A significant increase in disorders of gut-brain interaction (DGBI) has been observed in the post-COVID-19 pandemic era, with overall prevalence rising from 38.3% to 42.6%.
This research offers the first direct, population-level comparison of DGBI rates before and after the pandemic, highlighting its lasting impact on gastrointestinal and mental health.
“COVID-19 infection may increase the risk of developing DGBI,” researchers noted. “However, the extent of this effect on a population level is poorly understood.”
To investigate this, data from two large population-based surveys were analyzed. In 2017, the Rome Foundation Global Epidemiological Survey (RFGES) collected data on DGBI prevalence across 26 countries. In 2023, similar surveys were conducted in the UK and USA, with updated questions about COVID-19, using identical demographic quotas to ensure comparability.
The 2017 survey included 4,050 individuals from the UK (n=2027) and USA (n=2023). The 2023 survey comprised 4,002 individuals from the UK (n=2002) and USA (n=2000). Participant sex and age distributions were nearly identical between the two survey periods due to quota-based sampling.
Of the 4,002 individuals surveyed in 2023, 1,974 (49.3%) reported having been diagnosed with COVID-19, with many experiencing it multiple times.
Olafur Palsson, PsyD
Credit: Olafur Palsson on LinkedIn
The overall prevalence of DGBI, defined as meeting diagnostic criteria for at least one condition, significantly increased from 38.3% pre-pandemic to 42.6% post-pandemic (odds ratio [OR], 1.20). This rise was observed in both the UK and USA.
Specific domains also saw increases: esophageal DGBI rose from 8.8% to 10.1% (OR, 1.16), gastroduodenal DGBI from 11.9% to 16.4% (OR, 1.45), and bowel DGBI from 30.1% to 32.5% (OR, 1.12).
Among the most studied DGBIs, functional dyspepsia increased from 8.3% to 11.9% (OR, 1.48), and irritable bowel syndrome rose from 4.7% to 6.0% (OR, 1.31).
Individuals with DGBI in the post-pandemic period, particularly those with long COVID, reported a reduced quality of life, more mood disturbances, increased somatic symptom reporting, and higher healthcare utilization compared to those with DGBI before the pandemic.
Factors independently linked to having any DGBI in the post-pandemic era included younger age (OR, 1.01), female sex (OR, 1.51), anxiety (OR, 1.33), depression (OR, 1.48), medium-to-high somatic symptoms (OR, 2.24), a higher number of COVID-19 infections (OR, 1.21), experiencing abdominal pain (OR, 1.56) or diarrhea (OR, 1.31) during acute COVID-19 infection, and having long COVID (OR, 1.38).
“In summary, this two-country population-based survey shows that there has been a rise in the prevalence and burden of DGBI following the COVID-19 pandemic,” the researchers concluded. They urged healthcare services and research funding bodies to prepare for the increase in post-COVID and long-COVID patients with DGBI and to focus on optimal management strategies for this group.
