What Does Anxiety Stomach Pain Feel Like? 5 Pain Types Explained.

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The Brain-gut Axis: How anxiety causes stomach pain.

Your brain and your digestive system are tightly and profoundly interlinked. For example, your digestive system has many nerve cells that are considered an entire system called the (enteric nervous system).

The enteric nervous system seems to be closely related to what you think and feel. Your gut is the mirror of your thoughts.

Most common functional gut diseases such as IBS and functional dyspepsia are linked to anxiety and other psychological dysfunctions.

Although we know that the link exists, we don’t completely understand the relations and the interactions.

How anxiety causes abdominal pain:

  • Increased sensitivity of your digestive system to pain (unpainful stimuli such as stomach gas becomes painful).
  • Generalized (somatization): This means patients with anxiety-related abdominal pain often feels pain elsewhere (chronic headache, bladder pain, back pain, etc.) due to psychological factor.
  • Dysmotility: Stress and stress hormones increases (or decrease) the motility of the digestive system.
  • Amplification of pain signals inside the brain.
  • Stress hormones affect gut immunity and gut micro-organisms (microbiota).

1 . IBS pain.

IBS is one of the comments presentations of anxiety. IBS abdominal pain feels like Colics or spasms anywhere in your abdomen.

This study estimates that approximately 44% of people with IBS suffer from psychological problems. This is far more common than people without IBS (only 8%).

When you get IBS flare-ups at times of anxiety, It is a sign that your IBS is a result of It.

How anxiety-related IBS pain feels like:

  • The IBS pain is in the form of colics (spasms) that can occur anywhere in your abdomen.
  • The IBS pain comes and goes in attacks (flare-ups and remissions).
  • The onset of pain is associated with changes in defecation (abdominal pain improves or worsens after bowel movements)
  • The pain is associated with changes in bowel frequency (diarrhea or constipation).
  • The pain is associated with changes in stool consistency (stool becomes more hard or loose).
  • The anxiety-related IBS pain is often associated with atypical pain such as pelvic or bladder pain, back pain, chest pain.
  • Patients with IBS and anxiety are more common than functional bowel disorders (IBS and Functional dyspepsia commonly co-exist together).
  • Other atypical and anxiety-related symptoms include nausea, shortness of breath, chronic fatigue, restlessness, joint pain, or fibromyalgia.
  • IBS symptoms should occur at least one day per week for the last three months.

Learn more about the symptoms and diagnosis of IBS.

Learn More about Anxiety and IBS.

Anxiety-related IBS pain feels worse during the attacks of anxiety and stress. Moreover, it is more refractory to antispasmodic.

People with anxiety and IBS may need stronger pain-modulators such as Tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs).

2. Functional Dyspepsia pain.

Functional dyspepsia (indigestion) is one of the most common conditions all over the world. Up to 30% of people worldwide suffer from dyspepsia. (reference).

The exact cause of functional dyspepsia is still unknown. However, anxiety plays a vital role in this condition.

One study found that anxiety and other psychological dysfunctions are about twice more common in patients with functional dyspepsia (reference).

Several theories have been postulated to explain functional dyspepsia. Anxiety was in the center of most views:

  • Abnormal motility of stomach: slow, rapid, or irregular stomach motility.
  • Visceral hypersensitivity: lower thresholds to pain in your stomach. You feel pain when food starts to stretch your stomach or duodenum.
  • H. pylori infection: some studies links h pylori infection (a stomach bug) to functional dyspepsia.
  • Altered gut microbiome: alternation in the beneficial micro-organisms inside your intestines and stomach.
  • Psychological factors: Stress, anxiety, depressive disorders can result in dyspepsia.

Anxiety-related functional dyspepsia pain feels like fullness after eating is the main feature of functional dyspepsia (Indigestion).

How anxiety-related FD pain feels like:

According to ROME IV criteria for the diagnosis of functional dyspepsia, the presence of one or more of the following symptoms (after excluding the organic diseases of your gut) indicates FD.

  • Postprandial fullness: a feeling of fullness or tight band around your stomach. It usually starts during or soon after eating.
  • Early satiety: You cannot complete your meal because of the fullness or the tight band that develops around your stomach.
  • Epigastric discomfort, pain, or burning: that develops after eating.

In 75% of cases of functional dyspepsia (FD), no organic cause can be detected.

MORE: Functional Dyspepsia 101: Causes, Symptoms, and Treatment. 

3. Functional Abdominal pain and bloating.

Functional abdominal pain is a separate entity. It is a type of non-specific abdominal pain that comes and goes in waves.

Functional abdominal pain is also related to anxiety and psychological morbidity.

How functional abdominal pain feels like (according to ROME IV criteria):

  • Episodic or continuous abdominal pain that does not occur solely during physiological events such as eating and menses
  • Insufficient criteria for other functional GI disorders, including irritable bowel syndrome, functional dyspepsia, or abdominal migraine
  • After appropriate evaluation, the abdominal pain cannot be fully explained by another medical condition.

Functional abdominal bloating is the feeling of an inflated balloon inside your abdomen. Bloating is very common with other functional diseases such as IBS.

Bloating probably reflects a state of hypersensitivity of your gut. Bloating is a widespread complaint. About 10-30% of people experience bloating.

Organic bloating can be due to diseases such as food intolerance. On the other hand, Functional abdominal bloating occurs without organic causes.

Functional bloating is related to psychological stress and anxiety (reference).

4. Other forms of anxiety-related abdominal symptoms.

Anxiety-related abdominal symptoms can present with other forms such as:

  • A sense of tight band around the stomach.
  • A feeling of “butterflies” in the stomach.
  • Frequent passage of gas (flatulence).
  • Nausea and upset stomach.
  • A sense of fullness after eating very little.
  • Regular bowel movements (diarrhea).