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Dr Basu
Dr Basu, Experienced Specialist
Category: Medical
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Experience:  MD
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I think i may be suffering with anxiety problems which

Resolved Question:

Hi I think i may be suffering with anxiety problems which seen to manifest itself in me having to have a bowel movement each time i go on a journey in car,train, bus plane. i seem to be okay. when going to work but the rest of the time is awful. its really upsetting me so much so i dont want to go out much.
Submitted: 2 years ago.
Category: Medical
Expert:  Dr Basu replied 2 years ago.
Hi there,
This is Dr Basu, Experienced Specialist.
I am here to address your concerns and provide great service.
Yes you are likely suffering from IBS or irritable bowel syndrome.
Anxiety makes the intestines more active causing bowel movements.
This can be addressed with a special diet to reduce the frequency.
You should consider following low fermentable sugar diet ( FODMAP diet) to reduce your symptoms.
Please go to this link for detailed information:
http://stanfordhealthcare.org/content/dam/SHC/for-patients-component/programs-services/clinical-nutrition-services/docs/pdf-lowfodmapdiet.pdf
Please consider taking a probiotic containing Saccharomyces Boulardii.
This is a friendly yeast helping to prevent loose bowel movements.
You can use over the counter Loperamide tablets 4 mg as needed.
Prescription medication Amitriptyline 25 mg at bedtime daily will help long term.
Please consider seeing a psychotherapist for cognitive behavioral therapy ( CBT).
CBT helps a lot with these symptoms over time.
Best wishes,
It was my pleasure to help you today.
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Dr Basu, Experienced Specialist
Category: Medical
Satisfied Customers: 29063
Experience: MD
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Expert:  Dr. Kaushik replied 2 years ago.
Greetings.
Welcome to the site.
Well, i will like to offer a different opinion on your problem.
I believe that you are suffering from Situation specific Anxiety Disorder where in the situation such as travelling either in car, train or plane tends to trigger an anxiety reaction which may manifest in the form of a panic attack coupled with increased bowel movements ( and perhaps increased urgency to pass urine also ) thereby causing urge to go to the loo. So here in your case as per me, you are having an underlying Situation specific Anxiety disorder, where situation is travelling.
As far as management of this condition is concerned, as you would have known by now that it is quite stubborn and tends to develop a vicious cycle with the same series of events happening over and over again whenever the anxiety trigger is faced ( travel ), so in order to take care of this condition you got to discuss with your doctor about getting started on a combination of 1 anti depressant drug which also doubles up as a good anti anxiety agent such as escitalopram at dose of 10-20 mg/ day or sertraline at dose of 25-100 mg/ day + 1 benzodiazepine anti anxiety drug for short term usage only ( 4-6 weeks only) such as clonazepam at dose of 0.25- 2 mg / day in 2 divided doses. This drug regime shall prove to be quite effective in alleviating your anxiety symptoms and make the travelling experience much less taxing and unnerving which eventually will completely undergo remission in due course of time. You may expect to notice improvement in your symptoms within 2-3 weeks of starting this regime, however for complete relief you got to take the drug regime for at least 3-4 months.
In addition to this, you may want to consider seeking CBT therapy/ counseling from a clinical psychologist so as to learn coping mechanisms / skills in making yourself more resilient towards stressful situations / events.
I hope this helps.
Wish you all the best.
Please kindly leave a Positive rating if you are satisfied with the answer.
Regards