Trends in Prevalence of Rome IV Disorders of Gut-Brain Interaction During the COVID-19 Pandemic: Results From a Nationally Representative Sample of Over 160,000 People in the US.

Background: We hypothesized that disorders of gut-brain interaction (DGBI) increased during the pandemic due to the enteropathic nature of SARS-CoV-2, together with the potential for COVID-19 pandemic-related stress to negatively impact the gut-brain axis. To test our hypothesis, we conducted a series of pre-specified cross-sectional surveys initiated at the beginning of the pandemic to trend the prevalence of Rome IV DGBI over time among a nationally representative sample of more than 160,000 people in the US.

Methods: From May 2020 to May 2022, we performed a series of cross-sectional online surveys among a representative sample of adults ≥ 18 years old in the US. We administered Rome IV gastroduodenal and bowel DGBI questionnaires (e.g., chronic idiopathic constipation [CIC], functional bloating, functional dyspepsia, irritable bowel syndrome [IBS]) along with sociodemographic and comorbidity questions. Multivariable logistic regression was used to adjust for time and potential confounders.

Results: Overall, 160,154 people completed the surveys. During the COVID-19 pandemic, the prevalence of IBS (6.1% [May 2020] to 11.0% [May 2022]; +0.188%/month; adjusted p < 0.001) and CIC (6.0% [May 2020] to 6.4% [May 2022]; +0.056%/month; adjusted p < 0.001) increased over time. Among those with IBS, the largest prevalence increase was seen in mixed IBS (+0.085%/month), followed by IBS with constipation (+0.041%/month) and IBS with diarrhea (+0.037%/month). No changes in prevalence were seen for the other examined gastroduodenal and bowel DGBI.

Conclusions: During the COVID-19 pandemic, we observed significant increases over time in the prevalence of IBS and CIC. Further research exploring pathophysiologic mechanisms underlying these findings and whether these trends persist beyond the pandemic is warranted.