My anxious tummy is making life so difficult

[Justrelax]

I have basically lifelong anxiety. It's been much worse in the past and I've had a few courses of CBT and have been on betablockers for quite a while. What I've learned in CBT, combined with the betablockers, keep things pretty under control in many ways. I hold down quite a high level professional job, manage a team and manage my household and children. It's not perfect but I do fine and do enjoy my life. But the one thing I'm really struggling to get a handle on is my stomach. Whenever I'm stressed I get stomach cramps and end up on the loo quite a lot (been diagnosed with IBS, undoubtedly anxiety related). I get stressed even doing things I'm excited about like seeing friends etc and the tummy problems ruin it. I often end up not eating before events to try to control it. I'm petrified of going to someone's house and then ending up running to the loo (when I have to go I have to go!) I'm going on holiday in three weeks and though I'm excited, the idea of how the stress of travelling will impact my tummy is ruining it for me - thinking about whether I can get to the loo on the plane, what if there's a queue, what if I can't find a loo when we're walking around the city, dreading that we're going to a friend's for dinner there and I'll have to eat and then probably need to run to the loo and so on.

Does anyone have any really great tips for dealing with this please? I always carry immodium but I also have an unrelated condition that means I need to avoid constipation. I drink peppermint tea when I can but I'm not convinced it makes any difference.

Please no detailed talk of bowel movements on this thread. I'm not the poo troll and don't want to attract any weirdos to this thread. I'm just looking for tips related to anxiety and stomach problems and how other people manage to live life if their tummy can go crazy at any moment as it's getting me down.

I don’t know, I’m similar and it holds me back, you have my sympathy! I also have to not eat at times.

What dose of betablockers are you on? I whacked mine up when this was my issue. It did stop eventually.

I'm on 80mg slow release so a decent dose. And to be fair this dose keeps the other physical symptoms of anxiety away (shaking, heart racing etc) it just doesn't seem to control the tummy ones.

I can only sympathise, I find that any stress affects my digestive system badly.😧

I'm sorry to anyone else who is struggling with this too. The other thing I find hard is that people WANT to feed you as a sign of love and care. When I go to people's houses, they're almost disappointed if I take a small portion or say no to a treat they've laid on so I then feel stressed about disappointing them. My ultimate fear though is having to run to the loo in someone else's house. This has happened to me more than once so it's not an unfounded fear. Just makes me want to stay home all the time. I wish there was a trick to make my stomach stop knotting itself up like this.

It might be worth asking if you can increase it to see if it helps. I was doing 120-160 (not slow release) when things were bad.

I take 80mg now just as maintenance (although sometimes skip a dose) and haven’t had issues for ages but I will pop an extra one (or two) if anticipating serious stress.

Mine are for a mix of anxiety and migraine as I had a heady combination of panic attacks and migraine at one point. I can’t come off it completely as the migraines come back with a vengeance quite quickly but the panic is long gone really.

It sounds awful OP. I assume you have tried elimination diets in the past to see if its actually a specific intolerance you have? Eggs, dairy etc?
I'd been seeking further mental health support, but also more IBS support. How long ago was the IBS diagnosis? Do you have an IBS group online to discuss tips/advice?

When I go away I take Loperimide every day but only one capsule. This doesn’t make me constipated but just slows things down for me.

I can highly recommend the IBS Network as a source of information - they’ve got great resources too.

You may have already tried all of this, but these were some of my initial thoughts.

If cramping is one of the main symptoms, you could look at using Buscopan (definitely talk to your GP beforehand, as I’m not sure if they’d be contraindicated because of the risk of constipation). Mebeverine (Colofac) has been amazing for me at points - again check with your GP.

Gut-focussed hypnotherapy might be helpful with managing some of the anticipatory and in the moment anxiety - you can do this online / through apps but I’ve heard people say that face to face is more effective.

I keep those Imodium instants in my wallet at all times. And I avoid my trigger foods when my anxiety is at a high level.

I don't know if you feel you can be honest with people, but I'm always apologetic and explain that my digestion is cooperating that day. I say it's love to eat the food but I can't.

I don't feel like I can be honest because people want so much to please you when they provide you with food. I usually end up pretending I'm 'so full' or whatever. I'm a curvy girl so people must look at me and wonder how it's possible that I eat like a bird and yet am not stick thin.

Thank you so much. I've tried buscopan before but unfortunately the time between cramping and needing the loo is extremely minimal so it's kind of too late when the cramps hit. Unless I take it regularly I suppose...

I've looked into gut directed hypnotherapy but not tried it. Maybe I should! I feel like I might not be great at hypnotherapy as (due to anxiety!) I have real problems letting go or with lack of control in any way.

Maybe I should join an IBS group - I didn't think of that, thank you. I've had it for over 20 years since diagnosis but it's not terrible outside of anxiety situations.

