# why is this forum here? is there a connection between anxiety and IBS?



## alicaisse (Sep 19, 2003)

Which causes which?chicken or egg?I have both, that's why i'm wondering!


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## california123 (Jun 8, 2003)

There are a number of studies that show a high correlation between IBS-D and anxiety. (By that I mean anxiety manifests itself through D. Obviously virtually everyone becomes anxious once they have bad D.) For me, I have no doubt that anxiety brought on my D. It started in January and was bad every day for six months. Had the tests, eliminated foods/milk, tried all the anti-D meds and nothing made a difference. Then I started thinking about the stress I was under looking out for two elderly parents with dementia and started reading about symptoms of anxiety (I've posted the list below)and there it was--the big D. Started taking small dose of anti-anxiety drug and D stopped within 48 hours and has not returned since. I'm now seeing my psychiatrist every few weeks and have reduced the original med and added Effexor an anti-anxiety/anti-depressant. I feel soooo much better even though the stress in my life remains high. I also do yoga and breathing meditation as well as work on just slowing myself down. Take care and good luck.Symptoms of Generalized Anxiety Disorder The symptoms of anxiety range in intensity from feelings of uneasiness producing trembling and sweaty hands, to bouts of diarrhea, heart palpitations and full-blown panic attacks. Anxiety can cause complete, but temporary, memory blocks, or cause entirely inappropriate behavior. Long term severe worry, tension, irritability or depression, for no clear reason. Excessive or unwarranted worry (usually over work, finances, relationships, and health) Heart palpitations (rapid or irregular heartbeat) Sense of impending doom Difficulty or Inability to concentrate or mind going blank Muscle tension especially in the neck, shoulders, and chest; muscle aches; trembling or twitching in the muscles Diarrhea Chest pain Dry mouth Sweating or hot flashes Excessive sweating, sweaty palms Abdominal pain and/or diarrhea Undereating or overeating, loss of appetite Insomnia (difficulty falling or staying asleep, nightmares) Irritability Fatigue, headache, Easily fatigued Trembling or feeling shaky Rapid and shallow breathing, or feeling short of breath (hyperventilation) Loss of sex drive Being easily startled Occasional panic attacks Restlessness


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## california123 (Jun 8, 2003)

I found another site that not only discusses a whole range of anxiety symptoms, but goes into some detail about why each may occur. This list includes rapid gastric emptying, indigestion, heartburn, constipation and diarrhea! http://www.npadnews.com/anxiety-symptoms.asp It is from the National Panic and Anxiety News


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## Kathleen M. (Nov 16, 1999)

This forum is here because it seems that a lot of people have issues with both.In some it is more clear than others which problem was first, but often it is not. Some people may have had a tendancy to become anxious prior to IBS, but it didn't rear it's head until after the IBS triggered it....and some people clearly had panic attacks and other anxiety issues long before they had IBS. And some people do not have issues with both at all. Anxiety isn't a part of the overall picture of what is going on with them.They two problems do tend to feed off each other, creating a vicious cycle. You are anxious about needing a bathroom, which makes you more prone to needing the bathroom, which makes you more anxious about needing the bathroom...etc.For some people getting a handle on the anxiety part of their situation really helps overall by breaking the cycle.K.


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## Guest (Sep 21, 2003)

I think the most important thing is that if anxiety is present, relaxation therapies can be very helpful, as can certain medications... even psychotherapy.... or something as simple as exercising or listening to music.(My anxiety has gone hand in hand with the IBS since I was about 5 years old and I'll be 51 on Wednesday.)Evie


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## Guest (Sep 22, 2003)

I am of the opinion that anxiety is at the root of IBS. I don't think anxiety always manifests itself in somatic (physical) symptoms. It is insidious and cunning in its onset and effect. I also believe that those of us with IBS may well have a genetic predisposition for what we call IBS. I also think that much of what we experience as IBS is often set up as a learned process in our formative years, for often we see parents or other role models that may well set us up for emotionally sensitive reactions to food and the digestive process.


