Impacts of the COVID-19 pandemic on functional dyspepsia and irritable bowel syndrome: A population-based survey

J Gastroenterol Hepatol. 2021 Jul;36(7):1820-1827. doi: 10.1111/jgh.15346. Epub 2020 Dec 1.

Abstract

Background and aim: Functional gastrointestinal disorders are a group of stress-sensitive gut-brain disorders. The COVID-19 outbreak has caused immense stress and anxiety among the general public. Strict measures to counter COVID-19 emergency, including physical distancing, have also taken a toll on physical and mental health. We investigated the impact of the COVID-19 pandemic on the gastrointestinal and psychological symptoms of functional dyspepsia (FD) and irritable bowel syndrome (IBS).

Methods: An online survey was conducted in Japan for a group of randomly assigned panelists from May 26 to 27, 2020. Each respondent answered a questionnaire on stress, physical distancing, and worries about COVID-19. Gastrointestinal symptoms were assessed to diagnose FD and IBS (Rome III), and psychological symptoms were assessed using the Hospital Anxiety and Depression Scale.

Results: A total of 5157 subjects were finally enrolled, with FD in 8.5%, IBS in 16.6%, and FD-IBS overlap in 4.0%. For both gastrointestinal and psychological symptoms, respondents with FD-IBS overlap showed the worst scores, followed by IBS-alone, then FD-alone respondents. During the COVID-19 pandemic, 11.9% of respondents reported deterioration and 2.8% reported improvement of gastrointestinal symptoms. FD-IBS overlap, psychological disease comorbidity, and stress at work/school were significantly associated with symptom deterioration. Younger age, commuting by public transport, and work/study from home were associated with symptom improvement.

Conclusions: The COVID-19 pandemic negatively affected FD/IBS subjects, with respondents showing FD-IBS overlap syndrome as the most important independent factor associated with deterioration in gastrointestinal symptoms. Physicians need to take extra care of FD/IBS patients in the post-COVID period.

Keywords: COVID-19; Functional dyspepsia; Functional gastrointestinal disorders; Irritable bowel syndrome; Psychological disease; SARS-CoV-2.

MeSH terms

  • Adult
  • Aged
  • Anxiety / diagnosis
  • Anxiety / epidemiology
  • Anxiety / etiology*
  • Anxiety / physiopathology
  • COVID-19 / epidemiology
  • COVID-19 / prevention & control
  • COVID-19 / psychology*
  • Cross-Sectional Studies
  • Depression / diagnosis
  • Depression / epidemiology
  • Depression / etiology*
  • Depression / physiopathology
  • Dyspepsia / diagnosis
  • Dyspepsia / epidemiology
  • Dyspepsia / etiology*
  • Dyspepsia / psychology
  • Female
  • Health Policy
  • Health Surveys
  • Humans
  • Irritable Bowel Syndrome / diagnosis
  • Irritable Bowel Syndrome / epidemiology
  • Irritable Bowel Syndrome / etiology*
  • Irritable Bowel Syndrome / psychology
  • Japan / epidemiology
  • Logistic Models
  • Male
  • Middle Aged
  • Pandemics
  • Prevalence
  • Psychological Tests
  • Risk Factors
  • Self Report
  • Severity of Illness Index
  • Stress, Psychological / diagnosis
  • Stress, Psychological / epidemiology
  • Stress, Psychological / etiology*
  • Stress, Psychological / physiopathology