Hello,
IBS (especially mixed type) is a gut–brain interaction disorder, not just a stomach problem. When symptoms worsen with bloating, nausea, and inability to eat, it usually indicates heightened gut sensitivity + anxiety/autonomic overactivation, not damage to the intestine.
Fludac (fluoxetine) can sometimes increase bloating, nausea, and appetite loss initially, especially in IBS patients. This does not mean psychiatric treatment is wrong- it means the choice or dose of medication may need adjustment.
Next Steps
- When IBS worsens and food intake reduces, a psychiatrist may:
- Modify or change antidepressant choice
(Some medicines worsen GI symptoms; others improve gut motility and pain)
- Use gut-friendly psychotropics, such as:
- Low-dose TCAs (e.g., amitriptyline/nortriptyline at night)
- Certain SNRIs or SSRIs with better GI tolerance
- Short-term anxiolytics only if needed
- Coordinate with a gastroenterologist for combined management
- Start psychological therapies (CBT, gut-directed hypnotherapy), which have strong evidence in IBS
- Address eating fear, nausea-related anxiety, and symptom hypervigilance
Health Tips
For more queries, Reach out for an online or in-person consultation:
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