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## Guest (Sep 22, 2003)

I have to agree that I believe that anxiety is a key factor in this. My experience is that anixety is the engine that drives my IBS more than any other factor.Many people have told me that they think that I am a rock and that I handle pressure exceptionally well. And to a certain extent I suppose that I do. There are not too many things that really scare me, but the naked truth is that I have this fear of having an accident.It nags at the back of my mind, always. I cannot remember a time anymore where that little voice was not there whispering inside my head. Sometimes it wins. There are times when I cannot stay strong enough to beat it, and there are times when nothing can possibly stop me.I have several methods of coping- hypnosis, weightlifting/punching bag and just plain talk to myself. Specifically I silently repeat over and over that I am going to be ok. Sooner or later it works.Thus far I am accident free. Who knows if this will ever change, it may or it may not. For the most part I manage to keep the hounds at bay. And on the days when it gets really bad you can find me in my garage working the punching bag over. There is such a release in that for me, I just pour out my frustration and I usually feel better.But the reality for me is that if I find a way to completely release that fear, my life will be better. And I do consider it to be good now.


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## evild (Aug 20, 2003)

I am one of those people who can not say for sure. I was always pretty much the kind of person who worries a bit about things. Most people I knew up to 2 years ago would think that was a lie. It was not until my IBS became the problem that it is these days though that I ever had any "freak outs" unfortunately these panic attacks have become more frequent, and each one triggers a case of D. My best friend told me she was getiting married, my first reaction was panic, rather than being happy for her. If I had to guess based on my history which came first... I would go with the IBS, which I have had to some degree since I was a kid.These days... I try not to think about things like that I have both now... so I am just trying to deal with both. I have no doubt that helping either one will inevitably help me with the other. Right now I am trying tai chi and yoga to try to straighten out my head a bit and relax.


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## california123 (Jun 8, 2003)

I posted this on the D board but thought it would also be of interest here. I thought this short discussion of the two kinds of anxiety and D was helpful. It is from the Northwestern University Med school site.Anxiety DisordersWhat are anxiety disorders?Anxiety is a natural response, one that moves our body toward fight, fright , or flight in response to immediate threats. But in the case of more than 25 million Americans, anxiety is a constant response to everyday events, one of apprehensions, uncertainty, and fear. Anxiety disorders can be symptomatic of other problems such as depression, drug abuse, or serious medical conditions, but in many cases anxiety disorders exist with no precursor.Many types of anxiety disorders exist, but two main types are common. Generalized anxiety disorder (GAD) can be described as a constant state of tension and anxiety lasting for at least six months. People have impaired normal functioning due to feeling on edge, fatigue, inability to concentrate, irritability, and sleep disturbances. Like all other types of anxiety, a rise in blood pressure is common, as well as rapid breathing, increase in muscle tension, nausea, and diarrhea. Panic disorder, the other main type of anxiety disorder, manifests in periodic attacks of anxiety or terror, usually lasting 15 to 30 minutes. People experience sweating, shakiness, shortness of breath, dizziness, nausea, feeling of unreality, and fear of dying or going insane. The attacks occur in any number of patterns and be spontaneous or in response to specific stressors. Other anxiety disorders include phobias, obsessive-compulsive disorder, and post-traumatic stress disorder.Genetics, biochemistry, environmental factors, and psychological stress all interact in the development of anxiety disorders. Usually panic disorders develop in late adolescence, while GAD can occur at any age. Women are affected more than men. Anxiety disorders can mimic symptoms of other conditions like heart attacks so physicians must perform comprehensive examinations in diagnosing the disorders. Those with anxiety disorders are at risk for suicide, depression, and substance abuse, and their disorder can have an adverse effect on physical health and relationships.Most anxiety disorders respond well to treatment. A common and effective method of treatment currently is a combination of cognitive-behavioral therapy with medication. Many anti-anxiety and antidepressant medications are available for those suffering from anxiety disorders, and research continues to uncover more alternatives everyday.


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## floridian (Sep 18, 2003)

My IBS-D pattern was to have a normal movement each evening, followed by progressively less normal movements until I was in agony. To me, this seems much more like an issue of nerves that don't turn themselves off than of any of the ordinary causes of D like bacteria, parasites, etc. I also have a hard time turning off the adrenaline once it starts flowing. For me, the term brain-storm is not a metaphor... when they hit, I will stay up working on an idea until I am physically exhausted. Calcium has worked wonders so far with the D, and Saint Johns Wort and Rhodiola have helped with the stress.


