Dr Nick Read

IBS, recurrent dyspepsia or gastritis caused by emotional tension?

I’m hoping you can give me some clarity on this issue. I have been suffering with gastro problems for about 4 years now. The started after prolonged usage of ibuprofen because I always suffered with headaches. This caused a bout of gastritis. Lansoprazole cleared the problem and I was fine for a while. Since then I have had re-occuring bouts of gastro problems. These start with mild discomfort and nausea. Then I start to feel full all the time and very sick. Then when my stomach is empty I have severe pain. Diet doesn’t seem to affect it. I also get belching, I have a horrible taste in my mouth regurgitation, and a lot of upper abdominal that goes through to my back. When my symptoms are bad, I can’t bear to be touched. I have had a gastroscopy 3 years ago and blood tests. All were negative.

I have taken a variety of drugs. Motilium helped for a bit but the symptoms started to creep back and eventually I was in severe pain. I went on omeprazole, which helped. I have been off these for a month and the symptoms are slowly creeping back.

I was diagnosed about a year ago with IBS. I feel the doctors have diagnosed this because they can’t identify anything else. I do not have diarrhoea or constipation. I’m not ruling out IBS completely if someone can explain to me why my symptoms are all upper gut, and can give me advice on what to do to manage the symptoms. I’ve read that symptoms of IBS tend to come and go, But my symptoms never go away; they just lessen in severity then creep back. I would be grateful for your opinion.

Response

You are right that some doctors tend to diagnose IBS when there is no definite signs of gastrintestinal pathology, though in your case, you had gastritis caused by NSAIDS. So now you tend to have recurrent bouts of gastritis type symptoms, which respond to treatment with acid blockers and motilium but then come creeping back. So if you wanted a more accurate diagnosis, this might be recurrent non ulcer dyspepsia or recurrent gastritis.

I suspect the symptoms of gastritis have become recruited to express emotional tension. The severity and variety of your symptoms, the fact that you don’t want to be touched might suggest an emotional resistance. We showed this some years ago that people who developed persistent diarrhoea following an attack of gastroenteritis has much more anxiety, depression and stress at the time of the original infection than those whose symptoms cleared up. The same would apply to symptoms of gastritis, symptoms of flu, back injury, surgical trauma and so on. Stress causes symptoms to recur and persist. You might think of it as a symptom memory.

So as well as finding a drug, like omeprazole, that will clear your recurrent symptoms, you might need to address any ongoing or previous stress in your life. Getting to the root of the problem could get rid of your symptoms completely.

I do hope this helps.