Living with anxiety presents its own set of challenges, extending beyond the emotional load it carries. Often, conditions like irritable bowel syndrome (IBS) and mental health issues like anxiety and depression co-occur. Studies highlight a robust correlation between mental health conditions and gastrointestinal problems, such as IBS, affecting up to 40% of IBS patients. It's important to recognize that while anxiety and IBS don't directly cause each other, they mutually intensify one another.

So, why does anxiety impact our digestive system in this manner?

The connection may lay between the gut and the brain, known as the gut-brain axis. This intricate two-way communication system consists of various elements:

• The brain

• The enteric nervous system (ENS): Often termed the "second brain," the ENS comprises approximately 100 million neurons responsible for digestion processes, including food movement and fluid secretion.

• The vagus nerve: An important conduit transmitting signals between the brain and gut.

• Gut microbiome

In times of stress and anxiety, the "fight or flight" response triggers the sympathetic nervous system, diverting blood away from digestive organs—potentially leading to abdominal pain—in favor of vital survival functions. This heightened stress can also cause increased water in the colon, resulting in loose stools and diarrhea. The gut-brain axis, particularly the ENS, assumes a pivotal role in this interplay, actively influencing digestion and responding to mental processes.

Visceral hypersensitivity further compounds matters—those with IBS and anxiety often exhibit heightened sensitivity within the gut-brain axis. This means that normal gut sensations or stimuli that would typically provoke no response can trigger exaggerated and distressing symptoms. This hypersensitivity may manifest as visceral pain, heightened awareness of bowel movements, or an intensified perception of gastrointestinal symptoms. The heightened communication between the gut and the brain magnifies discomfort, anxiety, and emotional distress, initiating a cycle where IBS symptoms exacerbate anxiety and vice versa.

In addition to the gut-brain connection, a crucial trigger shared by both IBS and anxiety, which may elucidate their interconnectedness, pertains to biological, social, and psychological factors.

Considering the symptoms of IBS and their potential to induce or worsen anxiety, it makes sense why heightened anxiety and nervous system activity might adversely impact digestion. IBS and anxiety can influence social interactions and coping mechanisms (like avoiding going to eat out with friends, feeling anxious about travelling due to digestive concerns, etc) . Individuals predisposed to traits like perfectionism or a history of childhood adversity may be more susceptible to developing these conditions. Moreover, coping methods such as catastrophizing, rumination, and avoidance behaviours can exacerbate symptoms and intensify anxiety levels, further entwining these two disorders.

Understanding this intricate gut-brain connection can offer valuable insights into the physical digestive symptoms experienced during periods of anxiety. This realization can help individuals suffering from both anxiety and IBS seek appropriate treatment and manage their conditions effectively.

If you've been grappling with both anxiety and diarrhea, there's hope for relief. Addressing the root causes and seeking appropriate treatment can make a significant difference in managing your condition. Let’s chat!

References

PMID: 22837881 Psychiatric, Somatic and Other Functional Gastrointestinal Disorders in Patients With Irritable Bowel Syndrome Read here

PMID: 11916191 Are anxiety and depression related to gastrointestinal symptoms in the general population Read here

PMID: 29284804 Anxiety and Depression in Irritable Bowel Syndrome Read here

PMID: 31157418 the prevalence of anxiety and depression in patients with irritable bowel syndrome Read here

PMID: 2259069 Canadian Digestive Health Foundation Public Impact Series Read here