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## eric (Jul 8, 1999)

FYIGut Feelings: The Mind-Body Connection Chris WoolstonCONSUMER HEALTH INTERACTIVE Below: ï¿½ Listening to your gut ï¿½ The stress alarm ï¿½ Functional disease in a dysfunctional world ï¿½ Setting your mind on relief http://www.ahealthyme.com/topic/mindbodygu...AETVTWCYSYZSFEQ Aslo thisGut ThoughtsThough few know about it, humans have a second brain that handles most of the body's digestive functions. Study of the enteric nervous system is a rapidly growing specialty, offering insight into malfunctions of the "gut brain" as well as the more complex cranial brain. Digestion is such a prosaic function that most people prefer not to think about it. Fortunately, they don't have to ï¿½ at least not with the brain in their heads. Though few know about it, humans (and other animals) have a second brain that handles most digestive functions. Deep in your gut lies a complex self-contained nervous system containing more nerve cells than the spinal cord, and indeed more neurons than all the rest of the peripheral nervous system. There are over 100 million nerve cells in the human small intestine alone. Malfunctions of this "gut brain" may be involved in irritable bowel syndrome (IBS), a condition that affects an estimated 20 percent of the U.S. population and is believed to be responsible for $8 billion in health care costs alone in the United States each year, according to the International Foundation for Functional Gastrointestinal Disorders. Patients with IBS suffer bouts of chronic diarrhea, constipation, or sometimes both alternately. IBS is the most common diagnosis made by gastroenterologists. The study of the enteric nervous system is a rapidly growing specialty known as neurogastroenterology. "What the gut has to do is extremely complicated," says Michael Gershon, chair of the department of anatomy and cell biology at the Columbia University College of Physicians and Surgeons and author of The Second Brain (Harper Perennial, 1999). "If the brain had to control that, it would have to run huge cables and have a huge number of cells devoted solely to that purpose. It makes great evolutionary sense to [separate these functions] and essentially use a microcomputer that is independent rather than a central processing unit." In fact, researchers believe that the gut brain evolved first ï¿½ because digestion came before locomotion in multicellular creatures. In mammals, the two systems originate near each other in the outer layer of the early embryo. Like many poorly understood organs, the gut brain was discovered by classical anatomists in the 19th century and then ignored. "No one knew what it did," says David Wingate, emeritus professor of gastrointestinal science at Queen Mary, University of London. "When you'd ask what it was for in medical school, they'd say, 'Let's move on.' " In 1899, physiologists studying dogs found that unlike any other reflex, the continuous push of material through the digestive system (now called the peristaltic reflex) continued when nerves linking the brain to the intestines were cut. By the 1970s, a society for the study of gastrointestinal motility had been set up ï¿½ but how this motility was controlled remained unclear. The vagus nerve, for example, sends some fibers from the brain to the gut; however, it connects directly with only a tiny minority of cells there. In 1965, Gershon published a paper in Science suggesting that serotonin might act as a neurotransmitter in the gut. At the time, acetylcholine and norepinephrine were accepted as transmitters in the peripheral nervous system, but serotonin was seen as a centrally acting transmitter used by some nerves to modulate the action of others. The peripheral nervous system wasn't supposed to use such controls ï¿½ only the brain and spinal cord were believed to process information through "interneurons" such as those containing serotonin. At a meeting of the Society for Neuroscience in 1981, however, Gershon and others marshaled enough data to finally convince skeptics that serotonin was indeed a key transmitter in the gut. In fact, it is now known that 95% of the body's serotonin is used by the gut ï¿½ and the enteric nervous system contains every neurotransmitter and neuromodulator found so far in the brain. "We now know quite a lot about the library of programs run by the [gut brain]," says Jackie Wood, professor of physiology and cell biology and of internal medicine at Ohio State University. "For example, when the bowel is empty, one particular program runs." Called the migrating motor complex (MMC), this involves a series of movements running from the stomach to the end of the small intestine, which is believed to function in keeping the potentially dangerous bacteria stored in the colon from moving upwards rather than out. At least 500 different species of deadly bacteria have been found to inhabit a person's colon at any given time; "traveler's diarrhea" often results when this mix is changed through exposure to new pathogens. If this happens, the gut runs a program designed to expel as much of its contents as quickly as