When You Have Dysautonomia and IBS at the Same Time

Over the years, I have heard from many IBS patients that they also deal with nervous system symptoms alongside their digestive symptoms. Often these symptoms occur in conjunction with bowel movements. This combination of nervous and digestive system dysfunction may be related to a health condition known as dysautonomia. Here is an overview of dysautonomia and its relationship with IBS.

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What Is Dysautonomia?

Dysautonomia is thought to be present when the autonomic nervous system does not function as it should. The autonomic nervous system is the part of the nervous system that is responsible for most of the unconscious working of the various organs and systems of our bodies, including such processes as respiration, digestion, and heart rate.

The autonomic nervous system is broken down into the sympathetic and parasympathetic nervous systems. The sympathetic nervous system is the part responsible for our "fight or flight" response, with its symptoms of rapid heart rate, fast breathing and changes to the way blood flow is directed through the body. The parasympathetic nervous system is the part that works to maintain regular body functioning. In dysautonomia, there can be excessive sympathetic activity, with a possible failure of parasympathetic activity, resulting in dramatic and disruptive symptoms. Dysautonomia can involve localized or full-body neurological dysfunction.

Dysautonomia is a catch-all term that encompasses many different health problems. In primary dysautonomia, there is a known injury to the nervous system secondary to an identified neurological illness. Secondary dysautonomias are those in which the neurological damage is the result of a non-neurological illness. Some dysautonomias are the result of medication side effects, while others are of unknown causes. Depending on the cause, dysautonomia can be short-term or chronic, and again, depending on the cause, improve or worsen over time.

Some identifiable causes of dysautonomia include:

Dysautonomia has also been associated with the following health problems:

Dysautonomia is also known as "autonomic dysfunction," and when there is clear-cut damage to the autonomic nerves, as "autonomic neuropathy."

Symptoms of Dysautonomia

Dysautonomia can present itself in many ways. Orthostatic hypotension is seen as a classic symptom. This rapid drop in blood pressure when a person stands up results in a feeling of dizziness, weakness and in some cases, fainting. Other symptoms include:

  • Anxiety
  • Blurred vision
  • Discomfort during exercise
  • Dizziness
  • Excessive sweating
  • Fainting
  • Fatigue
  • Gastrointestinal symptoms
  • Impotence
  • Low blood pressure
  • Numbness
  • Rapid pulse rate
  • Sexual difficulties
  • Tachycardia
  • Tingling sensations
  • Urinary difficulties

Overlap With IBS

The research on the overlap of dysautonomia and IBS is limited. One published report involved a review of a large number of case-control studies that took measurements of markers of sympathetic nervous system functioning in a variety of health problems, including IBS, chronic fatigue syndrome, fibromyalgia, and interstitial cystitis. Such measurements included changes in heart rate and blood pressure, sweating, response to a tilt table test, and symptom questionnaires. Definitive answers from this review are clearly limited due to the wide variability of health problems, testing protocols and symptom measurements used in the case studies. However, it is notable that 65% of these studies found evidence of sympathetic nervous system hyper-reactivity. It is thought that chronic stress may contribute to the onset of these disorders, as well as to the dysfunction of the autonomic nervous system.

Interestingly, one small study found a "blunting" of autonomic system reactions to stimulation of the large intestine in IBS patients that was related to how long they had the disorder. This is in contrast to most published reports that show an increase in sympathetic reactivity to inner stimulation. It is unknown if this finding had to do with the type of stimulation used or if there are changes in autonomic reactivity over time.

As you can see by the lack of research in the area, little is known as to why a person would have both IBS and dysautonomia.

What to Do When You Have Both

If you think you may have dysautonomia, see your healthcare provider and discuss your symptoms.

As of now, there is little in the way of pharmacological treatment for dysautonomia (or IBS for that matter). What is generally recommended for dysautonomia are therapies that may improve the functioning of your autonomic nervous system. Many of these are also helpful for IBS:

  • Cognitive behavioral therapy
  • Deep breathing exercises
  • Progressive muscle relaxation
  • Tai Chi

The following self-care tips may help, particularly if you experience orthostatic hypotension:

  • Be sure to drink plenty of water.
  • Be sure to take in plenty of dietary fiber.
  • Avoid eating too many fatty foods.
  • When rising, be sure to stand up slowly, keeping the head lowered slightly.

Frequently Asked Questions

  • How does dysautonomia affect blood pressure?

    Dysautonomia can affect blood pressure by dropping it to low levels. This can cause a person to feel weak, dizzy, and possibly faint if they stand up for too long. To prevent this from happening, it may help to stand up slowly and drink plenty of water.

  • Who do I see to treat dysautonomia?

    You should see your healthcare provider or doctor to treat dysautonomia. Since every person is affected in different ways by dysautonomia, there is not a singular specialist that is recommended to treat the condition.

  • What is bowel neuropathy?

    Bowel neuropathy (neurogenic bowel) is when you lose control of normal bowel functions. This can result in unintentional accidents and constipation. Bowel neuropathy is caused by nerve damage that affects an automatic process, so it may be related to an injury affecting the autonomic nervous system (ANS).

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. National Institute of Neurological Disorders and Stroke. Dysautonomia information page.

  2. Kingsley JD. Autonomic dysfunction in women with fibromyalgia. Arthritis Res Ther. 2012;14(1):103. doi:+10.1186/ar3728

  3. Cleveland Clinic. What is dysautonomia?

  4. Martínez-martínez LA, Mora T, Vargas A, Fuentes-iniestra M, Martínez-lavín M. Sympathetic nervous system dysfunction in fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, and interstitial cystitis: a review of case-control studies. J Clin Rheumatol. 2014;20(3):146-50. doi:10.1097/RHU.0000000000000089

  5. Cheng P, Shih W, Alberto M, et al. Autonomic response to a visceral stressor is dysregulated in irritable bowel syndrome and correlates with duration of disease. Neurogastroenterol Motil. 2013;25(10):e650-9. doi:10.1111/nmo.12177

  6. Cedars Sinai. Neurogenic Bowel.

Additional Reading

By Barbara Bolen, PhD
Barbara Bolen, PhD, is a licensed clinical psychologist and health coach. She has written multiple books focused on living with irritable bowel syndrome.