1. Health
You can opt-out at any time. Please refer to our privacy policy for contact information.

Discuss in my forum

Irritable Bowel Syndrome and Panic Disorder

The Link Between Panic Disorder and IBS

By

Updated April 28, 2012

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Photo Copyright Microsoft

Many people with panic disorder also suffer from IBS.

Photo © Microsoft

What is Irritable Bowel Syndrome?

Irritable Bowel Syndrome, or simply IBS, is a type of gastrointestinal condition that disrupts the colon and causes problems in the digestive system. IBS is estimated to affect close to 20% of US adults. The symptoms of IBS can vary for different people. Some of the most common symptoms of IBS include:

  • Abdominal pain
  • Frequent stomachaches
  • Cramping
  • Bloating and excessive gas
  • Constipation, diarrhea
  • Changes in bowel functioning, including fluctuating between constipation and diarrhea

Although IBS is not a life-threatening illness, it often develops into a chronic condition that can greatly impact many aspects of one’s life.

IBS and Panic Disorder

Research has indicated that rates of IBS are high among people diagnosed with anxiety disorders and/or mood disorders. The frequency of IBS symptoms has been found to be especially high for people diagnosed with panic disorder. Much like panic disorder, IBS poses many distressing symptoms that can be embarrassing and difficult to manage.

Recurrent and often unexpected panic attacks are the main symptom of panic disorder. Similar to IBS, panic attacks are characterized by many uncomfortable physical sensations. Some of the most common symptoms of panic attacks include sweating, trembling, chest pain, accelerated heart rate, and shortness of breath. Both conditions also share many of the same symptoms, such as anticipatory anxiety and avoidance behaviors. The symptoms of both IBS and panic disorder can be upsetting, embarrassing, and difficult to manage.

It is currently unclear why a significant percentage of panic disorder sufferers also struggle with the symptoms of IBS. It has been hypothesized that both conditions are triggered by the fight or flight stress response. The fight or flight response is prompted by the sympathetic nervous system, causing changes in the body to prepare to fight off or flee from a perceived threat. Common physical reactions include sweating, rapid heart rate, and a slowing down of the digestive system. People with panic disorder and IBS may have an overactive fight or flight response, causing strong somatic reactions despite a lack of danger.

The incidence of IBS is even higher for those diagnosed with panic disorder with agoraphobia. People with agoraphobia display many avoidance behaviors in which they steer clear of places and situations that they fear will trigger panic attacks. It has been speculated that the higher rates of IBS for agoraphobia sufferers could in part be due to overlapping avoidance behaviors, such as worrying about where to find a restroom, embarrassment associated with the symptoms of IBS, and having to manage the difficult gastrointestinal symptoms.

There is also some evidence that certain foods, substances and lifestyle choices elicit panic disorder and IBS symptoms. Common dietary triggers for both conditions include caffeine, alcohol, and sugar. IBS and panic disorder symptoms can also worsen due to chronic stress and habitual negative thinking.

Treatment Options for Both Conditions

Much like panic disorder, there is currently not a cure for IBS. However, both panic disorder and IBS are treatable conditions. Many of the common treatment options for panic disorder have also been shown to safely and effectively treat IBS. For example, some selective serotonin reuptake inhibitors (SSRIs) commonly prescribed for panic disorder have also been found to reduce IBS symptoms. On the other hand, some of the medications for panic disorder can worsen IBS symptoms, so it is important that you discuss your symptoms and treatment options with your doctor.

Psychotherapy is also a common treatment option that can help with both panic disorder and IBS. Psychotherapy can assist with stress management techniques, as high stress levels often exacerbate both conditions. Going to therapy can help you deal with the physical and emotional feelings associated with both disorders. Additionally, psychotherapy can assist in reducing the symptoms of common co-occurring conditions, such as depression.

Research has shown that cognitive behavioral therapy, in particular, can be an effective type of psychotherapy for people struggling with both IBS and panic disorder. CBT often encompasses education, desensitization activities, homework assignments, and relaxation techniques to assist in managing your conditions. CBT techniques can help reduce the symptoms of panic disorder and the digestive problems associated with IBS.

The symptoms of IBS can greatly impact one’s quality of life. Having both IBS and panic disorder can be extremely difficult to deal with. However, by getting professional help and managing your stress, you can learn to effectively cope with both of these conditions.

Sources:

American Psychiatric Association. "Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text revision" 2000 Washington, DC: Author.

Gros, D. F., Antony, M. M., McCabe, R. E., Lydiard, R. B. “A Preliminary Investigation of the Effects of Cognitive Behavioral Therapy for Panic Disorder on Gastrointestinal Distress in Patients with Comorbid Panic Disorder and Irritable Bowel Syndrome” Depression and Anxiety, 2011, 28, 1027–1033.

Gros, D.F., Antony, M.M., McCabe, R.E., & Swinson RP. "Frequency and Severity of the Symptoms of Irritable Bowel Syndrome Across the Anxiety Disorders and Depression" Journal of Anxiety Disorders, 2009, 23, 290-296.

Sugaya, N., Kaiya, H. Kumano, H., & Nomura, S. “Relationship Between Subtypes of Irritable Bowel Syndrome and Severity of Symptoms Associated with Panic Disorder” Scandinavian Journal of Gastroenterology, 2008, 43, 675-681.

  1. About.com
  2. Health
  3. Panic Disorder
  4. Related Conditions
  5. Irritable Bowel Syndrome and Panic Disorder

©2014 About.com. All rights reserved.

We comply with the HONcode standard
for trustworthy health
information: verify here.