possible ï¿½ unpleasant for the vacationer, but much better than a fatal infection. "Another program involves a flood of serotonin throughout the entire circuit, which produces the digestive pattern that mixes and stirs the contents," says Wood. Because the gut brain is smaller and more accessible than the brain itself, understanding it could offer insights about how to parse the more complex organ. "[That idea] was what lead me to begin my research when I was a fledgling neuroscientist," says Gershon. "I looked at the brain and found it daunting, and I still do, so I looked for a simpler nervous system to study." He adds, " 'Simple nervous system,' of course, turned out to be an oxymoron." Unlike the cranial brain, however, the gut brain doesn't seem to be conscious ï¿½ or at least, in health, it doesn't impinge much on consciousness. "The gut is not an organ from which you like to receive frequent progress reports," says Gershon. For most digestive processes, no news is good news. The problem in IBS, in fact, may be that the enteric nervous system becomes overly sensitive to normal functioning and reports to the brain when it shouldn't. Or, the brain may overreact to normal bowel signals. Normally, the brain may avoid conscious awareness of most gut activity. But in IBS, says Wingate, one theory is that "the barrier to information being projected into consciousness is lowered." As in many heterogeneous conditions defined by symptoms rather than specific pathology, different subgroups of patients may have different causes or varying levels of contributions by different factors. In some cases, IBS may be an autoimmune problem ï¿½ something like multiple sclerosis of the gut, where immune cells attack nervous tissue. "If you catch it early enough," says Wood, "You can use steroids to treat it [in such cases]." High doses of steroids shut down immune activity and prevent immune cells from causing harm, but they don't help once damage has been done. The gut is, in fact, a major immune organ, containing more immune cells than the rest of the body combined. The enteric nervous system interacts intimately with the immune system, and can affect mood and behavior by signaling the central nervous system. Further, the gut brain may in fact be the only system that can refuse central signals. Says Gershon, "The gut brain can say no to the big brain, absolutely. In fact, there are nerve fibers that project towards the CNS, and if the [bowel] doesn't like the message, it can turn it off or cancel it." Indeed, the vagus nerve mostly carries information from the enteric nervous system to the brain ï¿½ for every one message sent by the brain to the gut, about nine are sent in the other direction. And recent research has found that stimulating this nerve can have antidepressant and even learning-enhancing effects ï¿½ so "gut feelings" could genuinely be more than just a metaphor. The similarities between the two nervous systems may also mean that they are vulnerable to similar toxins and disease processes. For example, in both Parkinson's disease and Alzheimer's, the degenerative processes seen in brain nerve cells are also seen in the neurons of the enteric system. by Maia Szalavitz Din meningPiskesmï¿½ld har fysiske og kemiske ï¿½rsagerSchleudertrauma hat physische und chemische Ursachen (deutsch)ï¿½velser til genoptrï¿½ning efter whiplashDin kost pï¿½virker din psykeKostï¿½ndring vejen til min helbredelseEn LAP-fuld grï¿½nne urter gï¿½r sindet sundereEn alternativ konference This link could also help explain the connection between psychological problems and gut problems ï¿½ and could put to rest the myth that problems such as IBS are simply "neuroses" because they so often occur in people with other psychological disorders. It may be that the real reason that bowel disorders often accompany psychological problems is that both brain and gut neurons are suffering simultaneously ï¿½ in addition to the fact that having to spend a significant portion of one's life attending to bathroom functions is in itself depressing. Simultaneous effects of drugs on both systems also account for the gastrointestinal "side effects" of Prozac and other drugs that act on serotonin metabolism ï¿½ which actually may have more effect on the bowel than on the brain, because serotonin predominates in the bowel and the drug moves through the digestive system before reaching the brain. Fortunately, in most people, the bowel quickly develops tolerance to these drugs, and gastrointestinal side effects usually subside within a few days or weeks of the start of treatment. In fact, low doses of SSRI (selective serotonin reuptake inhibitor) drugs may actually help patients with IBS. And since different serotonin receptors predominate in the brain and in the gut, new drugs may be developed to affect certain subtypes but not others. "What's exciting," says Wingate, "is getting away from essentially anecdotal ways of categorizing patients by symptoms and being able to study their Problems in a very systematic biological way." http://www.kiwiterapi.dk/whiplash/frames/gutthoughts.htm


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