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With a global prevalence of 23%, irritable bowel syndrome (IBS) is a chronic gastrointestinal condition crippling millions of people across the world. [1] Characterized by uncomfortable symptoms, such as bloating, abdominal pain, and altered bowel habits, IBS holds the power to lower the quality of life significantly.

Read Also About Gut Health And Anxiety

Concurrently, anxiety disorders are one of the most common mental health disorders, with millions of diagnosed cases globally. Recent research confirms a strong link between IBS and anxiety, indicating a multifaceted relationship between the human mind and the gut. Understanding this complicated interplay between the body can improve the understanding of IBS from anxiety and how to manage both.

Researchers believe the gut-brain axis closely intertwines IBS and anxiety. The bidirectional communication network links the central nervous system with the gastrointestinal system through multiple pathways, such as the following:

Neural Pathways

The vagus nerve is one of the most critical factors connecting the brain and gut by conducting signals between the two systems. It regulates stress response and mood and aids in digestive processes. [2]

Hormonal Pathways

The human body consists of the hypothalamic-pituitary-adrenal axis, which is responsible for controlling the stress response. When you experience stress, this axis stimulates the release of cortisol, which travels to the gut and impacts digestive function.


The human gut is home to trillions of live microorganisms, collectively known as the gut microbiome. These microbiomes secrete neurotransmitters, such as gamma-aminobutyric acid (GABA) and serotonin, that directly interact with the brain and regulate mood and anxiety. [3]

Immune Pathways

When the body is under attack, the immune system triggers inflammation as a defense mechanism. This rising inflammation level sends a signal to the brain that alters the overall mood and behavior. On the contrary, when you are under stress, it can change your immune system, potentiating inflammation in the digestive tract.

Anxiety is known to exacerbate IVS symptoms through multiple mechanisms. Understanding these mechanisms is crucial to keep both conditions under control.

Neurotransmitter Imbalances

Neurotransmitters, such as serotonin, regulate mood and gut function. Approximately 90 percent of this hormone’s production takes place in the gut. When high anxiety levels impact the gut, they disrupt the normal balance of serotonin, impacting digestive health and mood simultaneously.


Anxiety can easily make a person hyperaware of what’s going on in their body, including the gut. This condition is termed hypervigilance, and it can easily magnify the perception of discomfort and pain due to IBS. Research further confirms this link by stating that individuals with IBS have a low pain threshold, meaning they are more sensitive to experiencing gastrointestinal discomfort. [4]

Stress Response

Both stress and anxiety can push the body into a fight-or-flight response and trigger the release of cortisol and adrenaline. These two hormones prepare the body to tackle the immediate threat by disrupting various normal functions, including digestion. So, when a person is anxious, this natural response alters the gut mobility, leading to the characteristic IBS anxiety symptoms.


Chronic anxiety and stress can naturally increase the inflammatory levels in the body. This elevated level can impact the gut lining to exacerbate IBS symptoms. High inflammatory levels also release certain chemicals in the body, like cytokines, that influence brain function, increasing anxiety and depression. [5]

Living with IBS can have profound effects on mental health. It can not only contribute to the development of anxiety but can also worsen it.

Quality of Life

Lingering IBS symptoms, such as bloating, abdominal pain, and unpredictable bowel habits, can negatively impact your overall quality of life. It can make you avoid social activities, travel, and work engagements due to a constant fear of flare-ups. Consequently, people can develop frustration, isolation, and embarrassment, which further provokes anxiety.

Sleep Disturbances

IBS can cause people to frequently go to the toilet, often in the night, which disrupts their sleep and causes insomnia. A lack of sleep exacerbates anxiety, pushing them into a vicious cycle where anxiety and IBS keep exacerbating each other.

Fear of Symptoms

As mentioned above, the unpredictable nature of IBS symptoms can push people into anticipatory anxiety, where they constantly worry about having symptoms in inconvenient places. This fear makes them develop avoidance behaviors, which limit their social interactions and increase anxiety levels.

Economic Burden

IBS has been associated with a high economic burden that worsens underlying anxiety. The high cost of managing symptoms, along with lost work productivity, can lead to financial stress, further exacerbating anxiety.

The biopsychosocial model provides an intricate framework for people to understand how various biological, social, and psychological factors collectively influence IBS and anxiety. This model suggests that the two conditions are not solely reliant on any of these factors but are somewhat influenced by a combination of the following:

  • Biological Factors: Many biological factors, such as the immune system function, the composition of the gut microbiome, and genetic predisposition, play a role in IBS and anxiety.
  • Social Factors: Cultural beliefs, socioeconomic status, social support, and the presence of environmental stressors regulate how a person experiences and manages IBS and anxiety.
  • Psychological Factors: Factors like a person’s personality traits, stress levels, and coping mechanisms also determine the severity and management of IBS and anxiety.

Understanding the biopsychosocial model is necessary as it provides a solid foundation to develop effective treatment plans addressing the multifaceted nature of IBS and anxiety.

