What Is Benzo Belly?

What are benzos?

Benzodiazepines, popularly known as benzos, are a class of depressant drugs prescribed to treat anxiety, insomnia, seizures, and alcohol withdrawal. Commonly used benzodiazepines include:^[1]

• alprazolam (Xanax)
• diazepam (Valium)
• clonazepam (Klonopin)
• lorazepam (Ativan)

Because they cause relaxation and euphoria, benzodiazepines are liable to be abused, with people taking them for longer than prescribed and at higher doses. They may procure prescriptions from separate doctors or obtain them on the black market, where pills purporting to be benzodiazepines may be impure and cut with other substances.

In recent years, careful doctors have become more reluctant to prescribe benzodiazepines for anything but short-term, acute use (two to four weeks, maximum), over concerns about addiction and physical dependence.

What are the symptoms of benzodiazepine withdrawal?

Benzodiazepines create physical dependence in as little as four weeks. Benzodiazepines are among the most difficult drugs to stop taking, causing a cluster of unpleasant and dangerous withdrawal symptoms, some of which may last for months or even years.

Withdrawal symptoms start in two to three days with short-acting benzodiazepines such as brotizolam (Lendormin), midazolam (Versed), and triazolam (Halcion). Withdrawals on longer-acting benzos such as Valium may not emerge for five to ten days.^[2]

Withdrawal symptoms may accompany even gradual tapers and dose reductions. These include:^[3]

• insomnia
• headache
• heart palpitations
• elevated blood pressure
• sweating
• tremors and muscle twitches
• muscle tension, pain, and stiffness
• rebound anxiety, agitation, and panic attacks
• indigestion
• diarrhea
• paranoia
• tinnitus
• confusion
• paranoia
• Photophobia
• dysesthesias (abnormal sensations, such as pain, prickling, or aching) 
• shortness of breath 
• depression

Rapid discontinuation can cause:^[2]

• confusion
• psychosis
• seizures
• catatonia
• death

Some of these withdrawal symptoms can last for months or even years. These symptoms are referred to as post-acute withdrawal syndrome (PAWS). 

What is benzo belly?

Benzo belly is a colloquial term for the gastrointestinal symptoms of benzo withdrawal. These may include:

• stomach and lower abdominal pain
• bloating, sometimes so severe people describe themselves as looking pregnant
• excessive gas, causing burping and flatulence 
• diarrhea
• constipation
• appetite changes

Symptoms may be aggravated by certain foods and patients are often convinced they have food allergies, despite negative testing. They may be diagnosed with irritable bowel syndrome (IBS).

Scientists aren’t sure why withdrawal from benzodiazepines can cause gastrointestinal problems but it likely has something to do with the disruption of the gut-brain axis, the two-way signaling between the central nervous system and the GI tract. Bacteria in the gut have also been found to release GABA, the neurotransmitter targeted by benzos.^[4]

Is there a cure for benzo belly?

There is no cure for bento belly. The gastrointestinal symptoms of benzodiazepine withdrawal usually gradually recede but in some cases last for more than a year or may persist indefinitely.^[5]

A gradual tapering of the benzodiazepine dose—often over months—can limit the severity of gastrointestinal symptoms and other markers of post-acute withdrawal syndrome (PAWS).

If you’re experiencing benzodiazepine withdrawal, you can reduce your discomfort by:

• Eating small, light meals, avoiding anything too rich, spicy, or acidic.
• Keep a food diary, tracking which foods worsen your symptoms.
• Taking probiotics, which replenish gut bacteria. They’re found in fermented foods like yogurt or can be taken as supplements.
• Taking medication for excessive gas and bloating, such as antacids or activated charcoal.

Sometimes GI problems can be a sign of more serious illness such as cancer or Crohn’s disease and should be investigated, especially if you see blood in your stool.