Gastrointestinal Symptoms and Anxiety Disorders

Gastrointestinal (GI) disturbances commonly include symptoms of stomach pain, heartburn, diarrhea, constipation, nausea, and vomiting. While there are plenty of possible causes of GI issues, when no medical explanation 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.

Common Anxiety-Related GI Symptoms

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

• Constipation
• Diarrhea
• Increased hunger
• Indigestion
• Loss of appetite
• Nausea
• Stomach cramps

In addition to these general symptoms, some gastrointestinal conditions—such as irritable bowel syndrome and gastroesophageal reflux disease—have also been linked to anxiety disorders.

Irritable Bowel Syndrome (IBS)

Irritable bowel syndrome (IBS) is a gastrointestinal disorder that causes symptoms including pain, bloating, cramping, and constipation. While the condition is not life-threatening, it is chronic and can have a serious impact on a person's quality of life.

Symptoms of IBS can include:

• Bloated or swollen abdomen
• Diarrhea, constipation, or a combination of both
• Flatulence (gas)
• Stomach pain
• Whitish mucus in the stool

People who have IBS are also often diagnosed with mood and anxiety disorders, particularly panic disorder.

Gastroesophageal Reflux Disease (GERD)

Gastroesophageal reflux disease (GERD) is a digestive condition in which people experience acid reflux, which is when stomach acid enters the esophagus and leads to symptoms such as heartburn and trouble swallowing.

Common symptoms of GERD include:

• Bad breath
• Chest pain
• Difficulty swallowing
• Hoarseness of the voice, especially upon waking
• Mild pain or stuck in throat type sensations
• Persistent dry cough

Some research suggests that people who have GERD are also more likely to experience anxiety.

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—both for your GI concerns and the underlying anxiety.

Prescribed medications along with psychotherapy can help you to reduce your 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.

When to Seek 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:

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

Coping

There are also some things that you can do to help cope with symptoms of anxiety and related stomach problems. These include:

• Practice stress management techniques. Stress is a normal part of life, so developing good coping skills is important. Relaxation techniques that can help include deep breathing, progressive muscle relaxation, and meditation.
• Avoid excessive caffeine. Not only can caffeine increase feelings of anxiety, but many caffeine-containing products can also lead to gastrointestinal upset.
• Eat healthily. Focusing on a gut-friendly diet may help calms symptoms of stomach upset. Make sure that you are eating fiber-rich foods and try adding foods containing probiotics to your diet (such as yogurt, sauerkraut, and kombucha). Some animal studies have suggested that probiotics may have anxiety-reducing effects, though more research is needed to understand their impact on human mental health.