To manage IBS from anxiety, you must develop a holistic approach addressing both the psychological and physical aspects of these conditions. Following are some strategies to adopt:

Dietary Modifications

Diet plays a crucial role in the management of IBS symptoms. While the dietary interventions may vary from one person to another, the following approaches have been shown to help:

  • Identifying food triggers: Maintain a food diary to identify items that trigger your symptoms. Common triggers may include alcohol, caffeine, artificial sweeteners, and fatty food.
  • Low FODMAP Diet: This dietary plan involves reducing the consumption of fermentable oligosaccharides, monosaccharides, polyols, and disaccharides to stop IBS flare-ups. It requires you to skip certain vegetables, fruit, grains, and dairy products to reduce the IBS symptoms by up to 75 percent. [6]
  • Balanced Diet: Eating a balanced diet with sufficient levels of fiber can regulate bowel movement. In most cases, soluble fiber is the preferred choice as it has a higher tolerability index than insoluble fiber. Some familiar sources of soluble fiber include oats, vegetables, and fruit.

Cognitive Behavioral Therapy

Cognitive behavioral therapy, or CBT, is a psychotherapy that helps people change their negative behaviors and thought patterns. [7] The technique has been known to keep IBS and anxiety under control through the following effectively:

  • Cognitive Restructuring: CBT helps you identify and get rid of negative thoughts related to IBS symptoms while giving you the confidence to manage them.
  • Stress Management: CBT also equips you with valuable tips on managing stress and anxiety to reduce their impact on the gut.
  • Behavioral Strategies: CBT promotes gut health, such as healthy eating, adequate sleep, and regular exercise.

Stress Management Therapies

Effective stress management can keep IBS and anxiety under control. The following techniques can be used in this regard:

  • Mindfulness Meditation: Mindfulness involves paying attention to the present and accepting it without judgment. Studies highlight mindfulness meditation as an effective strategy for controlling anxiety and improving IBS symptoms.
  • Deep Breathing: This exercise helps activate the parasympathetic nervous system, which pulls the body out of a state of fight-or-flight and promotes relaxation.
  • Yoga: Yoga has been an effective way to reduce stress, improve gut movement, and manage IBS symptoms through the combined power of physical postures, meditation, and breathing exercises.


Sometimes, medications are needed to control IBS and anxiety. The following are the potential options to consider:

  • Anti-Diarrheals and Laxatives: Depending on whether you experience diarrhea or constipation, laxatives and anti-diarrheal medicines may control symptoms.
  • Antispasmodics: These medications have been designed to relax the muscles in the gut to control abdominal cramping and pain.
  • Anti-Anxiety Medications: Anxiolytics, such as benzodiazepines, provide short-term relief from severe anxiety and the consequent IBS flare-ups. Remember that these medications are not suitable for long-term use due to the high risk of addiction.
  • Antidepressants: Using low-dose antidepressants, such as tricycle antidepressants and selective serotonin reuptake inhibitors, can keep pain managed while improving mood.

Regular Workouts

Regular physical activity brings numerous benefits for both mental and physical health. For those struggling with irritable bowel syndrome and anxiety, exercise:

  • Reduces Stress: Workouts release endorphins, small chemicals that reduce stress and improve mood, positively impacting anxiety and IBS.
  • Improves Gut Motility: Exercise makes bowel movements more regular, controlling the symptoms of diarrhea and constipation.
  • Improves Overall Wellbeing: Regular exercise improves sleep and enhances energy levels, giving people a positive outlook on life.

Professional Support

Seeking professional help is essential to manage irritable bowel syndrome and anxiety. Healthcare providers, including mental health professionals and gastroenterologists, can be contacted to get a comprehensive care plan tailored to your needs. In most cases, professional support includes the following elements:

  • Medical Evaluation: An in-depth medical evaluation can help establish a firm diagnosis while ruling out other conditions.
  • Nutritional Support: Seeking help from registered dieticians can provide you with personalized dietary advice to keep IBS under control.
  • Psychological Support: Therapy and counseling sessions can support IBS and anxiety management by helping you acquire and practice healthy coping strategies.
  • Support Groups: Interacting with other people with similar issues provides emotional support and advice to keep them under control.

The connection between IBS and anxiety has been a focus of research for years. With ongoing research exploring the underlying mechanisms and new treatment modalities, the following are some promising areas of research:

Gut Microbiome

The gut microbiome plays a significant role in triggering IBS and anxiety. Ongoing research aims to understand how changing this microbiome population through various techniques, such as prebiotics, probiotics, and fecal microbiota transplantation, can affect the symptoms of both conditions.

Novel Therapies

Researchers have proposed many new therapies, such as vagus nerve stimulation and transcranial magnetic stimulation, that could improve both conditions by positively affecting the gut-brain axis.

Personalized Medicine

With advancements in the microbiome and genetic research, researchers are coming up with more personalized treatment approaches to manage IBS anxiety symptoms. Identifying microbial profiles and specific genetic markers associated with IBS and anxiety can hold the key for better management of both conditions in the future.

Integrative Techniques

These approaches combine standard medical treatments with adjuvant therapies, like herbal medicine, mindfulness, and acupuncture. Many ongoing trials focus on whether such integrative techniques can improve treatment outcomes.

IBS and anxiety share an intricate relationship, with multiple factors influencing it in one way or the other. This multifaceted nature of both conditions reinforces the concept of using an integrated approach that focuses on the mind and the body to manage the ongoing symptoms and improve the overall quality of life.

While there is no one-size-fits-all approach to managing IBS and anxiety, using a combination of stress management, dietary alteration, medication, therapy, and professional support can provide significant relief.

As research explores the complexities of the gut-brain axis and its effect on health, new treatment strategies and options will continue to emerge, offering hope and support for struggling populations. For now, adopting an individualized approach remains the single most effective way to deal with the multifaceted nature of these issues.


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