Study finds significant uptick in chronic digestive disorders during COVID-19 pandemic

A study led by Cedars-Sinai investigators uncovered a significant uptick in chronic digestive disorders, like irritable bowel syndrome, during the COVID-19 pandemic. The study findings, published in the peer-reviewed journal Neurogastroenterology & Motility, highlight a potential link between pandemic-related stress on the gut-brain axis.

Using data from a national online study, we found that rates of digestive issues such as irritable bowel syndrome and chronic idiopathic constipation rose significantly. These findings underscore the significant toll the pandemic has taken on digestive health."

Christopher V. Almario, MD, MSHPM, lead author and gastroenterologist at Cedars-Sinai

Also known as disorders of gut-brain interaction, conditions like irritable bowel syndrome and chronic idiopathic constipation are common gastrointestinal disorders driven by complex interactions between the gut and nervous system.

Nearly 40% of people in the U.S. are estimated to meet diagnostic criteria for at least one disorders of gut-brain interaction, making these conditions a major source of healthcare burden and reduced quality of life.

"These disorders involve chronic gastrointestinal symptoms that are often triggered or worsened by psychological stress," said Almario.

To better understand how the viral infection might be linked with digestive health, researchers analyzed data from over 160,000 adults across the U.S. who participated in a national online survey conducted from May 2020 to May 2022.

Participants completed detailed questionnaires covering digestive symptoms, mental health and lifestyle changes. By tracking responses over time, the researchers observed a steady rise in gut-related health issues that began early in the pandemic and persisted throughout the survey period.

Key findings showed that:

• Rates of irritable bowel syndrome increased from around 6% among U.S. adults in May 2020 to about 11% in May 2022.
• Chronic idiopathic constipation rose slightly from 6.0% to 6.4%.
• Among adults who reported IBS, investigators noted that the prevalence of mixed IBS, a subtype of IBS where a person experiences both diarrhea and constipation, was most commonly reported. The investigators did not observe significant increases in other types of functional digestive disorders.

As doctors uncover the long-term health effects of COVID-19, study investigators hope this study may draw attention to how the virus' impact on mental health may affect the gut-potentially triggering or worsening disorders like IBS and other gut-brain conditions.

"This research calls for a renewed focus on gastrointestinal health in the post-pandemic era," said Brennan Spiegel, MD, MSHS, corresponding author of the study and director of Health Services Research for Cedars-Sinai.

Spiegel, director of the Cedars-Sinai Master's Degree Program in Health Delivery Science and the George and Dorothy Gourrich Chair in Digital Health Ethics, says even those who did not get COVID-19 but endured significant psychological distress also may have had alterations in their gut-brain axis.

"Healthcare providers must be vigilant in recognizing and addressing the long-term effects of the pandemic on digestive health," said Spiegel.