Can anxiety cause nausea accompanied by dull stomach cramps and bloating?

Hi doctor,

I am a 24 years old male weighing 149.9 lbs, and my height is 5 feet 11 inches.

I have had to battle through a vicious stomach-anxiety loop for the last couple of months and am looking for a second opinion.

The symptoms include,

1. On and off, the feeling of the phantom or gaggy nausea at the back or bottom of my throat.

2. On and off stomach noises (grumbling).

3. Occasional dull crampy feeling in the stomach.

4. On and off, the feeling of a lot of gas being stuck, feeling heavy and uncomfortable in the stomach.

5. No fever, no other aches or pains, no diarrhea, and no constipation.

6. Normal stool cycle and normal stools.

7. No loss of appetite.

Tests:

1. Blood work - all came back normal, with no elevated or low levels of anything of significance (liver function fine, CBC fine, antibody markers, inflammation markers, no malnutrition, TGT).

2. Abdomen ultrasound - all normal.

3. Abdomen CT Scan - all normal, no masses, polyps, blockages, or inflammation.

4. Routine stool test - all normal, no blood, no mucus, no pus.

5. Occult blood stool test - normal on two consecutive days.

6. Fecal calprotectin test - normal.

Medication (all with minimal relief):

1. Esomeprazole for GERD (gastroesophageal reflux disease).

2. Ten days of antibiotics.

3. Course of deworming.

4. Probiotics.

5. 5 mg Escitalopram for anxiety (I am currently on day 22).

Background:

For the last five months, on random days, and sometimes even throughout the day, I get an unrelenting feeling of nausea that is sometimes accompanied by dull stomach cramps (that are not deadly painful or anything, but are certainly uncomfortable) and a lot of bloating (I feel like a huge amount of gas is stuck in my system). However, is that I have never actually thrown up. It is only a severe feeling of nausea (as if the gas or food in my stomach is up in my throat) that I carry around with me through the day. I have also never had any fever or noticed any inconsistencies with my stool or stool patterns. A point to note though is that I am an extremely anxious person. The stomach discomfort gives me major anxiety, and I have even had three panic attacks.

Given that all my screening tests have been clear, two gastroenterologists have said all my GI (gastrointestinal) symptoms are anxiety-linked. However, I do not always feel stomach symptoms when I am anxious or stressed. On the flip side, I sometimes feel GI discomfort even when I am completely at ease.

Questions for the second opinion:

1. Could this all be entirely anxiety linked?

2. Is it possible to feel GI symptoms even when I am not anxious?

3. Do I not need a colonoscopy or endoscopy, given all my screening tests are clear?

3. Have I left any stone unturned?

Hi doctor,

Thank you for the reply,

I took these tests, including stool tests, two weeks ago during my good period (when I was not feeling symptoms). Now, as of the last three or four days, I have been uncomfortable again. Will the ultrasound, CT scan, and stool test results change in two weeks? I am feeling bloating and cramping.