Visceral pain, reflux & TMS? (Long, but I’d love your input)

Can visceral pain be MBS? (Apologies for the length)

I’m relatively new to the world of TMS/MBS and I’m trying to figure out whether my symptoms fall into this category.

First things first: This is about gastrointestinal symptoms – reflux, gastritis, and chronic (visceral) pain.

Summer 2023 – the beginning of it all (I think):

Two years ago, I was in my mid-twenties, incredibly stressed, finishing my master’s thesis, applying for PhD programs abroad (I’m from Germany but always dreamed of studying in the UK), excited about my future while putting massive pressure on myself. My partner and I were planning to move to London, which was both exciting and overwhelming. A few months before the move, I started having panic attacks, which became more frequent. I was overworked, exhausted, and had a history of anxiety from age 16–19, though I had been mentally stable and largely anxiety-free throughout most of my twenties. Around the same time, I had a GI infection, and afterwards I began experiencing recurring digestive issues.

Fall 2023 – London:

My GI issues and anxiety worsened. I was constantly nauseous (I’ll spare you the rest of the GI details). I started reading about post-infectious IBS and thought: great, this is it. I was under extreme pressure due to my PhD applications, waking up in a panic every day and having multiple panic attacks, which increasingly became focused on my health and digestive symptoms. I was so stressed and yet desperate for this time to be “perfect.”

Winter 2023/24:

My fear became overwhelming – I could hardly leave the house without my partner. The GI issues worsened. I became convinced I had something serious. (Yes, I went to A&E twice. I was discharged both times with an anxiety diagnosis.) Then, on one especially bad day, I suddenly developed a globus sensation – that feeling of tightness or a lump in the throat. It felt like I couldn’t breathe. I was terrified. I spent countless nights on Reddit and PubMed. I read it could be caused by reflux or anxiety. At first it came and went, then became daily and constant. I thought my life was over. I also developed chronic urticaria, which further convinced me I was seriously ill.

Spring 2024 – Back in Germany:

I started seeing doctors. Eventually, I noticed clear reflux symptoms – but I wasn’t sure how much was real and how much was anxiety. A GI prescribed omeprazole (PPI). Reluctantly, I started taking it – and surprisingly, the globus improved significantly. Not completely gone, but better. My panic attacks disappeared completely, but depression set in. Then, after two nearly symptom-free weeks, we visited relatives in London. I felt anxious (family from my father’s side, with whom I have a difficult relationship), and during dinner, I suddenly had a tickling in my throat and a coughing fit. I thought I was having an anaphylactic reaction and panicked. After a few minutes, it passed. The next day, the itching returned – less like an attack, but steady throughout the day. It lasted a week, then vanished.

Spring/Summer/Fall 2024 – Berlin:

We moved back to Germany for medical treatment. I had an endoscopy: mild chronic gastritis (Type C), otherwise unremarkable. The GI told me to taper off the PPIs. At the time, my symptoms had improved by about 70–80%. I tapered. Around my partner’s birthday (again some emotional pressure), the itching came back – this time it lasted nearly two weeks, then disappeared again. But after quitting the PPIs completely, I had severe acid rebound, lasting 3 months – globus, chest pain, burning, etc. An ENT diagnosed LPR (silent reflux) and I resumed PPIs and the reflux diet.

Winter 2024:

Two weeks of esomeprazole 40 mg helped again – symptoms reduced ~80%, globus gone. But then I caught a cold and took ibuprofen + antibiotics → symptoms returned, stronger than ever. The first symptom this time was the inner itching – now in the chest, not just the throat. It was aggressive and terrifying. Then it faded and the others (pain, tightness, reflux) came back. I was devastated.

Spring 2025:

After four awful weeks, suddenly I had two nearly symptom-free weeks again. I relaxed my strict reflux diet. The symptoms returned. After 10 days, the strange itching joined again. This time, it blended with the others – the symptoms merged, shifted, intertwined.

Amitriptyline – March 2025:

I had read about visceral hypersensitivity, how chronic stress or inflammation can sensitize gut nerves and cause exaggerated pain signals. It’s common in IBS and functional dyspepsia. I learned low-dose amitriptyline can help by retraining the brain’s response. I was scared of meds, but desperate. At 20 mg, ALL symptoms vanished – except the itching.

Now – the inner itch:

Initially I hoped it would just take longer. But instead, it became the main symptom, more and more persistent. At first every few days, then daily, now from morning to night. Sometimes milder, sometimes stronger, but always there. What is it like? An inner, deep burning, tingling, itching feeling in my chest and throat. It moves around – left, right, middle, throat, or sternum. Sometimes it feels like a deep inner wound that itches. Sometimes tickling, sometimes pressure, rarely it affects my voice. Sometimes I get “attacks” – 1–5 minutes of unbearable intensity. It always disappears during sleep.

I started pregabalin – 300 mg. After a month, I’d say it has reduced the itching by ~50%, but it’s still distressing. Also: lorazepam helps acutely, almost always.
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A Mind-Body Syndrome?

I’ve listened to every podcast, read every post on Reddit, and studied Dr. Schubiner’s work (I studied psychology and clinical psych). I recognize myself in the MBS concept – but I still have doubts. What if this itching is maintained by peripheral input and not just central processing? Papers on visceral hypersensitivity say that even nerves in the esophagus can become sensitized and send abnormal signals. So how can I know if it’s my brain or my peripheral nerves? The fact that amitriptyline helped all other symptoms suggests those were central – but the itch remains. Is this proof it’s peripheral? Yesterday I saw a pain specialist for the first time. He told me: “Visceral pain can’t be modulated by the brain. It’s not well understood.” That threw me into another spiral of doubt.

