Diarrhea and Anxiety: Insights from a Psychiatric Perspective

Bowel movement issues

Hello Doctor: I have been dealing with anxiety issues, possibly stemming from taking care of my father who had esophageal cancer about 4 to 5 years ago.
Since then, I have become very concerned about my own health.
I have experienced diarrhea in the past, but starting from August or September of this year, I have been experiencing ongoing diarrhea, abdominal bloating, lower abdominal cramping, and palpitations.
I have consulted with a gastroenterologist and a traditional Chinese medicine practitioner, and I have undergone stool tests, abdominal ultrasound, and blood tests, all of which showed no anemia.
After taking some medications, my condition has generally improved, but I still have diarrhea, which varies from once a day to three times a day, and is mostly loose and unformed.
On October 6th, I visited a psychiatrist who prescribed Lyrica and Sibutramine.
After taking them, I experienced nausea and a desire to vomit, and the diarrhea has continued (there is no blood, and the abdominal pain and palpitations feel improved).
I would like to ask the doctor:
1.
Is the unformed stool and diarrhea after taking psychiatric medications possibly due to the medication? (Because the stool was more formed before, and now it is almost always unformed.)
2.
If it is medication-related, how long might it take for this to resolve?
3.
Does the doctor have any recommendations? Should I return for a follow-up to discuss changing medications?

Xiao Kang, 20~29 year old female. Ask Date: 2023/10/12

Dr. Wang Yixiang reply Psychiatry

Dear Mr.
Hsiao-Kang,
It seems that your main issues are diarrhea and anxiety.
While the two may potentially influence each other, we prioritize treating them separately for simplicity.
I recommend discussing the causes and treatment of your diarrhea with a gastroenterologist.
Additionally, some gastrointestinal health supplements can be taken under the guidance of your physician.
Please continue your treatment for anxiety with a psychiatrist; some medications may cause nausea initially, but you will likely adjust over time.
If you find it truly intolerable, you can discuss switching medications with your doctor.
Wishing you well,
Dr.
Wang Yi-Hsiang
Department of Psychiatry, Nantou Hospital

Reply Date: 2023/10/12

More Info

Understanding the relationship between anxiety and gastrointestinal symptoms, such as diarrhea, is crucial for both diagnosis and treatment. Your experience highlights a common issue faced by many individuals who struggle with anxiety, particularly when it manifests physically.
Firstly, it’s important to recognize that anxiety can significantly impact gastrointestinal function. The gut-brain connection is well-documented; stress and anxiety can lead to various digestive issues, including diarrhea, abdominal pain, and bloating. This is often due to the body's fight-or-flight response, which can alter gut motility and increase sensitivity in the gastrointestinal tract.
In your case, it seems that your anxiety, which began several years ago while caring for your father, has led to a heightened awareness of your health and subsequent gastrointestinal symptoms. The fact that you have undergone various medical evaluations, including stool tests and abdominal ultrasounds, and that these tests have returned normal results, is reassuring. It suggests that there may not be an underlying organic cause for your symptoms, but rather a functional one, which is often the case with anxiety-related gastrointestinal issues.

Regarding your questions:
1. Could the medication from the psychiatrist be affecting your bowel movements? Yes, it is possible. Medications such as selective serotonin reuptake inhibitors (SSRIs) or other psychiatric medications can have gastrointestinal side effects, including changes in bowel habits. If you have noticed a shift in the consistency of your stools after starting the medication, it could be related to the drug. However, it’s also important to consider that anxiety itself can cause fluctuations in bowel habits, and the timing of these changes may coincide with your medication adjustment.

2. How long might these side effects last? The duration of side effects from psychiatric medications can vary widely among individuals. Some people may experience gastrointestinal side effects for a few days to weeks as their bodies adjust to the medication. If the diarrhea persists beyond a few weeks or worsens, it would be prudent to discuss this with your prescribing physician. They may suggest a dosage adjustment or a different medication that might be better tolerated.

3. What should you do next? It is advisable to follow up with your psychiatrist regarding the ongoing diarrhea and any other side effects you are experiencing. Open communication about how the medication is affecting you is crucial for finding the right treatment plan. Your psychiatrist may consider switching medications or adding a medication to help manage the gastrointestinal symptoms. Additionally, it may be beneficial to explore non-pharmacological approaches to managing anxiety, such as cognitive-behavioral therapy (CBT), mindfulness practices, or relaxation techniques, which can also help alleviate both anxiety and its physical manifestations.

In summary, your symptoms of diarrhea and anxiety are interconnected, and addressing one can often help alleviate the other. It’s essential to maintain an open dialogue with your healthcare providers about your symptoms and treatment options. With the right support and management strategies, you can work towards improving both your mental and physical health.

Similar Q&A

Managing IBS: Coping with Stress and Dietary Challenges

Hello, doctor... I am 38 years old. In the past, around the ages of 17 to 18, I experienced significant stress due to college entrance exams, which led to frequent episodes of diarrhea shortly after meals. I sought treatment through traditional Chinese medicine, and after the exa...

Dr. Chen Shidian reply Gastroenterology and Hepatology
Hello, sir. You have a good understanding of your gastrointestinal symptoms and their causes. Currently, there is no cure, but you can learn to relax. If necessary, you may use gastrointestinal medications before meals to reduce the peristaltic reflex triggered by food. Changhua ...

Understanding the Connection Between Mental Health and IBS Symptoms

Hello, I have a mental illness and have been receiving treatment in psychiatry for over twenty years. I can't remember when it started, but whenever I feel anxious or stressed, I experience diarrhea associated with irritable bowel syndrome (IBS). Initially, I only had a ment...

Dr. Yang Zhichao reply Gastroenterology and Hepatology
Hello Mr. Jin Pi, indeed, there is a significant correlation between anxiety and irritable bowel syndrome (IBS). Coffee and tea can also increase the frequency of bowel movements. However, there is not a strong correlation between scoliosis and IBS. I recommend that you consult a...

Overcoming Anxiety-Induced Nausea After Gastroenteritis: A Guide

Since the severe gastroenteritis at the beginning of the year, I seem to have developed a psychological barrier that makes me very anxious. Just the thought of going out to eat causes my appetite to decrease, and even when I'm very hungry, I find it hard to eat. I often feel...

Dr. Qiu Junda reply Psychiatry
Hello: From your letter, it appears that your symptoms have persisted for over six months, which is beyond the normal range and likely causing you considerable distress. I wonder if you have sought medical attention during this time. The description in your letter does suggest th...

Overcoming Health Anxiety: Coping with Parasitic Fears and Depression

The reason for what happened is that last summer, I wanted to quit my habit of biting my nails, which I had for two months. So, I searched for the negative effects of this habit and ended up finding articles about pinworms. I completely freaked out because I have been afraid of w...

Dr. Lin Mianzhang reply Psychiatry
Hello, Cheng: Your situation exhibits symptoms of hypochondriasis, which may be related to psychological stress. This can be improved through psychotherapy. During the therapy process, you can discuss with your therapist whether there are deeper underlying reasons behind your ten...