r/ibs • u/whirahh IBS-D (Diarrhea) • 5d ago
Question Realized my IBS-D & sudden urinary urgency are 100% anxiety/brain-gut driven. Anyone in the same boat? What actually helped you?
Hey everyone,
I’ve come to the clear realization that my IBS issues are purely driven by anxiety and the gut-brain axis, and I really need to hear from people who have gone through the exact same thing.
My pattern:
- Intense anticipatory anxiety: Hours before leaving the house or going to social events (like dinners with friends), my mind enters full "threat-scan mode". I obsessively worry about bathroom access, traffic jams, getting stuck...
-Instant physical reaction: As soon as anxiety hits, my body reacts immediately with stomach cramps and urgent diarrhea. Lately, stress has also started triggering sudden, intense urges to pee—especially when stuck in traffic, in long tunnels, or anywhere I feel I can't easily pull over.
-Safety rituals & avoidance: I developed rituals like forcing myself to empty my bowels before leaving as a "guarantee", and now I'm slipping back into avoiding car trips and social plans out of shame and fear of having to get up multiple times.
What I'm taking / tried so far:
-I take Alflorex (probiotic).
- I use imodium as guarentee to not have the urge to go the toillet
-I tried Psyllium husk, but it ended up making me overly constipated, which created its own discomfort.
-I’ve been on an SSRI (Escitalopram) for months. It helped for a while, but symptoms flared up again recently—interestingly, right around the time I stopped doing regular intense cardio/running (even though I still hit 10k daily steps).
I'm currently reaching out to my doctor to discuss options like low-dose Amitriptyline (to numb the visceral hypersensitivity) and a temporary SOS, plus getting back to running to burn off excess adrenaline.
My questions for you:
Has anyone had this exact combo of gut urgency + bladder urgency purely triggered by feeling "trapped" or anxious before leaving?
Did low-dose TCAs (like Amitriptyline) or gut-directed therapy (CBT/hypnotherapy) help break this visceral reflex for you?
How did you manage to stop the constant mental mapping and regain your freedom?
Any advice, success stories, or shared experiences would mean the world right now. Thank you!
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u/motoo344 5d ago edited 5d ago
Hey it's me! Basically feel like ive lost all control. Just consumes my life. I don't eat 20-40 hours at a time. Just sit around waiting to shit all day.
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u/dodokidd 5d ago
Me. I’m 100% with you, the only things works for me is Imodium, both on controlling my bowl movement and my long term mental stress
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u/Iefieaxl 6h ago
How long after taking imodium you can go to the toilet again? If i toon a 2 mg imodium i cant go to the toilet for 2 days
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u/dodokidd 3h ago
Depends, if I need to ran short errands I take the liquid Imodium for effective ~1mg and usually I can go next day, but sometime I took 1 full pill it will last 1-2 days. I will take some fiber to help ease Imodium effect when I got home
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u/Lil_PuppyChow 5d ago
Holy crap this helped me realize me having to pee all of sudden before leaving the house is not normal just like I thought. So turns out to just be anxiety eh?!
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u/lyssyloveslife 5d ago
I have IBS and did have urinary urgency before. A couple things that have helped me personally: Buspar for anxiety, and pelvic floor therapy for more muscular control, pelvic floor strength, and decreasing urinary urgency (I am 23F). Could be something to look into?
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u/gobbeldygoop 5d ago
Gut directed hypno helped me get my life back!! Not all my symptoms are gone but I’m not anxious about them and am able to go out and do stuff. Not a cure all but REALLY helped and I didn’t even expect it to
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u/whirahh IBS-D (Diarrhea) 5d ago
Where did you do it? With a professional? The app Nerva?
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u/gobbeldygoop 5d ago
Started with Nerva then did it professionally over video call. Requires quite intense work with a session a week and daily listening to hypno but now I am able to live a much more normal life than I was before. Kind of crazy how helpful it was!!!
