Anxiety and Your Health: IBS and IBD

Patient Expert

A stomachache is a common physical symptom of stress and anxiety. Millions of people suffer from gastrointestinal problems, including irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). Though they sound similar, these two disorders are quite different in their causes and treatments.

Read on to learn more about their connection to stress and anxiety.

Irritable Bowel Syndrome

Suffered by about one in five adults in the United States, IBS is characterized by abdominal pain, cramping, bloating, gas, constipation, and diarrhea. Women are more likely to experience symptoms, which usually begin in late adolescence or early adulthood.

There is no specific cause known, but some experts suggest that people who suffer from IBS have a colon that is more sensitive and reactive to certain foods and stress. Although painful and uncomfortable, IBS does not damage the intestines permanently or cause other gastrointestinal diseases.

People with IBS frequently suffer from anxiety and depression because the colon is controlled in part by the nervous system, which responds to stress. Evidence also suggests that the immune system - which also responds to stress - plays a role. Anxiety and depression can worsen IBS symptoms, and in turn the symptoms can make you feel more anxious and depressed.

There is no cure, but treatments can help manage IBS symptoms and discomfort. Of the estimated 70 percent of people with IBS who seek treatment, 50 to 90 percent have an anxiety disorder or depression; it is possible to treat these at the same time. Your doctor may recommend one or a combination of treatments that may include diet changes, medication, or cognitive-behavioral therapy (CBT).

Learn more about IBS and types of treatment.

Inflammatory Bowel Disease

Up to one million Americans have IBD, chronic illnesses (Crohn's disease and ulcerative colitis) that cause inflammation of the intestines. Men and women are affected equally, primarily affecting people between ages 15 and 35.

IBD symptoms include persistent diarrhea, abdominal cramps and pain, fever, and rectal bleeding, and some people may also experience fatigue and loss of appetite. Unlike IBS, IBD can damage the intestines so surgery may become necessary. CBT or other psychological treatments alone do not help relieve symptoms.

It's important to note that an anxiety disorder does not cause IBD. But one study found that those diagnosed with ulcerative colitis are more likely to have an anxiety disorder or depression, compared with the general population. Another study found that IBD patients have higher rates of panic disorder, generalized anxiety disorders, obsessive-compulsive disorder (OCD), and depression, compared with the general population.

Scientists believe that IBD is caused by the immune system's reaction to normal bacteria in the intestines. In people with Crohn's or ulcerative colitis, the immune system thinks the bacteria is a foreign substance and starts attacking it. White blood cells, which normally help the body ward off infection, are sent into the intestines, where they produce chronic inflammation, which can lead to ulcerations and bowel injury.

Like IBS, no cure is yet available for IBD; surgery is usually required for most people with Crohn's disease and for 25 to 33 percent of people with ulcerative colitis. To help you cope with any accompanying emotional stress, ask your doctor to recommend a therapist familiar with IBD; find a therapist in your area.

Read more about IBD.

Resources _Irritable Bowel Syndrome _


International Foundation for Functional Gastrointestinal Disorders

General Information

What I need to know about irritable bowel syndrome (National Digestive Diseases Information Clearinghouse from the National Institutes of Health)

Irritable Bowel Syndrome (Mayo Clinic)

Inflammatory Bowel Disease


Crohn's and Colitis Foundation of America

General Information

Understanding Inflammatory Bowel Disease (American Gastroenterological Association)

Inflammatory Bowel Disease (American College of Gastroenterology)

PLEASE NOTE: The Anxiety Disorders Association of America (ADAA) does not endorse or promote any specific medications or treatments.