Anxiety and Nausea?

[jjm2894]

Hey guys,

Long story short, i've been suffering from pretty severe anxiety and a few fairly mild stomach symptoms (intermittent nausea, abdominal discomfort, etc.) for the past three months or so. Over the past week i've really been able to effectively adjust my attitude to accept that i'm healthy and that the anxiety is responsible for my perceived symptoms. Over that time my stomach seems to have improved, with no nausea to speak of and only very mild discomfort.

This morning, however, I woke up with some nausea again, and it's really threatening to end this positive wave I've been on. I guess i'm just looking for some reassurance that a little nausea doesn't mean i'm unhealthy or afflicted by some deadly disease. Have you guys ever experienced prolonged periods of stomach issues, nausea etc. with no underlying physical cause? Is it really possible that it's caused by the anxiety, like i've been trying to believe lately?

thanks

[Two One]

Absolutely anxiety can cause nausea. Anxiety can even cause nausea to the point where it is chronic, even daily. Most of my anxiety symptoms manifested themselves in my gastrointestinal tract. I had a lot of abdominal discomfort, tightness etc. which is very distressing to someone like me (emetophobic). There were times where it felt like my stomach was simply not digesting my food at all.

To help you understand better, when you become anxious the brain initiates the fight or flight response in the amygdala. Once this happens your adrenal glands are activated almost simultaneously which releases the neurotransmitter, norepinephrine. The release of neurotransmitters also results in the production of the stress hormone, cortisol which increases blood pressure. However, it is the flood of epinephrine and norepinephrine that cause the immediate physical reactions of the fight or flight response. Your heart rate accelerates, the pupils become dilated, blood flow to the muscles is increased causing them to tense up and prepare the body for action. Blood flow is diverted away from the digestive tract which causes digestion to slow down significantly or stop all together, causing the nausea.

[Zoot]

I wrote a message to introduce myself in the Welcome forum, but it hasn't been posted. Not sure if it's still being reviewed before posting or if it was lost in transmission. Anyway, one of the reasons I came to this forum is because I have very similar questions about anxiety and abdominal issues. I don't really have answers, but my experience is at least somewhat similar to yours.

A little over 3 months ago, after a trip to Mexico, I had abdominal pain for three days--I assumed because I drank a lot and ate indulgently. I continued having issues over the holidays--again drinking a lot and eating indulgently. By January I started paying attention to it more and realized I had stomach discomfort or pain ("sour" stomach) every day. Went to my GP, got tested for parasites, but they found nothing. The pains continued, I got more tests done. Bloodwork was fine, x-rays showed some degree of constipation, and ultrasound found that my spleen was enlarged (which the GP did not think is clinically significant and was unexpected). Understand also that my daughter was killed by leukemia 6 years ago. Although I thought I was coping well with that loss, looking back, I think I've been avoiding many emotions, and drinking more heavily. Anyway, these medical issues very likely triggered more intense anxiety for me. Definitely I began Googling my symptoms and letting my mind go to the worst case scenario. I started on some antacid medication (Prevacid) which may be working, but developed worse symptoms at times. Although I've never had one before, I believe now that a few weeks ago I had a panic attack (or at least, panic symtpoms)--it felt like I was having a heart attack, had trouble breathing, tight chest, pain in my back. I was also by this point having loose bowel movements. (Sorry for over-sharing, but my poop was also "flat" which freaked me out even more.) I have told all of this to my GP and she's referred me to a gastroenterologist and scheduled a colonoscopy for me, but has said clearly that she doesn't think anything significant is wrong with me. (I'm 40 and otherwise healthy.)

Anyway, the recognition that most (or even all) of these symptoms could be caused by anxiety has led me to try to control my interpretations of bodily symptoms. It's only been a few days, but my sense is that it's helping. Many of the "pain" symptoms, when I approach them more mindfully, could well be hunger and upset stomach from anxiety. My bowel movements today even firmed up and didn't look squished anymore. (I really hope that change continues, as it's very reassuring to me).

So, no, I don't have clear answers for you, but it does seem pretty clear that stress and anxiety can cause or intensify gastrointestinal problems. Google articles on the gut-brain connection. It is probably also wise to not ignore physical symptoms and do discuss them with your doctor. I have, myself, had some issues trusting my GP, but I know she's generally really good and that many doctors have good training in distinguishing "real" problems from those caused by excessive worry.

[NixonRulz]

It sounds as if you did have a panic attack. Aren't they great?

And all the nausea, diarrhea, stomach cramps can surely be caused my anxiety

Excessive worry and stress seem to strike the stomach pretty early on.

[ctb1988]

Like Two One, a lot of my daily anxiety manifests itself in GI symptoms. In fact, nausea is one of my biggest physical symptoms of anxiety. For the most part, I have no appetite during the day and feel extreme nausea, nervous / sour stomach. I literally have to force food down my throat sometimes.
So, yes, anxiety most DEFINITELY causes nausea. It may not be your cause, but it is definitely a possible culprit!