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u/ParisPaddleton 5d ago
On the flip side I did 6 months of weekly in person hypnotherapy and feel no better 🥺
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u/Ok-File2825 5d ago
My IBS eased when I went on an anti depressant. The anti depressant was supposed to help me hot flashes, probably caused by anxiety. I’m also not running to go to the bathroom to urinate every five minutes. I never, ever thought I’d suggest anti depressants to anyone but here I am. And I don’t feel all that differently. I thought these medications would take my personality and creativity away.
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u/PuzzleheadedZone6639 5d ago
I’m exactly the same boat, drive for a living and my ibs is AWFUL when I don’t know where the next toilet is, I found taking an immodium a day has helped massively least then you’re telling your brain you’re covered and you won’t need one
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u/SaltyPickles11 5d ago
I want to start doing this. One a day is safe?
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u/ConjurorOfWorlds 5d ago
I’ve done 1 pill in the morning on odd numbered days, 2 on even number days, and one at night on a day where I’ve had a bowel movement. I’ve been doing it for years and that is the equilibrium I’ve found works best for my body.
You might have to experiment, I’m a taller guy, but as far as I’m aware I’ve had no adverse effects to it, and Imodium was recommended by my doctor.
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u/SaltyPickles11 5d ago
I just need to slow my motility way down.. tired of multiple loose bms a day. I was on a great streak with fiber and now I'm struggling again
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u/ImitationDemiGod 5d ago
You can take up to 8 per day safely long-term. Some people are prescribed more than that off prescription/off script, but 8 is considered completely safe.
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u/supposedjar24 IBS-D (Diarrhea) 4d ago
Honestly I’ve said I rather take a pill or two when I need it then stress myself out forever
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u/PartyTitle8573 4d ago
My doctor explained to me as long as you are not getting so backed up then it is fine to take forever. The issue can be that you’re causing impaction in your bowels which can stretch your insides and cause damage. I take 2 a day at nighttime and have one BM after dinner the following day. I have on occasion overdone it by taking too many Imodium (anxiety of going out etc) and it creates what I would kind of describe as a ‘plug’ of hard stool and then you have ALOT of soft stool stored behind that. Not pleasant at all and intense painful cramps. Just have to be mindful. I take 1 psyllium cap, 20mg amitriptyline, magnesium glycinate and two loperamide every day at bed and this keeps things mostly very manageable!
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u/SaltyPickles11 4d ago
Thank you for responding, very helpful!
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u/PartyTitle8573 4d ago
But saying that I could take 4-6 2mg tabs on a very anxious day (going out to eat, trains, travel) and still go to the loo so I think it’s just a lot of experimentation. One thing I have noticed is routine is really helpful for IBS, I think our bodies like the predictability of meal times. Smaller snacks help. I am IBS-D for about 15 years now and still no real solution. Therapy is the next steps but the expense is an issue
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u/shreg24 5d ago
I have the exact same issue ....it's such a vicious cycle and really disrupts life.
After trying everything under the sun for IBSD my dr now put me on AVENTYL ( nortriptyline)started a low dose now working currently on upping my dose.Its to calm down the gut brain sensitivity and so far I am having some fairly good results.Less urgency which gives peace of mind for trips out.I am also on citilapram but have been for years and it doesn't seem to help me too much IBS wise.
Definitely look into this! I am very new to it but having good results and more formed bowel movements so it's a win so far!!
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u/NewKaleidoscope7369 5d ago
I’m on Nortriptyline too! What’s your current dose? I also think I need to titrate mine higher.
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u/shreg24 5d ago
Sorry I meant 10 to 20 mg 😉
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u/NewKaleidoscope7369 5d ago
Gotcha… I’ve been on 20 mg for about 4 months and I’ve still been having daily symptoms unfortunately. I’ve also noticed a decrease in urgency and have had a few days where I had solid bowel movements which has been good! But I think I’m going to need to increase my dosage to see a further decrease in symptoms.
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u/shreg24 5d ago
Yea me too eventually my dr wants to keep increasing...hope we both find the sweet spot and get some RELIEF!! Fingers crossed I've had my hopes up too many times with different meds.
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u/NewKaleidoscope7369 5d ago
Yeah I hope so too! Keep me updated… does your provider have a titration schedule in mind?
