Visceral Anxiety

Visceral anxiety is a form of anxiety experienced by some patients with GI problems, in which a person’s response to a GI sensation is out of proportion to the severity of that symptom. It occurs when a sensation (such as a cramp, nausea, bloating, or pain) or situation (such as going to a restaurant or party) triggers unhelpful thoughts or behaviors. These unhelpful responses can take different forms:

1. Fear
2. Worry
3. Avoidance
4. Sensitivity – Being highly aware of GI sensations while stressed, eating, traveling, etc.
5. Hypervigilance – Paying so much attention to GI sensations that you have decreased ability to do or think of other things

Imagine you are a patient who has frequent GI symptoms, and one night you go out to the movies with some friends. Just as you walk into the theater, you start to have some mild symptoms. Immediately, a flood of questions goes rushing through your mind:

• "Am I going to have another episode now?"
• "Should I try and go to the bathroom now, instead of making a scene and leaving in the middle of the movie?"
• "Will I get to the bathroom on time?"
• "Is my belly going to make noise throughout the whole movie and embarrass me again?"
• "Is it just something I ate, or the beginning of me getting really sick?"
• "Maybe I should just tell everyone I’m not feeling well and go home!"

In this scenario the patient experiences nothing more than mild symptoms, but it seems like so much more. A person without a history of GI illness would probably just notice the symptom, move on, and focus on watching the film. However, because the person in the scenario has a history of GI problems, there is an exaggerated response from one mild symptom, and this prompts fears of getting sicker, even to the point of calling it a night and going home.

People with visceral anxiety often find themselves worrying about situations where they might experience worsening of their symptoms, such as eating at new restaurants, going to parties, being on an airplane or long car ride, or feeling trapped in a movie theater. Even if you are not anxious about other things in your life, research shows that you may still be vulnerable to developing visceral anxiety. So, it is important for anyone with chronic GI illness to recognize visceral anxiety and control inappropriate responses to their symptoms before they begin to impact quality of life.

Many people find that "talk" therapy is very useful for dealing with anxiety provoked by GI symptoms. My Quality of Life (MyQOL) Toolbox contains many tools you can use to manage your emotions and troubling thoughts about your GI symptoms.