[Bluesookie]

As a long time nausea sufferer I can tell you: yes, nausea can definitely be caused by anxiety. It has always been my main symptom and the most difficult to deal with. The mornings...
I googled it a lot of times, searching for a way to end that horrible feeling , even though I knew it was being caused by my anxiety (i ended up finding this forum that way :) )

I tried ginger cookies, peppermint tea,... nothing seemed to work. To be honest, the only thing that worked was treating my anxiety. While on paroxetine I had no nausea. It's been 5 months since I stopped the meds and, thankfully, I haven't had the daily nausea I was used to.

I still have nausea when there's a stressful event. I usually try breathing exercises and it helped me when I started to think that, the worst that could happen (from the nausea) wasn't that bad, that I could deal with it.

Hope you feel better soon.

[jjm2894]

Thank you all for your words of reassurance. It's given me considerable solace to know that other people out there suffer from anxiety-related nausea.

Zoot, I especially appreciate your post because it describes almost exactly what i've been through in the past few months as well (down to the ultrasound revealing an enlarged spleen—wonder if that's in any way anxiety-related as well?). It instantly made me feel better to know that there is someone out there who's experiencing very similar symptoms. I have been doing a bit better with the anxiety for the past week or so, and my GI issues also seem to be improving as a result, which you mentioned as well.

I skipped my GP (who I don't really trust—again, part of my anxiety or my propensity to doubt and wonder "what if") and went straight to a gastro doc, who ordered the ultrasound. After that, he suggested an endoscopy, which has been on my calendar for a month or two. At this point, my improvement in attitude and stomach symptoms has me feeling pretty confident in canceling the endoscopy. Are you planning on going through with the colonoscopy?

[Zoot]

My anxiety levels are up today and so is my stomach pain. I do still think the stomach issues are likely caused by anxiety, but if I could get an endoscopy soon, I likely would, if only to put my mind more at rest. My colonoscopy is not scheduled until May 1 and I found out my gastro appointment is not until July 23 (the Canadian medical system is wonderful in most ways, but can be painfully slow when you want answers). My hope is that things will settle before then and I ultimately cancel both appointments, but I'm keeping them scheduled for now.

[Zoot]

Oh, as for the enlarged spleen: My immune system is weak and I've had colds and (once) the flu this season. The ultrasound happened a few days after one of the colds and after the flu. It's possible that my spleen was working overtime helping to combat viruses. Maybe your experiences are similar?

[jjm2894]

Hey Zoot, I sent you a personal message responding to some of your comments and questions.

[Zoot]

Hey jjm, thanks for the PM. I can't reply to it because I need to have 10 posts before I'm able to send PMs, so I'll give a public reply.

My mood and anxiety have been all over the place lately. My stomach issues are generally better but do seem to track my overall anxiety. I still haven't decided on whether to keep the endoscopy/colonoscopy (I'm actually not sure if both were scheduled or just the colonoscopy). I completely understand your perspective on that issue. I guess I'm just stuck on the fact that I've never had health anxiety issues before and I still feel as though there was something physical that started my stomach issues, before they become aggravated by anxiety. I've got some time to make up my mind still anyway.

I haven't noticed anything unusual with my lymph nodes. I guess you mean the lymph nodes closer to the groin? I haven't noticed them at all, though if they were enlarged, I'm sure I would have noticed. If you've had blood work done and it all looked normal, I wouldn't worry about it too much. Easy advice to give, I guess. I like your advice about mindset around controlling your attitude. I admit I find that easier some days than others. A couple of days ago, it definitely felt more like my attitude was controlling me.

I hope your attitude stays so positive--it's great to hear that you're doing well!

[jjm2894]

I know it's so much easier said than done... one day a little mental trick or tweaking of your thought process will work, and the next day that same trick doesn't help at all. It's that back-and-forth that inspired me to sort of focus attacking the anxiety at its root, which may mean shifting your focus from the stomach issues onto the anxiety (something you can control). I've seen a psych doctor a couple times recently and she is helping me to treat my anxiety through readjusting my thought process and learning to live with uncertainty. For many that suffer from health anxiety, it's the uncertainty of "is something wrong with me?", "what's causing these symptoms?", "what if....?" that really causes the concern that leads to obsession. Not trying to analyze WHY you're experiencing something unusual is important, and I've only recently come to know that.

To your point about the stomach issues requiring a physical cause: it's actually entirely possible that your GI issues were generated by your anxiety. I don't think either of us suffer from it, but look up something called "somatization disorder." Discovering that such a thing existed was extremely freeing for me: the thought that you can have symptoms, even severe, that have no physical source/cause. In the same way doing online research can convince you that something could be terribly wrong, researching somatization disorder helped convince me that maybe nothing is really wrong at all.

For me, in order to shift my focus entirely over to beating this anxiety long-term, I needed to first accept that whatever these stomach issues were, they probably didn't indicate a serious/rare/highly unlikely condition. The chances really are infinitesimal. And you know what? If, by the off chance I do have something terribly wrong with me, there's nothing I can do but handle it if and when it comes. Obsessing over the issue, or whether or not your symptoms mean you have an issue, isn't going to do you any good or make you any better. In fact, it'll perpetuate your anxiety, unhappiness, and stomach symptoms too. Accepting your physical health today is the first step to treating the real problem: the anxiety. That's the main mental adjustment that has helped me start to break the cycle of worry. Hope it's of some assistance to you.