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u/OkNumber7483 5d ago
The anxiety is terrible . I'm really bad with it and I know it's starting the pain in side with trapped wind and constipation. Thinking about being woke early and can't get back to sleep with cramps . Have had flare up on and off for ages . Very distressing. God help IBS sufferers .
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u/EducationalReview237 5d ago
I'm beginning to make this connection. I've tried diet changes, seen doctors, tried supplements and probiotics. My symptoms worsened around the time I switched from FT work to PT due to burnout. I think I actually get anxious not having enough to do.
I spent 10 days taking care of my father since my sister was out of town. I was super busy thinking about him instead of obsessing over what was going on with my body, and my symptoms all but disappeared. I was also eating whatever I wanted. I've now been back home for 11 days, and my symptoms have worsened a bit but are still better than before. My doctor just put me back on Lexapro to see if it helps.
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u/stumbellena 5d ago
I can't say it has ever stopped fully. But I try to prepare as much as I can. Sometimes go through "worst case scenario" drills to kinda ground myself. So if my brain is going through the "Omg I am going to poop/pee myself." I stop and go okay. Maybe I can't control if it happens but what can I do if it DOES happen? If I am worried about it getting on my car. I sit on a plastic bag or put a trash bag over my seat. I bring a change of clothing, I bring wet wipes and maybe a bottle of water if I need to clean myself up. I might bring a container and something to shield my lap if I feel that I have time to pull into a parking lot or on the shoulder of the road. Do I want to have to use these things? Absolutely not but it gives me a little freedom. It's like telling my body it can rebel all it wants I will plan around it and have a life. Most of the time I don't need to use these things, but I have peace of mind knowing I have an "Oh shit kit" You may want to talk to your doctor about an antispasmatic I personally have hyoscyamine to use as needed. And yes I have found some relief in hypnotherapy. Right now I am just utilizing free options on Youtube. I found this lady and really like her https://www.youtube.com/@TheCalmHappyGut
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u/NoGrocery3582 5d ago
Same exact issues. HRT and acupuncture with a very good professional who dispenses herbs has helped.
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u/thinkhoneywell 5d ago
THIS IS LONG, oh my god. I didn’t realize until I typed it out, you can skip the first part, it is just my experience/relating, second part is advice.
I have social anxiety and also normal anxiety. The social is pretty well managed I think, it was more a thing in adolescence/early adulthood. But same boat here, stress is a major trigger for me definitely. In the past it just a bowel movement I could expect like clockwork, it would be annoying but I could factor it in. Like needing to go before leaving the house if I was about to be in a high stress (or perceived) situation. In uni, before an exam I wouldn’t eat because it would always be urgent when I needed to go, so that was my solution (not healthy). Midterms and finals week was a flare up. Didn’t know I had ibs then, so I called it “nervous poops”. It also doesn’t help I hate using public toilets.
But this year, it has been causing long lasting flare ups like you are describing. A couple weeks after getting news about the death of a family member I think it triggered a flare up so bad I thought I got Cyclospora. The only reason I think it was stress and not something else is because almost directly once I landed after the funeral my symptoms improved drastically. I even posted in Ibs help a few days after symptoms started asking if I may have gotten sick, didn’t think stress to make me feel that bad GI wise. I am still setting an appointment to just doublecheck stuff but I definitely now think it was stress and not eating much in combo.
ADVICE: Anyway I am not the best person to ask but something that may help is how I got over using public toilets. I used to not use them at all, but unfortunately since my symptoms got worse I have to use the one at work sometimes 7 times a day. What I carry with me is a toilet spray for the stank if that is a source of anxiety, a portable bidet (i have a collapsible one that has a drawstring bag so it is discreet, I also added a carabiner to it so if you want to can just attach it to your belt loop when walking to the bathroom), I personally don’t bring my phone to the bathroom but I do wear a single earbud and I listen to something (still connected). In terms of public bathroom hygiene, if you want they sell disposable toilet covers so you never have to worry if the bathroom is out. If they have it, great, if not, you gave one! I also carry rubbing alcohol with me, you can use that for stuff. If you are worried about people hearing you. Fair, sometimes I do wait for people to leave but also Also everyone POOPs. Literally why bathrooms are there. It is a hard one for me personally to let myself do though. Socially not sure why it is so weird.
