An upset stomach can be natural when you’re anxious, but how do you know if it’s something more than nerves — such as irritable bowel syndrome (IBS)?
Stress and anxiety can manifest in the body in surprising ways. For many people, digestive issues are common when life feels overwhelming.
Along with nausea and uneasiness, stress can even feel as though there’s a large, uncomfortable rock sitting in your stomach.
When you live with both anxiety and a medical condition such as irritable bowel syndrome, however, it can be difficult to know which one is responsible for your symptoms.
Anyone can experience anxiety. It’s part of the body’s natural physiological response to challenging situations.
When your body detects a real or perceived threat, it springs into action. Your brain starts sending out instructions geared toward survival — such as rapid breathing, elevated heart rate, and butterflies in your stomach.
All these changes are intended to help you in the short term. If you need to escape danger, for example, the last thing your body wants you to do is to eat a heavy meal.
When anxiety becomes long term, such as in anxiety disorders, many of these survival mechanisms start to cause negative effects in the body.
Irritable bowel syndrome (IBS) is the clinical name given to a group of digestive symptoms that mainly affect your bowel movements.
Several classifications of the condition exist, including:
- IBS-C: symptoms occurring mainly with constipation
- IBS-D: symptoms occurring mainly with diarrhea
- IBS-mixed: diarrhea and constipation are both regularly experienced
Unlike many other gastrointestinal conditions, IBS doesn’t appear to cause visible damage to your digestive tract, but it’s driven by underlying issues within the nervous system of the gut.
The American College of Gastroenterology estimates that about 10% to 15% of adults in the United States live with symptoms of IBS, but only 5% to 7% have received a diagnosis of the condition.
IBS can affect anyone of any age. The exact cause of the condition is unknown. But IBS and other similar conditions are classified as disorders of gut-brain interaction (DGBI).
Other factors might also play a role in IBS, including:
- stressful situations
- bacterial or viral infections
- food sensitivity or intolerance
- imbalance of intestinal bacteria growth
When you live with IBS and anxiety, it can be difficult to know which one is at the root of what you’re feeling.
Symptoms of anxiety include:
- persistent feelings of worry or apprehension
- sleep disturbance
- muscle tension
- sense of impending doom
- difficulty concentrating
- increased or irregular heart rate
- upset stomach or nausea
- rapid or shallow breathing
Common symptoms of IBS include:
- abdominal pain
- excessive gas production
- mucus in stool
IBS symptoms could come on without warning. This component of unpredictability might make you feel anxious about going to new places or being too far away from a restroom.
Both anxiety and IBS can cause digestive symptoms, and anxiety can be a side effect of IBS, especially if your symptoms come on without warning.
Anxiety and anxiety disorders don’t cause IBS, though they might worsen symptoms of the condition.
Both IBS and anxiety also appear to experience the same structural brain changes that could occur from significant life stress, according to a
This doesn’t mean that one condition causes the other. It suggests, instead, that if you’re predisposed to developing an anxiety disorder, for example, you might also have an increased likelihood of developing IBS.
The reverse is also possible — if you’re predisposed to IBS, you might also have an increased chance of developing an anxiety disorder.
You don’t have to live with a mood disorder to experience anxiety and IBS, however.
When you live with both IBS and anxiety, apprehension about IBS symptoms could make your anxiety worse, and your anxiety could make your IBS symptoms feel more intense.
Prevention often means finding a way to break this cycle. When you feel yourself ruminating about when IBS will strike, finding a way to interrupt your thoughts could help.
When you practice mindfulness, you learn to allow your thoughts to occur in the moment without following them down into the “rabbit hole“ where you focus on them over and over again.
Mindfulness could help you with both body awareness and cognitive focus, which might help stop the IBS and anxiety cycle.
The connection between IBS and anxiety is complex, and you might need to involve management strategies for both conditions.
Working with a mental health professional in addition to a healthcare professional could help you work toward anxiety reduction while also treating your IBS symptoms.
Both IBS and anxiety could benefit from cognitive behavioral therapy (CBT). During this process, you’ll learn to identify inaccurate beliefs that might be contributing to negative emotions and worsening the symptoms of IBS.
A healthcare professional might also recommend gut-directed hypnotherapy, which is a form of hypnosis.
Visualization exercises and suggestive images and metaphors are used during hypnosis to calm your digestive tract and help move your focus away from your gut sensations. A 2020 review found that hypnotherapy is an effective approach for the long-term management of IBS symptoms.
While you progress in the clinical setting, there are ways you could help prevent anxiety on your own, including:
- limiting alcohol and caffeine
- eating regular, balanced meals
- using focused breathing techniques
- practicing yoga, meditation, mindfulness, or other relaxation methods
- treating yourself to a massage or other self-care activity
- seeking humor when you feel anxious
- reminding yourself that you’re human, and it’s OK to be imperfect
- journaling about what may be causing feelings of anxiety
- using positive affirmations
- distracting yourself with a hobby or activity
- asking family and friends to support you
IBS management strategies could overlap with anxiety reduction techniques. These strategies might include:
IBS and anxiety are linked in a number of ways. Not only can they have similar genetic pathways, but experiencing one may also increase the symptoms of the other.
Anxiety doesn’t cause IBS, but it’s natural to feel anxious when you live with unpredictable digestive symptoms.
Both IBS and anxiety can be managed, however, and often through the same processes.
To locate a mental health care professional, you can visit our find help page to find services in your area.