IBS and Anxiety: Layered Treatment

Anxiety and irritable bowel syndrome (IBS) create a vicious cycle that can be very difficult to break. You experience diarrhea (IBS-D) or constipation (IBS-C)…and it makes you feel anxious…which makes the IBS worse…which causes more anxiety. It’s difficult to stop the cycle and challenging to cope, let alone think about “treatment.” The key might be to do only what you feel like doing and take small steps to fight it, but do more than one thing to add to the power of your efforts. You could call this treatment layering.

Irritable Bowel Syndrome and anxiety are a frustrating combination!

Irritable Bowel Syndrome (IBS) is often intertwined with anxiety. To fight this damaging combination, try layering treatments.

The nature of IBS treatments
Part of the frustration of IBS is that treatments often don’t work. This might be, in part, because everyone is different and the causes of IBS vary widely. It’s not even clear what the causes of IBS are. You might suspect your problems began when you experienced a traumatizing life event or as a side effect of medication, but it’s rarely obvious. That makes treatment difficult, even for the well-versed physician.

Add anxiety to the mix and treatment becomes even more complicated. Which came first? The anxiety or the IBS? This which-comes-first-chicken-or-egg connection between anxiety and IBS means doctors must keep trying new treatments and are often limited to treating symptoms…which can cause more anxiety when the hit-and-miss approach misses more often than hitting. It’s not unusual for a treatment to work only slightly, which is almost cruel: relief seems within reach, but you can’t quite get there!

Many IBS sufferers get frustrated with the trials of treatment and give up, retreating to their silent suffering.

Could a lot of little treatments add up to big IBS relief?
Treatment for the symptoms of anxiety, diarrhea and constipation are different, so some patients have had luck treating each separately. One person might use an anti-diarrheal over-the-counter preparation along with relaxation techniques for anxiety. Another might use a probiotic for constipation and acupuncture for anxiety. It makes sense to treat symptoms separately (always carefully watching for issues with combined medicines) when you can’t determine the cause of an illness, but the vicious circle of IBS can be more powerful than the treatment.

Why not try treatment layering another way to increase the power of your efforts: adding treatments for the same symptom? This doesn’t necessarily mean taking more than one medication for the same symptom. With IBS, there are many non-medicinal treatments that make combinations possible.

Potential IBS Layered Treatments
To find success with layered IBS/anxiety treatments, think of the illness as a destination and come up with several different routes to relief. For example, one way to treat anxiety is medically with anti-depressants. Others are meditation and exercise. Diarrhea can be treated with over-the-counter medication and diet changes, and you also can plan ahead of time to deal with episodes to decrease your anxiety about the diarrhea…which can help you avoid worse diarrhea.

The possible combinations mean you have some choices, which can decrease your anxiety and potentially decrease your diarrhea or constipation.

What do you believe will work for you? Here are some possible combinations to get you started:

IBS/anxiety treatment story #1:
Susan has had problems with diarrhea since she was a child. Even though she hates it, she is used to planning for it, but as an adult finds that missing out on events with friends has become more of an issue. She is depressed and frustrated. Susan believes the anxiety has made her symptoms worse, so she wants to work harder to manage the symptoms. Because spending time with friends is so important to her, she begins planning small get-togethers at a pub near her home. She invites a number of different people so she can leave if necessary without causing too much of a ruckus. At the same time, she has begun looking into natural remedies, such as probiotics and dietary choices for digestive balance. (She doesn’t want to take more meds.) To keep anxiety levels down, she now makes sure she gets plenty of sleep—she loves to sleep, so this is a perfect remedy for her! She also exercises regularly doing only what she feels like doing at home and has begun going to a counselor. The combination of these efforts is beginning to make a difference.

IBS/anxiety treatment story #2:
Constipation has been Ivy’s constant companion for several years now, and she doesn’t want to give up her medication. But she’s getting tired of the pain and worry. With encouragement from a friend, she decides to try treatment layering to get better results. She’s going to keep taking meds and drinking prune juice when things get bad. She doesn’t like to exercise and knows it’s unlikely she’ll get herself on a regular schedule, but she has made a commitment to walking around the block three times a week. In addition, if she gets the walks completed, she has begun rewarding herself with a weekly therapeutic massage designed especially for IBS-C sufferers, which addresses both constipation and anxiety. At home, she makes hot baths a regular treat instead of only taking them when she’s in the worst pain. She is going to try probiotics, with monitoring by her doctor, to see if the introduction of good bacteria will make a difference. Someone told her about visualization, and although she’s not sure it will work, she gives it a try and begins to believe it makes a difference.

IBS/anxiety treatment story #3:
Max struggles with the fact that IBS makes him feel “unmanly.” That’s the source of his anxiety at the moment and he can’t seem to get a handle on it…which makes the IBS worse. It has kept him from dating, which again makes his anxiety worse. Rather than focusing on dating, Max has decided to let that go for now and begin layering treatments to get himself in a better place. First, he wants to try getting better without medication. He enjoys martial arts, but hasn’t felt secure enough to attend classes, so he buys a video and begins practicing at home, which helps him get ahead both physically and emotionally. He works with a dietician to improve his diet and select supplements to try—something he hasn’t felt he should spend the money on until now. The investment is helping him stick with it, and his dietician is someone he can talk to honestly about what’s working and what’s not. He decides to try hypnotherapy to see if he can make bigger leaps ahead toward wellness. It does help, but eventually he realizes he is going to have to give in to meds for a while. He makes a plan with his doctor to combine meds with other approaches with a goal of weaning him off the meds as he progresses.

Choose IBS/anxiety treatments you can face
You might find you have no choice, like Max, and must give in to what works, even if you don’t like it. However, that doesn’t mean you can’t try a few layered treatments for IBS and anxiety to see if you can make progress toward better health. Get yourself started with two or three approaches you can mentally tolerate—maybe even look forward to.

Be sure to collaborate with your doctor. Above all, allow yourself to think positively about your efforts. The fact that you are even thinking about making a few gentle changes means you are breaking out of the cycle of IBS and anxiety. Go with that feeling! Before you know it, all those layers might add up to a big leap toward better health.


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