Gastrointestinal Symptoms and Anxiety Disorders

Gastrointestinal (GI) disturbances commonly include symptoms of stomach pain, heartburn, diarrhea, constipation, nausea, and vomiting. When no medical cause for GI disturbances is found, they are often termed “functional GI symptoms.” Many studies have shown a correlation between anxiety, depression and functional GI symptoms.

Generally, study results have demonstrated that people who have at least one GI symptom are more likely to have an anxiety disorder or depression than those without any GI symptoms.

In fact, unexplained physical complaints, as a whole, — fatigue, headache, stomach upset, nausea, diarrhea, constipation, dizziness, musculoskeletal pains — were more commonly reported in individuals with an anxiety disorder and/or depression.

Associated Symptoms

Common GI symptoms that have been associated with anxiety disorders include:

1. Irritable Bowel Syndrome (IBS)
   • Stomach pain
   • Flatulence (gas)
   • Bloated or swollen abdomen
   • Diarrhea, constipation or a combination of both
   • Whitish mucus in the stool
2. Gastroesophageal reflux disease (GERD)
   • Chest pain 
   • Difficulty swallowing  
   • Hoarseness of the voice, especially upon waking 
   • Persistent dry cough
   • Mild pain or stuck in throat type sensations 
   • Bad breath

When to See Your Doctor

You should consult with your family doctor if you are experiencing unexplained mild to moderate gastrointestinal disturbances for more than a few days, or if your symptoms stop and then return.

Your family doctor may order tests or refer you to a specialist to rule out any serious medical problem that may be causing your symptoms.

If it is found that you have functional GI symptoms related to anxiety, there are many effective treatments available, which may include also treating your anxiety-related symptoms.

Prescribed medications along with psychotherapy can help you to reduce our feelings of anxiety and develop healthy ways to cope with stress. Learning to manage your anxiety while treating your GI symptoms can be the most beneficial in helping you deal with both issues.

GI Symptoms That May Indicate Urgent or Emergency Care

Whether or not you believe your GI symptoms are anxiety related, you should consult your doctor as soon as possible if your symptoms occur with any of the following:

1. Unexplained weight loss
2. Persistent, low-grade fever
3. Feeling bloated or full after eating very little
4. Blood in the stool
5. Having a bowel movement that is black, tarry and foul-smelling

Immediate medical care is warranted if your symptoms include:

1. Extreme abdominal pain
2. Inability to have a bowel movement
3. High fever
4. Extreme diarrhea lasting more than one day
5. Disorientation or confusion
6. Chest, neck, shoulder or jaw pain
7. Rapid or significantly decreased heart rate
8. Moderate to severe rectal bleeding
9. Vomiting blood (if the vomited matter looks like ground coffee, this may indicate blood)

_Sources:

_{Haug, T.T., Mykletun, A. and Dahl A.A. "The Association Between Anxiety, Depression, and Somatic Symptoms in a Large Population: The HUNT-II Study. Psychosomatic Medicine" 2004 66:845-851.}

_{Haug, T.T., Mykletun, A. and Dahl A.A. "Are anxiety and depression related to gastrointestinal symptoms in the general population?" Scand J Gastroenterol 2002 37(3):294-298.}

_{Jansson, C., Nordenstedt, H., Wallander, M.A., Johansson, S., Johnsen, R., Hveem, K. and Lagergren, J. "Severe Gastro-oesophageal Reflux Symptoms in Relation to Anxiety, Depression and Coping in a Population-Based Study." Alimentary Pharmacology & Therapeutics 2007 26(5):683-691.}

_{The John Hopkins University Digestive Disease Library. Irritable Bowel Syndrome. 2008.}