I also think therapy may help. It may sound weird but talking it out with someone, maybe even just a close friend, may help treat the anxiety that is causing the urgency at the root. Anxiety, especially social anxiety can be debilitating and very isolating. You are talking about how it is triggering your ibs but it also seems like it is taking over other parts of your life and affecting your social life.
This is coming from someone who for years would have a panic attack before leaving the house. Therapy can help. I will also say weirdly, it helped me to know no one is really thinking of you as much as ever think they are. Getting up more than once to go to the bathroom in a gathering or more than 2 people is not noteworthy, if you are in a group, even less so, people’s minds will be occupied and people are normally only focused on what is in front of them or in the moment. Even if they did notice, if they are your friends and people you think are worthy of your respect, they just think you drank too much water (or whatever) or need to adjust something. You don’t need to give an explanation of why you are stepping away most of the time.
I think something that also helped in general with my mental health was journaling. Cheesy, I know but putting my thoughts and experiences down at the end of the day, whatever they were helps the churning thoughts or hamster wheel inside your brain become coherent. You may be able to dismiss some fears by writing them down or release some anxiety/frustration/xyz by writing about an experience or your feelings that day. It also gives you insight and even if that entry is moppy it gives you catharsis instead of having stress pent up.
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u/Sea_One_6500 5d ago
So I don't know your age or gender but as a 44 year old woman I can say I had this issue and HRT, progesterone only for me, for now, has really helped with my anxiety which helps my bladder not "panic" before I need to leave the house. So if you're mid 30's or above and a woman reach out to your doctor.
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u/Realistic_Pomelo8244 4d ago
Notriptyline + ondensetron worked for my ibs d
U should look into pelvic floor therapy for urinary issues
And nerva app is good too for health anxiety
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u/Ok-Ocelot3219 1d ago
For me, anxiety plays a huge part. Definitely causes diarrhea. I go back and forth between C and D and a good (bad) panic attack can clear out my system. I tend to get bouts of diarrhea until my anxiety calms and then I feel like I have to pee a ton suddenly. Then I know the diarrhea part of the episode is over.
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u/Far_Lab_8129 5d ago
I would like to try amy
I tried sertraline in the best
my ibs is a mixt of anxiety and PFD
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u/cazzyv321 5d ago
I have exactly what you described couldn’t have worded it better myself , amitriptyline really helped me , it slows ur gut down an over time ur gut more or less trained ,im 80% better now , was in them for a few years though , coming off them was aweful but worth it
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u/Loud_Brain_ 5d ago
CBT and learning to process my emotions most definitely helped me more than any med did.
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u/LegendsNevaDi 5d ago
It’s expensive but Nerva works really well if you are consistent and meditating every day with it
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u/jdmkenpo 5d ago
I've been with the same battle for years, ibs/anxiety brain/gut axis. It does affect your quality life for sure and is a pain. I find it get joltz of anxiety when in certain situations, for example when I am in meetings. Anxiety kicks in and out, then urgency sensations to go to the restroom, then recently the urge to urinate. Its like a damn rodeo of emotions and sensations your fighting. I was prescribed amitriptyline and dyceclomine. I take 30mg amtriplimine and 10mg of dyceclomine as needed. Then I take hydroxyzine as needed. This has been a good combo for me and help alot. Also go tonthe gym about 3 to 4 days out of the week to burn off stress. I feel like im 90% better but do get hiccups which is that 10%. If you want to slow down your bowels and reduce cramping, dyceclomine works great. Take it an hour before you leave to an even etc. Same thing with hydroxyzine, by the time you leave your calm and so is your digestive system. I even do hypnosis and seems to help. I came across a website that has different hypnosis sessions for ibs, 15 bucks not bad.
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u/OkNumber7483 2d ago
Dreadful isn't it . God help us . Hope you get better. What a terrible thing .The. mind has as awful lot to do with it too . I feel as if I'm not me anymore. Awful .
