, wound up and edgy;
- excessive fear, worry, catastrophising, or obsessive thinking; and
- avoiding situations that cause the anxiety – which can have a negative impact on work, study and social life.
The Links Between Anxiety and IBS
According to recent research:
- 70-90% of IBS sufferers who seek treatment, also suffer from psychological disorders such as anxiety and depression;
- people with anxiety and depression have a a two-fold risk of developing IBS;
- people with IBS have higher levels of anxiety and depression.
This makes sense when we remember that stress is a common trigger for IBS, so a person with anxiety would be experiencing regular high levels of stress thereby at risk of triggering an IBS attack.
On the flip side however, IBS may be the trigger for anxiety, as sufferers constantly fear that they might eat something that doesn’t agree with them, and always have to be aware of where the nearest toilet is.
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.
Managing IBS and Anxiety
For some, IBS might be a brief and transient condition as a result of medication or an illness, subsiding on its own.
Unfortunately, for most people IBS can’t be cured – however it is possible to manage the severity and frequency of symptoms.
The first and most important step is to identify the triggers, which can be done by keeping a food/symptoms diary. This involves keeping track of all the foods you eat, your bowel movements, any other symptoms, times when you are stressed, 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 futue, 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.