Anxiety and IBS-D to IBS-C

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New Member

Date Joined Apr 2009
Total Posts : 18
   Posted 6/3/2009 7:12 AM (GMT -7)   
(cross-posting this from the IBS forum for an anxiety perspective)

I have always had problems with IBS-D, but in recent months I've suddenly developed constipation! I have also had constant anxiety problems (and been unable to tolerate the Effexor XR I had taken for years for it). I have developed constipation, urgency without anything actually present to pass, days of constipation and then diarrhea, and severe abdominal pain.

I have been to the GI several times, and we are sure this is not the Ulcerative Colitis flaring up. I've had a colonoscopy and small bowel just to be sure! I've reduced my Lomotil down to 2 a day from 8 a day which helps a lot, but still having pain. I'm also taking Librax 4 times a day to help both the cramping and the anxiety, could this be causing problems? I've been taking it for about a month and a half.

I don't know whether to add fiber to my diet for the IBS now that I have constipation (though I still have loose stools from time to time) as it always made the diarrhea worse in the past. I'm often not hungry, either from the pain or the constipation, or for fear that eating will bring them back. Add in the anxiety, and I feel like I am going to pieces! I fear going out, I have problems just driving to and from work, and avoid social situations because I'm either in pain or fear the sudden need to use the bathroom even after all these weeks of constipation. I've had two UC flareups in the past year and terrible diarrhea for several months early this spring while we trying 5 new antidepressant/anxiety medications, so the memories and fears of diarrhea are fresh on my mind. The pain ranges from irritating to severe, and seems to be worse after I've slept for a while (it usually wakes me up about 4 am) and feels somewhat better after having a bowel movement.

Any help or encouragement? I feel like I can never relax, and the doctors are frustrated. One blames the anxiety and the other the IBS. I don't know what to do since I'm used to only diarrhea, and I don't know if I'm blowing it all out of proportion with the anxiety problems raging. My first child is also only three months old so life has been anything but stable lately, making everyone's instructions of "relax" much harder to follow.

Yesterday was my birthday, and I had to stay home due to the pain and spent a rough night tossing and turning to wake up to terrible abdominal cramping. It's somewhat better now that I'm up and about, but I am tried of living this way!
Ulcerative Colitis 2000
GAD & Depression 2002
IBS-D 2002 (usually only bad when other medical problems are present)
Meds: Pentasa, Synthroid, Lomotil, Diovan, Prednisone (flare-ups only)

Elite Member

Date Joined Apr 2005
Total Posts : 14995
   Posted 6/3/2009 8:05 AM (GMT -7)   
I have Crohns Disease myself and suffer with alot of constipation. I think that the meds you are taking are causing the constipation. The Lomitil is for diarrhea, and the Librax is for the cramps. Both of these could very well be contributing to your constipation. I would stop the Lomitil at least for now until things soften up. I have to take stool softners every night or else I will be in a world of hurt.

Also, when my anxiety kicks in I get bad diarrhea not constipation. Hope that helps.
Gail*Nanners* Co-Moderator for Anxiety/Panic Forum
Been living with Crohn's Disease for 33 years. Currently on Asacol, Prilosec, Estrace, Prinivil, Diltiazem, Percoset prn for pain, Zofran, Phenergan, Probiotics, and Calcium and Xanax as needed. Resections in 2002 and 2005. Also diagnosed with Fibromyalgia and Osteoarthritis and Anxiety. Currently my Crohns is in remission.
*Every tomorrow has two handles.  We can take hold of it by the handle of anxiety, or by the handle of faith"*

Regular Member

Date Joined Apr 2009
Total Posts : 114
   Posted 6/3/2009 9:49 AM (GMT -7)   

I'm an IBS-D sufferer. Eight Lomotil a day is quite a hefty dosage. I wouldn't be surprised if that was the culprit behind your constipation. When I would plug myself up with too much Lomotil or Immodium, inevitably I'd have a "blowout" a few days later. All that stuff had to come out. Also, if you are that plugged up, you may be experiencing "overflow" diarrhea. Meaning, that the only fecal matter that can get around the impaction is liquid.

I learned that my problems were caused by pelvic floor dyssynergia - due to constantly fearing having an attack and also from chronic pain, I was tensing my pelvic floor to the point where it stopped contracting properly, which just exacerbated my IBS issues. It was causing incomplete evacuation and impaction, which led to terrible almost constant overflow diarrhea.

I took a bunch of dulcolax to clean me out, started laying off the Imodium only taking it as needed, which turned out to be one pill every 2-3 days. I also underwent 5 months of physical therapy for my pelvic floor. It helped tremendously with the pain, urgency, alternating bowel issues, cramping, abdominal pain, etc. I still have rough days here and there, but overall, feel much improved.

Not saying that this is what is going on with you, but that is what caused it with me.

As far as anxiety, I am undergoing CBT and taking Celexa in order to combat the anxiety which is primarily caused by the IBS, which in turn, causes more IBS symptoms. I understand how your anxiety can make the situation worse. Effexor didn't do much for me either in the way of IBS, though it helped my anxiety. I didn't like the side effects, however, so I stopped taking it.

