Wednesday, 12 June 2013

Does anxiety give you stomach pain?

Are you prone to anxiety and do you suffer from recurrent stomach pain, diarrhoea or constipation?

You could have irritable bowel syndrome (IBS), a common chronic condition linked to psychological

disorders such as anxiety and depression.

IBS affects the large intestine or colon, which is the last portion of the digestive tract. If you have

IBS, your bowel movements may be stronger or slower than normal.

“While there are multiple factors leading to irritable bowel syndrome, there is a strong association

with psychological disorders such as anxiety and depression. However, it is not always clear whether

the anxiety or depression causes IBS or results from the IBS symptoms,” says Dr Wang Yu Tien,

Consultant, Department of Gastroenterology and Hepatology, Singapore General Hospital (SGH).

“IBS is a common condition that affects 9 per cent of the population in Singapore. In some other

countries it can affect up to 20 per cent,” he adds.

IBS can affect people of any age but it has been found to be more common in those aged 20-30.

Related article: Don’t put up with frequent diarrhoea or constipation!

Symptoms of irritable bowel syndrome (IBS)

The symptoms of IBS range from mild to severe. They are:

    Stomach pain or cramping
    Incomplete bowel clearance
    Mucus in the stool

Other less common symptoms include tiredness, backache, urinary frequency, and poor sleep.

For the vast majority of patients, the symptoms are quite mild and don’t require treatment. However

chronic recurrent symptoms can cause discomfort and inconvenience which adversely affect quality

of life, says Dr Wang.

Diagnosis of IBS is based on the patient’s medical history as well as routine tests. A patient who

suffers from abdominal pain or discomfort associated with altered bowel habits is diagnosed with IBS

when routine tests such as blood tests, scans and endoscopy fail to detect any other problem.

Patients who have other symptoms such as blood in the stools and unexplained weight loss may

require further investigation to rule out more serious conditions such as colon cancer.

Related article: How to find and stick to an IBS diet that will help

Risk factors for IBS

The exact cause of IBS is unknown. However, a combination of physiological and psychological

factors may play a role in its development. These risk factors include:

    Overly sensitive nerves in the colon
    Abnormalities in the nervous system or colon
    Food intolerances
    Bacterial overgrowth or unfriendly bacteria in the gut

The link between anxiety, depression and IBS

There is a strong link between IBS on the one hand, and anxiety and depression on the other hand.

However, it is unclear which one comes first.

“Psychological disorders can affect the way we perceive discomfort coming from the intestinal tract,”

says Dr Wang.

A study carried out by SGH found that almost half of 345 IBS patients screened from November 2010

to October 2011 had psychological disorders.

The most common psychological disorder associated with IBS is anxiety, followed by depression.

“We now screen all our severe IBS patients for psychological disorders. When we find a

psychological disorder we refer the patient to a psychiatrist or psychologist for intervention,” says Dr


“Understanding this condition can give patients the reassurance to live with this condition. A lot of

patients want reassurance that this is not cancer,” he adds.

Related article: Take control of IBS with proven lifestyle tips

Do you suffer from painful stomach cramps, a bloated abdomen and bowel woes? These are common

symptoms of Irritable Bowel Syndrome (IBS), and you can learn about this chronic condition at a

Public Forum organised by SGH. "Irritable Bowel Syndrome - Manage it Right" will be held on

Saturday, 29 June 2013, from 9am to noon. Click here for more information.

This article was written by Anjana Motihar Chandra for Health Xchange, with expert input from the

Department of Gastroenterology and Hepatology, Singapore General Hospital (SGH).

Looking for doctor’s advice and health tips from the experts? Visit,

Singapore's trusted health and lifestyle portal.

Health Xchange's articles are meant for informational purposes only and cannot replace professional

surgical, medical or health advice, examination, diagnosis, or treatment.

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