I've tried eliminating certain things and while I feel better day to day if I avoid gluten, it doesn't stop the tummy going when I'm in a situation that's stressing me out.

Have your digestive issues actually been investigated? Besides a GP just saying, must be IBS. I have an issue with my pancreas that causes exactly this. Now that it's diagnosed and being treated, it does make it easier to manage.

That being said, it sounds wanky, but one thing that has made a huge difference is cold water therapy. If I have a flare, or I anticipate that I will, I make sure I go for a dip in cold water at least once a day (easier because I have access to a river nearby, but people do get those cold water baths for home), and it makes a tremendous difference in my symptoms.

One thing I would advise, although not designed for this purpose, is some decent period pants. The ones where the "padding" goes all the way up the back (they don't all have that). I wear those when doing things like travelling as the security of knowing that they'd mostly "hide" any accident until I could deal with it, helps to lessen my anxiety which then makes me less likely to have an issue.

I did try various incontinence products but they all felt too much like nappies! But the period pants are comfortable and no one can tell you're wearing them.

As a crohns patient I completely understand the anxiety around needing the toilet.

Escitaloprám has transformed my anxiety, completely stopped it. Life is so much easier now without it.

Beta blockers did nothing for me.

DD was having bowel issues and diagnosed by GP as anxiety induced IBS. Was having bloating and pain most days and usually late for school as she was on the toilet. 15 so too young for meds and doing exams.

We did several things so hard to know which has actually worked. It's definitely stress though because once her Art GCSE was done she was so much better.
Peppermint tablets
Psyllium husks in pancakes in the evening to firm up stool.
NSDR (non-sleep deep rest) YouTube
Cut out onion and garlic and reduced very high-FODMap foods.
She also had some YouTube videos for gut-directed hypnotherapy (shout if you want me to find links)
Kefir daily. She's stopped that now because she's not keen.
Exercise! She plays for a team so gets regular exercise bit if it's not on she'll run on the treadmill for 10 mins.

This advice came from The Gut Doctor and the Huberman Lab podcast.

I feel your pain, when I’m in an anxious period it’s a nightmare and almost self perpetuating! It’s hell. One thing that really really helps me is a high protein diet as in 1g per lb of body weight, really seems to work! That and regularly taking buscopan.

Gosh I have struggled with this for years. It comes and goes but if I know I'm going somewhere where a toilet won't be accessible for a while you can bet I will be in an anxious state and on the loo for ages before.

It helps to understand why this happens. It's fight or flight. Your body is anxious and perceiving danger so digestion speeds up to purge the body making you lighter and able to run away from this imagined danger quicker. It would be useful if you were a cave man running away from a sabre tooth tiger but not so useful when you're on a plane or visiting friends.

I've tried all sorts over the years. Imodium, therapy, anti depressants, propranolol, meditation, breathing techniques. It's just one of those things that I think will always affect me. With acceptance and a bit of 'who gives a fuck' attitude it does get slightly better. But even now I map out service stations on any long journey and try to be prepared in the face of unfamiliar places. It's a fucking curse but more common than we think.

Following

Wegovy has been a game changer for me. It slows things down, and my issues have almost disappeared. It also controls my blood sugar well. I’m on the lowest possible dose so weight loss is limited but it is still worth it

Oh OP, I completely sympathise with you on this. I've been there and still am in a way. I found when the anxiety and stress was the worst my IBS was off the scale and like you constantly running toilet and not wanting to go to people's houses, making excuses, cancelling social events.
I was given a beta blocker to help but did take buscopan as soon as the slightest cramp started. I also found cutting gluten and dairy helped me so much and definitely helped my symptoms. I also found anything greasy or especially anything with rapeseed oil, spicy made it 1000 times worse.
I'm so sorry I can't offer a solution but wanted you to know you're not alone. 🫂

My SIL had great success with reflexology.
I did a Candida elimination diet and daily meditation and yoga which largely supported our my issues after 6 months

My IBS was hideous and mostly anxiety related (although I do have a few trigger foods). Often I would know I was anxious about something because my stomach would be off before my brain had actually realised I was anxious. Anyway, I lived with anxiety for 30 odd years and now take citalopram. It has been transformational and one of those things is that my IBS is now all but gone. I know anti depressants aren't for everyone but in my case they were life changing. I used to be knocking back the immodium but I honestly can't remember the last time I needed to take one. (Like a PP said, I would only take one at a time which seemed to slow things down enough but didn't completely bung me up)

I think, if you’re sure it’s anxiety related, that you really need to treat that first.

Are you still having therapy? Beta blockers are great in that they stop the physical symptoms of anxiety but they don’t do anything to tackle the root cause. Sorry if I’m off the mark, but if it really is the anxiety causing the problem then that’s what you need to treat. Are you open to anti-anxiety medication? It might be worth talking to your GP again.