New Study Aims to Understand Gastrointestinal Anxiety in Celiac and IBS Patients (+Video)

Celiac.com 08/19/2025 - Many people with digestive conditions, such as irritable bowel syndrome or celiac disease, experience more than physical symptoms. They also deal with anxiety tied to those symptoms—like fear of eating certain foods or going to places without easy restroom access. This kind of anxiety is known as gastrointestinal symptom-specific anxiety. To measure it, researchers often use a tool called the Visceral Sensitivity Index.

This study set out to test how well the Hungarian version of this tool works. It also explored how anxiety related to digestive symptoms affects people with self-reported irritable bowel syndrome and those with gluten-related disorders like celiac disease and non-celiac gluten sensitivity.

Study Design: Two Populations, One Tool

Celiac.com Sponsor (A12):
Researchers conducted two cross-sectional studies in Hungary. One included over 300 adults who said they had irritable bowel syndrome, and the other involved a similar number of people with gluten-related conditions. All participants completed questionnaires that asked about their anxiety around digestive symptoms, general mood, frequency of gastrointestinal issues, and overall well-being.

The study tested how reliable and consistent the Hungarian Visceral Sensitivity Index was for each group. It also explored whether the tool captured the same ideas in both groups, and how closely anxiety was tied to symptoms and quality of life.

Key Findings: A Reliable Tool With Important Differences

The Visceral Sensitivity Index proved to be reliable for both groups, showing that the questionnaire consistently measured what it was designed to assess. However, there were differences in how people with irritable bowel syndrome and those with gluten-related disorders interpreted some questions. This means that while the tool works well in both groups, comparing scores directly between them may not always be valid.

For people with irritable bowel syndrome, the anxiety measured by the index was strongly linked to general anxiety and a lower quality of life. Among those with gluten-related conditions, the anxiety was tied to negative moods, more frequent symptoms, and lower mental well-being.

Interestingly, different subtypes of irritable bowel syndrome showed different levels of anxiety. People with diarrhea-predominant or mixed types reported higher anxiety than those with unclassified symptoms.

Why the Anxiety Is Different in Celiac and IBS

Even though people with gluten-related disorders and irritable bowel syndrome may experience similar symptoms—like bloating, pain, or discomfort—the way they think about their condition differs. In irritable bowel syndrome, people often don’t have a clear explanation for their symptoms, which creates uncertainty and fear. They may worry that any food could trigger an episode.

In gluten-related conditions like celiac disease, the cause is clearer—gluten. But managing the condition requires a strict, lifelong diet. This need for constant vigilance can also cause anxiety, especially when eating outside the home or trying new foods.

The study found that in people with gluten-related disorders, anxiety was often tied to specific situations—like being afraid to try unfamiliar food or visit new places. This differs slightly from those with irritable bowel syndrome, whose anxiety may be more constant and less tied to specific triggers.

Anxiety’s Link to Mental Health and Quality of Life

The study also found that gastrointestinal anxiety is not the same as general anxiety or depression. Although related, it is a distinct issue. Some participants had high digestive anxiety even if they didn’t report mental health issues like depression.

In both groups, this anxiety was clearly tied to quality of life. In the irritable bowel syndrome group, higher anxiety meant lower disease-specific quality of life. In those with gluten-related conditions, the anxiety was linked to worse mental well-being.

This suggests that treating only the physical symptoms may not be enough. Mental health should also be part of the conversation, especially when anxiety is impacting someone’s daily life and diet.

Implications for Treatment: Beyond Diet and Medication

The findings support using psychological interventions to reduce gastrointestinal anxiety. Therapies like cognitive-behavioral therapy, gut-focused hypnotherapy, and acceptance and commitment therapy have already shown promise in helping people with irritable bowel syndrome. For gluten-related disorders, these techniques may help patients better manage fear around food, reduce stress, and improve adherence to gluten-free diets.

Reducing anxiety could also prevent unnecessary food restrictions, which can lead to nutritional deficiencies or social isolation. Helping people with celiac disease or other gluten-related issues feel confident eating safely may greatly improve their quality of life.

Limitations of the Study

While the results are useful, the study had some limitations. It relied on self-reported diagnoses, and no medical tests were used to confirm whether participants truly had irritable bowel syndrome or celiac disease. Also, the data were collected online, which may exclude some groups or affect how honestly people answer sensitive questions. Most participants were women, and there was limited diversity in age and ethnicity.

Additionally, the questions focused mainly on digestive symptoms. Other symptoms common in gluten-related conditions, like joint pain or skin issues, were not included. More research is needed to capture the full experience of these patients.

Conclusion: Why This Study Matters to People with Celiac Disease

This study shows that anxiety about digestive symptoms is a real and measurable problem—not just in irritable bowel syndrome, but also in gluten-related conditions. For people with celiac disease, this anxiety may come from the daily burden of managing a strict gluten-free diet, fear of accidental exposure, and social limitations.

The Hungarian version of the Visceral Sensitivity Index offers a valid way to assess this anxiety and could help doctors and psychologists better understand and support their patients. It also highlights the need to treat the emotional side of living with chronic digestive conditions, not just the physical symptoms.

For patients, this research validates something many already feel: that fear, stress, and worry about eating are part of the illness experience—and deserve attention. Recognizing and treating this anxiety could lead to better overall health, improved diet adherence, and a more fulfilling life for people managing celiac disease or similar conditions.

Read more at: bmcpsychology.biomedcentral.com

Watch the video version of this article: