In everyday life, gastrointestinal symptoms are quite prevalent and frequently the cause of seeking medical attention.1 GI symptoms are quite prevalent in developed  nations, with nearly every other adult reporting them within three months.2-3 Symptoms of gastrointestinal disturbances include abdominal pain, heartburn, diarrhea, constipation, nausea, and vomiting. Abdominal pain is responsible for almost 10 million clinical visits in the United States each year.4 Digestive disorders affect 2 million people in the Netherlands each year, resulting in 13% of all deaths, 12% of hospital admissions, and 17% of total OPD .5 Many individuals with irritable bowel syndrome or associated functional gastrointestinal diseases provide considerable management challenges for clinicians. GI may have a significant psychological and stress-related impact. It has been shown that increased rates of mental comorbidity exist with functional gastrointestinal diseases, which are particularly common general population.6 Anxietydisorders affect about 57 million persons.Anxiety and depression have been linked to a variety of chronic medical illnesses, including gastrointestinal issues, cardiovascular disease, and chronic respiratory problems.7 Comorbid psychiatric illnesses can affect the management & outcome of GI diseases, particularly health-related quality of life. Mental diseases are frequent in all countries, causing enormous misery.8 In primary care, up to one-third of patients may have diagnosable mental disorders, particularly depression and anxiety.9 Anxiety means some awful things expects to occur in future and depression depletes essential energy from the present moment, leaving an individual feeling muted and isolated. When people have symptoms of both anxiety and depression at the same time this clinical condition is termed as mixed anxiety and depression.  It is characterized by a mix of traits such as inner tension, irritation, emotional instability, & psychomotor agitation, which might raise the risk of suicide ideas and attempts.10 When treating combined anxiety and depression, it disturbs the gastro-intestinal tract and causes a variety of gastrointestinal symptoms. There is not enough data available to determine the prevalence of GI symptoms in young patients with mixed anxiety depression.

The present cross-sectional study was carried out at the medicine and gastroenterology department, Bolan Medical Collage Quetta from March 2025 to August 2025 after taking permission from the ethical committee of the institute. A total of 202 individuals with mixed anxiety depression of both gender and different age groups (ranged18-35 years) were enrolled while individuals with sever medical condition that could independently clarify the GI symptoms, gastrointestinal malignancy and incomplete clinical data were excluded from the study. Each participant performed various diagnostic tests including CBC, X-ray, ultrasound, selected CT scans, and urinalysis. Structured questionnaires were used to record data including demographic features and GI symptoms (heart burn. Abdominal pain, vomiting, nausea, diarrhea, loss of appetite, changed bowel habit, GIT acid abnormality, bloating and early satiety). GI symptom positivity was defined as having at least one of these manifestations. Data was collected through face-to-face interviews and medical record reviews. The Hospital Anxiety and Depression Scale (HADS), was used for psychiatric evaluation which was administered by qualified clinicians, data was analyzed through SPSS version 23. For data presentation descriptive statistics (frequency, percentages, averages, and standard deviations) and inferential analyzes (cross-tabulations, chi-square tests) was used.

A total of 202 individuals with mixed anxiety and depression were enrolled in this study. Out of these individuals 120 (59.4%) were females and 82 (40.6%) were males. The most common age group among the study participants was 21-24 years, 91 (45.0%) followed by age group 25-29 years 54 (28.20%) and 18–20 years( 26.6%) respectively. Majority of the individuals were unmarried 168(83.2%) and were from urban areas 119(58.9%) as presented in table 1. Of the 202 participants, 48% had at least one gastrointestinal symptom. The most prevalent GI symptom was 67(33.2%) abdominal pain followed by bloating 67(33.2%), nausea 55(27.2%), constipation 45(22.3 %) and heart burn 39(19.3 %) respectively as presented in table 2. Gastrointestinal symptoms were stratified on the basis of marital status, gender and age. These symptoms were more common in male gender as compared to female (48.8% versus 47.5%). unmarried had 47. % and married had 50 % of these symptoms. Similarly 21–24-year age group had the highest prevalence of GI symptoms (49.5%) followed by  25–29 age group 25–29 27 (47.4) and 18–20 25 (46.3) respectively. Results showed that the frequency was almost the same across marital status, age and gender as presented in table 3.  

Gastrointestinal symptoms are prevalent in the community, with single symptoms affecting 40%-70% of the population.11-12 Common gastrointestinal symptoms include stomach pain, nausea, heartburn, bloating, diarrhea, and constipation. Approximately 1/3 of individuals with GIS seek medical examinations. The primary motive for seeking medical attention is generally anxiety and concern about the issues, rather than their severity.13-14 There is a significant link between functional gastrointestinal disorders and psychological symptoms. Patients with GIT disorder have higher levels of mental symptoms, including sadness, anxiety, somatization, and neuroticism, in contrast to healthy controls and those with organic gastrointestinal illnesses.15 Mental problems are more prevalent in clinical specimens with gastrointestinal symptoms (60-85%) than in population data sets (10-15%).16-17 Research suggests that those seeking medical assistance for their GIS have higher levels of psychological distress compared to those who do not (19). While medical examination and reassurance from a family doctor can alleviate GIS in most people, it may not be sufficient for those with anxiety or depression problems, resulting in persistent GIS. These patients commonly visit gastrointestinal clinics. Studying functional GIS in populations is crucial for understanding this relationship. Clinical samples may not accurately represent the general public with functional GIS. These patients are likely a subset with higher GIS levels and greater psychopathology.18 The length of symptoms, as well as psychological characteristics such as depression intensity and patients' perspectives on the origins of their disease, are the greatest predictors for GIS consultation. The psychological distress experienced by patients with functional GIS in healthcare settings differs from that of individuals with similar symptoms in the rest of the population. This suggests that the psychopathology seen in individuals with functional GIS may be of two types: one caused by the illness itself, and another that requires medical attention. The aim of this study was to determine the prevalence of GI symptoms in young patients with mixed anxiety depression. In our study out of the 202 participants, 48% had at least one gastrointestinal symptom. The findings of our study was similar to the study conducted by Haug,et al in their study 48% of people experienced one or more of the four gastrointestinal symptoms. Other epidemiological study revealed the prevalence of gastrointestinal symptoms ranged from 30% to 69% .20 The disparities in frequencies were mostly attributable to changes in the quantity and kind of GIS analyzed. . In our study 59.4% were females and 40.6% were males. The gender wise distribution of our study are similar to the study conducted by Bener and Daffeeah in female were predominant than male in their study.21 In our study the most prevalent GI symptom was 33.2% abdominal pain followed by bloating 33.2%, nausea 27.2%, constipation 22.3 % and heart burn 19.3 % respectively. Similar types of GIT symptoms were reported in the previous study .21 Gastrointestinal symptoms in our study were stratified on the basis of marital status, gender and age. These symptoms were more common in male gender as compared to female (48.8% versus 47.5%). This aligns with global epidemiological patterns of functional gastrointestinal diseases.23 Similarly in our study 21–24-year age group had the highest prevalence of GI symptoms (49.5%). Another study reported that the age of participants with GI symptoms ranged from 20 to 26 years.24 These study findings reinforce the idea that GI issues are a substantial issue in the community.

Our study concluded that gastrointestinal symptoms are a significant part of the clinical manifestations of young individuals with mixed anxiety depression illness. 48% of individuals had at least one gastrointestinal symptom, with stomach pain, bloating, and nausea being the most common ones.