Gastrointestinal (GI) complaints and anxiety frequently go hand-in-hand. Results from a study published in a 2002 issue of the “Scandinavian Journal of Gastroenterology” support this observation, showing that anxiety is directly related to gastrointestinal problems in the general population. In some cases, these GI problems can become chronic and frustrating to diagnose or manage.
Functional GI Symptoms
People with anxiety often report a number of unexplained, nonspecific gastrointestinal symptoms such as nausea, abdominal pain, bloating, excess gas, cramping, dyspepsia, or other stomach or upper GI discomfort. In many cases, no single underlying physical abnormality can be identified as the cause. These types of symptoms are called functional GI complaints and are likely due to a combination of lifestyle/behavioral factors (diet, exercise, sleep habits), inflammation, and infectious factors. Chronic functional GI disorders are the most common of all gastrointestinal disorders.
Irritable Bowel Syndrome (IBS)
Irritable Bowel Syndrome (IBS) is a functional gastrointestinal disorder characterized by symptoms of bowel irregularity, such as diarrhea or constipation, bloating, the presence of mucous in the stool, and chronic abdominal pain and discomfort. According to Healing Well, psychological factors such as anxiety or depression are found in 40 to 60 percent of patients who seek treatment for IBS.
Although anxiety and IBS often occur together, it is not always clear whether anxiety causes IBS, whether IBS causes anxiety, or whether some other factor is causing both anxiety and IBS. A study published in the August 2003 issue of the “Journal of Behavioral Medicine” addressed this question, finding that, of any lifetime psychiatric disorder, anxiety disorders are the most likely to develop before IBS. This suggests that anxiety is causing the development of IBS.
Specific types of anxiety may be more likely to cause IBS. In March 2009, an article published in the “Journal of Anxiety Disorders” reported that those with panic disorder and generalized anxiety disorder are more likely than the general population and those with other anxiety disorders to report IBS symptoms.
A study published in 2007 in “Alimentary Pharmacology & Therapeutics” shows that there is a link between anxiety and gastroesophageal reflux symptoms in the general population. Gastroesophageal Reflux, commonly known as acid reflux, occurs when the lower sphincter of the esophagus opens spontaneously and allows stomach acids to rise up and into the back of the mouth. A more serious form of GER that can develop is GERD, or gastroesophageal reflux disease. Persistent reflux that occurs more than twice a week is considered severe enough to warrant a diagnosis of GERD.
Chronic GERD that is not treated or is not responsive to treatment can cause scar tissue development and narrowing of the esophagus, or bleeding and ulcers in the esophageal lining, a condition known as esophagitis. In some cases, Barrett’s esophagus--a condition in which the cells lining the esophagus become abnormal in shape and color--can develop. Those with the condition may be at risk of developing esophageal cancer.
- “Scandinavian Journal of Gastroenterology;” Are Anxiety and Depression Related to Gastrointestinal Symptoms in the General Population?; Haug TT et al.; March 2002
- Advances in Physiology Education: Translating Symptoms into mechanisms: Functional GI Disorder; Stephen M. Collins; 2007
- “Journal of Behavioral Medicine;” Psychopathology in Irritable Bowel Syndrome: Support for a Psychophysiological Model
- Journal of Anxiety Disorders: Frequency and Severity of the Symptoms of Irritable Bowel Syndrome Across the Anxiety Disorders and Depression
- Alimentary Pharmacology & Therapeutics;” Severe Gastro-oesophageal Reflux Symptoms in Relation to Anxiety, Depression and Coping in a Population-Based Study