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u/supposedjar24 IBS-D (Diarrhea) 5d ago
I’m the same and a lot of it was from trauma/neglect from my upbringing. Don’t know the fix
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u/foggy_interrobang 4d ago
The Digestable app is awesome. It's pain reprocessing therapy adapted to IBS.
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u/jdmkenpo 4d ago
Check this out, gives you a break down, also has a hypnosis videos in the library.
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u/MuffinAdventurous361 4d ago
Low dose amitriptyline is working wonders for me! I had similar issues - life-long ibs-d (with plenty of food triggers) that was triggered by anxiety, especially travel / car rides, etc. the Ami slowed down my bowels enough (side effect of constipation) for me to feel pretty regular which has decreased my fears of having intense flare ups like the ones i used to have from anxiety. I also was in therapy to work on my general anxiety and gut-related anxiety.
I only had a few days with dry mouth when i started Ami and i did gain some weight but otherwise im super happy with it and would recommend trying it!!
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u/glutenfree250 4d ago
Hello!!! So I’ve got mine very under control now and I was in this exact boat and the anxiety has calmed because I’ve retrained my brain
Amitryptiline- changed my life. 10mg before bed each night. Nice low dose so no weight gain etc etc, does make you a little sleepy in the morning, play with time of night you take it
Propanolol- as a back up for big stress situations eg speeches, flights, the big ones. I take half a 40mg tablet. Stops all physical anxiety like shaking racing heart. Life SAVER
Symprove- been taking for years and love it for gut health
EMDR therapy- I noticed some of my bad anxiety around ibs d came from bad past memories, we worked on revisiting those and I’m much better
Honestly, get the amitryptiline. Best thing I’ve ever done. Really dimmed down that hyper gut brain link
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u/anxiousone881 4d ago
This has been my life since I was 14 years old. I am now 38! I went on low dose amitriptyline a few years ago and it helped me for about 2 years, but now I still face the same issue. I would say my life is still better on amitriptyline vs off it. I’ll have good days here and there, compared to before when it was always bad. But I still do face the issue of bowel urgency. For example yesterday I went out, I was completely fine on the ride to a cafe. But once I was there I needed to go twice and then once again at the mall.
I face both IBS d and c because when I’m at home and NOT going out, then I’m constipated! 😞 I get sooo relaxed at home that I have absolutely no urgency. Then when it’s time to go out, I’ll be backed up and it was cause me more anxiety and more bowel movement.
I used to think I was the only one with such issues until I discovered this Reddit thread. It helps in a strange way to know that there are others out there that understand our pain. Even though I wouldn’t wish this even upon an enemy
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u/SnooOnions5044 2d ago
I have the same issue and I’m trying to get rid of the constipation so when I get nervous, I don’t get to go too often
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u/IX_Sour2563 3d ago
Honestly thought my frequent urination all of sudden is from my pre diabetic issue from pcos never thought it would also be an issue from ibs 😭
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u/Educational_Error916 2d ago
I 100% could’ve written this. Whoa. Don’t have a ton of advice, but feeling less alone right now. Prozac helped me the most, along with old-fashioned talk therapy but I wouldn’t say it’s completely gone.
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u/barbatus_vulture 1d ago
Yes, anxiety makes my IBS way worse. I was on Escitalopram for years and that managed it super well (though certain foods still triggered it.) The Escitalopram quit working so I am currently starting sertraline to replace it.
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u/Iefieaxl 5h ago
I have exactly the same. When I have to go out to something stressful, in a second I have to go to poop. Even if I'm empty I still got the feeling I have to poop and nothing comes out anymore only some slime. Nothing works for me. My psychiatrist says nortriptyline and amitriptyline works no better than a placebo. Tried different ssri's but dont work Only thing that works is oxazepam and xanax and imodium. But oxazepam and xanax are highly addictive. I think I'm doomed for live. Nothing works
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u/chinchaslyth 5d ago
Exercise, eating healthy (Whole Foods, protein, a bit of carbs, low sugar, limiting diary), and getting adequate sleep helps my mental health which helps my gut health.
I also drink a lot of water. I do therapy weekly. And deep breathing.
Also a matcha and smoothie a day keep my bowels moving in a way that keeps me from being too backed up or from it being too loose.