Perhaps talk to your doc about addressing your underlying anxiety first. It seems that the anxiety is being caused by your IBS and is also resulting in making your IBS worse. It's such a vicious cycle, isn't it? Look into meds or therapy to address those situations. It's helping me so far. Meanwhile, eat very carefully - avoid trigger foods, fatty foods, dairy, etc. Try to eat many small meals throughout the day. Exercise and get plenty of sleep. Drink lots of water! That helps with constipation. You could try something mild like Miralax, too, if you continue to feel clogged up. Fiber never helped me, but it helps some. Take Lomotil as needed. Also, heat therapy works wonder for relaxing those abdominal muscles! A heating pad is my best friend :) Or you can simply take a nice hot shower or bath.

Good luck and let me know if you need to talk anymore. I have been through hell and back with IBS and done just about everything there is to address the problems. Hopefully I can commiserate and share some of my thoughts and experiences with you :) Hang in there!

Veteran Member

Date Joined Dec 2008
Total Posts : 1015
   Posted 6/3/2009 10:20 AM (GMT -7)   
I was diagnosed with IBS over 20 years ago. I suffered greatly from it and was told by my doctor that when nothing else can be found wrong with your stomach, they tell you you have IBS. I'm not a doctor, but I believe anxiety causes IBS. I was so obsessed with my symptoms and what I could and couldn't eat, it just made things worse.
A psychologist performed EMD (Eye Movement Desensitization) on me and I haven't had IBS problems since. I don't know why it works, but it did for me. Find a psychologist that can perform EMD. Give it a try. Also, treat your anxiety. Of course you want to stay away from medications thats side effects might affect the stomach.
Is something bothering you in your life? Is there something under the surface that you know you need to take care of but you've been putting it off? Keep a journal and write down your thoughts. You will feel better soon!! Don't give up.
Generalized Anxiety Disorder
60 mg. Prozac, Ativan as needed.
"The part can never be well unless the whole is well." Plato

New Member

Date Joined Apr 2009
Total Posts : 18
   Posted 6/9/2009 10:17 AM (GMT -7)   
Thanks everyone for your encouraging response. I stopped all Lomotil, which helped the constipation somewhat, though I would still have agonizing abdominal pain for 2-3 hours before each bowel movement and constant anxiety. Went to see my psychiatrist, and we decided on Lorazapam 0.5-1 mg twice a day (after trying Lexapro, Cymbalta, Paxil, Effexor XR, and Buspar in the last three months--all of which caused terrible GI problems and landed me in the ER twice).

I have been doing just the Lorazapam 0.5 mg twice a day and the abdominal cramps are gone! I have noticed that the diarrhea seems to be returning, so I am slowly returning to low-dose Lomotil (I used to take 1-2 a day pretty regularly). I suppose that it will take some time to find the right doses of everything.

Thanks again for the encouragement!
Ulcerative Colitis 2000
GAD & Depression 2002
IBS-D 2002 (usually only bad when other medical problems are present)
Meds: Pentasa, Synthroid, Lomotil, Diovan, Prednisone (flare-ups only)

Forum Moderator

Date Joined Apr 2007
Total Posts : 32602
   Posted 6/10/2009 1:25 PM (GMT -7)   

Big A,

Glad to hear you are doing better.  Keep it up. I am suprised to hear that Buspar was your culprit.  This is an example of how the meds can be different for each member.

Take care



Kitt, Co-Moderator:
Depression,  & 
*~* *~*
"When you find peace within yourself, you become the kind of person who can live at peace with others."
Not a mental health professional of any kind
Clickable Link: Anxiety-Panic Resources

New Member

Date Joined Apr 2009
Total Posts : 18
   Posted 6/10/2009 1:34 PM (GMT -7)   

Buspar caused the least digestive upset (the others were nothing short of violent) and kept me in the bathroom for hours. Just what one needs when anxiety about IBS-D and UC are already plaguing you!

In the end the psychiatrist said apparently my digestive system cannot tolerate any serotonin changes at this point regardless of the medication, and responded with diarrhea and pain (with new research showing more serotonin in the gut than in the brain this makes sense). Thankfully she is also an IBS sufferer, so we made it through those eight weeks of drug trials together. I'm glad it's over! As you said, every drug can affect each patient differently, so stay in touch with your doctor and read those drug sheets from the pharmacy!

I'm still not completely recovered, but I finally feel like I'm on the road there. I do have several months of bad experiences to work through, but with medication, family, prayer, and support I know I'll get there in the end.
Ulcerative Colitis 2000
GAD 2002
IBS-D 2002
Meds: Pentasa, Synthroid, Lomotil, Diovan, Prednisone, Librax, Lorazepam (flare-ups only)

Forum Moderator

Date Joined Apr 2007
Total Posts : 32602
   Posted 6/10/2009 1:36 PM (GMT -7)   

I am sorry I misunderstood.  I have IBS-C and none of the meds give me D.  I have been on many of the SSRIs/SNRIs.

I am glad your on the mend.

Gentle Hugs


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