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.

 

That sounds exciting! Thanks for the tip!

 

I had similar issues to yours December through March, endo and colonoscopy clear except biopsy showed chronic active gastritis. Pretty much 95% better with mind body approach (mainly using Dan Buglio’s approach of not catastrophizing over symptoms, taking an ‘oh well’ approach and having faith that it wasn’t permanent) I also started a low fod map low acidic diet which helped a lot, but I never treated my diet as my saving solution, merely just a means of being kind to my body and GI system that was struggling due to chronic fight or flight. I am now introducing more of my old foods every week and am confident I’ll be back to eating whatever I want in a few months.

 

Thank you for your answer. I'm glad to hear that things are improving for you! His videos are great — I love watching them, too! It's great to hear that things are improving for you. Do you think you might also have 'visceral/oesophageal hypersensitivity'? I'm stuck mentally at this point, and I keep having doubts because I'm afraid that this diagnosis doesn't fully fit with TMS — although it does in some ways. However, it also means that your nerves in the oesophagus have become more sensitive. Unfortunately, I've spent the last year reacting very anxiously (frankly, I've been panicking!) to the symptoms, and I'm really struggling to be 'unbothered'!

 

no I don’t think I have esophageal/visceral hypersensitivity, and even if I did I would believe it was secondary to stress and the result of TMS. Our diagnosis of chronic gastritis without anything else obvious is a good indication that our over active nervous systems was playing a role, GI system slows down when in fight or flight, gastric emptying slows, decreases in stomach acid etc. If all first line tests were clear, which sounds like they were, I think it’s time to fully buy in to the TMS diagnosis. You can go on the medical merry go round for a life time clinging to the next doctor, next test, next treatment as being the answer, but odds are the answer to your issue isn’t going to come from ‘modern’ medical model.

the thinking of ‘my situation is unique and can’t be TMS’ is rife in those in the TMS world. It kept me from starting the work. My situation started (realistically been going on for decades but severely) from a vasectomy, I had crippling scrotal pain for 8 months, and I was convinced, since my body was in an unnatural configuration as a result of the surgery, that TMS wouldn’t apply to me, that it was hopeless. I even emailed Dan about this and he pretty bluntly told me that what I was going through was all TMS. That was 3.5 months ago. I am 95% scrotal pain free. I am still dealing with symptom imperative ( going on my 7th symptom now lol) but just started the work and actually believing was the first step to getting the proof I needed.

and in the instance that what you’re dealing with isn’t TMS, you lose absolutely nothing by applying these methods and learning to be more indifferent to your sensations, catastrophize less, getting in touch with your inner psyche more and overall just being kinder towards yourself.

the brain is responsible for literally everything, my scrotum was hypersensitive, interpreting every normal sensation (movement, pants, cold) as abnormal , but ultimately it’s my brain that was deciding to process them as uncomfortable sensations. It is all one system, and the brain is capable of creating literally any sensation it wants to.

it sounds like the acid reflux diet was helping, why did you go off that? I’m not of the mind of some people that you shouldn’t lean into diets and physical treatments. You absolutely can, but they need to come from a place of compassion not desperation. Alan Gordon’s book the way out mentions this a lot, we are allowed to use avoidance techniques (meds, diets, heat etc) if our symptoms are really debilitating us, and when we lower our symptoms we can utilize somatic tracking to more comfortably sit with them.

 

“visceral/oesophageal hypersensitivity'? ”

This actually screams TMS, especially if you’ve had a time in your life without these symptoms.

 

Thank you for your answer. Honestly, that's exactly what I needed to hear. I know all this, and it's the only thing that really makes sense. At the same time, I have huge doubts. I keep getting caught up in scientific publications that explain in meticulous detail how nerves behave in the oesophagus...and I lose sight of the bigger picture. You are also right that I have nothing to lose by pursuing a mind-body approach. However, I also want to be able to fully engage with it. Unfortunately, I am super cognitively rigid and an all-or-nothing person. I know that I can fully embrace a mind-body approach if I can let go of my doubts about finding the answer to my symptoms in a paper on, for example, mast cells and pain processing. I hope that makes sense.

As for the low-acid diet, I did the diet for so many months that, at some point, I thought: "I'm taking PPIs, I'm not eating anything enjoyable anymore, I'm losing too much weight, I'm getting increasingly sad, and my symptoms are only improving slightly". I wanted to enjoy life again, and to be honest, I just couldn't do it anymore. I completely agree with you that this is part of self-care — I also take medication for pain, and for now that's OK. But, as I said, I did it for too long. A few months ago, I started crying in the antipasti section of the supermarket and decided it was time to start eating a wider variety of foods again. I still don't drink coffee, and I've cut down on tomatoes, citrus fruits, and processed foods anyway.

 

Haha, that's absolutely true! The theory behind it also bears a striking resemblance to mind-body in a GI edition.

 

in Nicole Sachs’ book ‘Mind Your Body’, she has quite a bit on resistance towards believing in TMS and believing in the work. And the forms of resistance will vary person to person. In your instance resistance comes in the form of questioning the science, or needing some firm science data/to believe what you’re dealing with is TMS. I really think you should recognize and start with the fact that your resistance is in essence a form of TMS.

highly recommend reading Mind Your Body.

 

Yes, that makes perfect sense. I realise now that I would prefer to have the same "case study" for comparison. I completely understand why it's priceless to have a TMS practitioner who can reassure someone that TMS is the correct diagnosis. I feel stuck in the middle.

Thanks for the suggestion. Ironically, I spent a few years as a research assistant on a project investigating the effects of ACE on (mental) health. At some point during that time, I realised that it applied to me too. I wish more people knew about the connection between ACEs/early life stress and overall health!