So. That was long – I know. But I wanted to be precise because I feel like I don’t fit any category. I know my psyche plays a role. But I still don’t know if this is TMS, MBS, visceral hypersensitivity, or something else entirely. Has anyone here experienced something similar – especially involving visceral symptoms? Every reply, every suggestion or association would mean the world to me.

All the best,

Marie

PS: English is not my native language, so please excuse any mistakes!

 

@Marie A. Welcome to the Forum!

It's normal to have doubts about MBS/TMS at first. The process and techniques we use address those, and overtime they lessen. You say you've studied MBS and Dr. Schubiner, but have you done the exercises in his book Unlearn Your Pain? Are you discovering and addressing the psychological factors that have led you to this place? I can't tell from your post, which is focused on the physical.

You seem to be aware that anxiety plays a role, as you've gotten relief from anti-anxiety meds. You acknowledge that stress is a factor. I suggest that you start journaling about the sources of stress and anxiety in your life, and use one of the MBS programs to take it from there. Let us know if you need more specific recommendations on different programs. It's time to stop studying and start doing.

Best wishes.

 

Welcome! Your story is very similar to mine. I deal with IBS-which is just many gastrointestinal symptoms. I've been doing the work for a month and 1/2 now. I took me forever to realize that this pain is caused by my mind. And there are some days that I do doubt it. Here's what helped me:
Read Dr. David Clarke's book "They Can't find anything wrong with me!" A lot of times the TMS books are focused more on back pain. Dr. Clarke is a gastroenterologist and reading his viewpoint of TMS is really interesting. It gave me hope since he talked about my symptoms.
The SEP program is free on this site. That is what I am using. It's free and helps you learn and journal. It's a good starting place when you don't know where to start!

 

Thanks so much for your kind reply, Ellen!
You’re right – I’ve read a lot about MBS and Dr. Schubiner’s approach, but I haven’t actually done any of the exercises yet. I’m still stuck in that early stage of doubt, especially because so much of the MBS content I’ve come across focuses on back pain or musculoskeletal issues. With GI-related symptoms, I haven’t quite known how to fully connect to it yet – which is why I wrote this post in the first place.

Regarding treatment: I currently take low-dose amitriptyline, which helps with pain but not anxiety, and pregabalin, which does help calm things down – though I’m taking it mainly for the inner itching. I also tried CBT-based therapy, but it didn’t really help me. I’m now searching for a new therapist, but here in Germany, finding a spot can take time.

I’d be really grateful for any suggestions on MBS-based programs or book recommendations – especially ones that might be helpful for visceral or GI-related symptoms. Thanks again so much for your support.

 

Thank you so much for your message – it’s really comforting to hear that others have had similar experiences. And thank you for the book recommendation! I didn’t know about Dr. Clarke’s work – I’ll definitely order the book.
If you feel like sharing: has the SEP program helped you so far? And are you also dealing with visceral-type pain? I’ve been looking for a good starting place, so comments like yours are really helpful to me!

 

Yes, the SEP has been very helpful for me. It's helped me see that my personality type and my experiences in life have contributed to this pain. I like that it is free-you see so many people offer programs that cost a lot. I'm sure they are good. But I'm tired of spending money on this condition with doctor's visits and tests that happened in the past. Especially when it is up to me to do the work.

I do have visceral pain. I'm currently taking imipramine which is like the sister medicine of amitriptyline. It does the same thing and blocks the pain signals. The medication doesn't fully eliminate the pain but it helps take it down so I can live my life.

If you decide to start the SEP program just be prepared it might take time to see any improvements. When I first started I expected a huge transformation, and while some people do have remarkable turn arounds-it's not normal. This takes time as we work through the program and work through our experiences. Recovery is not linear-there will be ups and downs and that is actually normal!!

 

Thank you so much for sharing – it’s really encouraging to hear that the SEP has been helpful for you. I’m also genuinely surprised (and relieved) to find someone here dealing with visceral pain and using a similar medication. That gives me hope.
I’d be really interested to hear whether your symptoms are more in the chest/throat area or lower down in the abdomen – and whether you have a sense of how your pain or symptom picture first developed over time?

I’m planning to start the SEP soon and am already preparing myself mentally for the ups and downs. I’ve experienced plenty of that on this journey over the past year!

 

@Marie A.
I think you would benefit greatly from reading Hope and Help for Your Nerves, by Claire Weekes. She explains how a person’s nervous system can get hypersensitive. It can cause all sorts of problems, including yours. This plays into TMS and is a part of it. When I read her book, it really helped me understand the role adrenaline and fear were playing in my symptoms.

 

@Marie A. My symptoms were all over-upper and lower. At one point I was even on a PPI too! I didn't have too much relief from it and then it started to make my hair fall out! I stopped it immediately! After working on the SEP program, I realized I have had TMS as far back as my childhood. I think it is just my personality and how I react to external/internal stressors. When you do the SEP you may start to see a pattern in your life and what may have triggered it for you. And if you don't see a pattern-that's ok too! We are all so different in how this comes about. I've learned that even if you have the same symptoms as someone else, the way to treat it may be very different. The good news is that you can do the work yourself to get better and it's a pretty simple process. The hard part...your brain will try to resist it and it will take time. It's a lot of trial and error to see what works for you.