How do I manage IBS-C, fatigue, anxiety, and low mood?

Question

Hello doctor,

I am a 61-year-old woman who has had IBS-C for eight years. Recently, my symptoms have become worse. I have also started experiencing constant fatigue and anxiety, which I never had before.

Could my worsening IBS be causing my tiredness and low mood, or could these be separate problems?
I have heard about the gut-brain connection. Is there real scientific evidence supporting this link?
Should I consider consulting a mental health professional along with a gastroenterologist?
Are there medicines that can help manage both gut symptoms and anxiety without making constipation worse?

Kindly advise.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand the concern.

Your symptoms show you are likely to have irritable bowel syndrome with constipation predominance (IBS-C). It is quite common for patients with irritable bowel syndrome (IBS) to experience fatigue, anxiety, or low mood when symptoms worsen. These issues are not simply separate problems.

When the bowel is irritated or functioning abnormally, it can influence mood and energy levels. In the same way, psychological stress can worsen bowel symptoms.

Certain medicines may also help manage both gut symptoms and mood. For example, low-dose antidepressants such as Amitriptyline or Sertraline are sometimes used in irritable bowel syndrome (IBS) to regulate the gut–brain axis and reduce pain sensitivity. A doctor usually selects these medicines carefully because some medications may worsen constipation, while others may have a neutral or slightly beneficial effect.

It is also important to evaluate other possible causes of fatigue. These may include anemia, thyroid disorders, poor sleep, or nutritional deficiencies. Appropriate medical tests may help identify these conditions if they are present.

Overall, irritable bowel syndrome with constipation predominance (IBS-C) often improves with a combined management strategy. This may include dietary adjustments such as increasing soluble fiber or following a Low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (Low-FODMAP) diet, maintaining regular physical activity, practicing stress management, and using appropriate medication when needed. With this integrated approach, many patients experience significant improvement in both bowel symptoms and emotional well-being.

I hope you are satisfied with my answer.

Thank you.

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