Key Questions Answered
Q: What are disorders of gut-brain interaction (DGBIs)?
A: Disorders of gut-brain interaction (DGBIs) are chronic conditions — including irritable bowel syndrome (IBS) and functional dyspepsia — in which communication between the gut and the brain is disrupted. They produce persistent gastrointestinal symptoms without clear structural or biochemical causes.
Q: How much did these disorders increase after the pandemic?
A: The study reports an overall rise from 38.3% to 42.6% in DGBI prevalence between 2017 and 2023, with IBS increasing by 28% and functional dyspepsia increasing by nearly 44%.
Q: Is there a link between long COVID and these gut-brain disorders?
A: Yes. People reporting long COVID were substantially more likely to meet diagnostic criteria for DGBIs and also reported greater anxiety, depression, and reduced quality of life.
Q: Why does this study matter?
A: This is the first population-level comparison using the same diagnostic tools before and after the COVID-19 pandemic, making it a pivotal source for understanding how the pandemic has affected gut-brain health and highlighting the need for updated clinical strategies.
Summary: An international, population-based analysis shows a meaningful increase in disorders of gut-brain interaction since the start of the COVID-19 pandemic. Using standardized Rome Foundation diagnostic questionnaires in representative samples from 2017 and 2023, researchers documented notable rises in both irritable bowel syndrome (IBS) and functional dyspepsia. The study also links long COVID to higher DGBI prevalence and worse mental health and quality-of-life outcomes. These results emphasize the demand for improved care models and further research into the gut-brain axis in the post-pandemic era.
Key Facts:
- Post-Pandemic Surge: Disorders of gut-brain interaction increased from 38.3% to 42.6% between 2017 and 2023.
- IBS & Dyspepsia Rise: Irritable bowel syndrome rose by 28% (from 4.7% to 6.0%); functional dyspepsia rose by nearly 44% (from 8.3% to 11.9%).
- Long COVID Association: People with long COVID were more likely to have DGBIs and reported greater symptom burden, mood disturbances, and lower quality of life.
Source: American Gastroenterological Association
A new international study published in Clinical Gastroenterology and Hepatology confirms a significant post-pandemic rise in disorders of gut-brain interaction. Researchers compared nationally representative samples from the United Kingdom and the United States using consistent Rome Foundation diagnostic tools in 2017 (pre-pandemic) and 2023 (post-pandemic), offering the first direct, population-level before-and-after assessment.
Study overview and implications
The investigators conducted internet-based, population-level surveys in both countries with pre-defined demographic quotas to match national profiles. Each survey included the Rome IV diagnostic questionnaire to identify DGBIs and collected data on non-gastrointestinal somatic symptoms, anxiety and depression scores, quality of life measures, and health-care utilization. The 2023 survey also gathered detailed COVID-19 illness history, including infection counts, acute gastrointestinal symptoms during COVID-19, vaccination status, and whether participants experienced long COVID.
Key results showed a statistically significant increase in overall DGBI prevalence from 38.3% to 42.6% (odds ratio 1.20). Domain-specific rises were observed across esophageal, gastroduodenal, and bowel disorders. Functional dyspepsia rose from 8.3% to 11.9% (odds ratio 1.48), while irritable bowel syndrome increased from 4.7% to 6.0% (odds ratio 1.31). People reporting long COVID had higher rates of DGBI, worse anxiety and depression scores, more somatic symptoms, reduced quality of life, and greater health-care use compared with pre-pandemic cases.
Factors associated with post-pandemic DGBI
- More COVID-19 infections correlated with higher odds of DGBI (OR 1.31).
- Experiencing abdominal pain (OR 2.06) or diarrhea (OR 1.33) during COVID-19 illness was linked to later DGBI diagnosis.
- Suffering from long COVID increased the likelihood of DGBI (OR 1.65).
- Not being vaccinated was associated with greater DGBI prevalence (OR 1.35).
What this means for clinicians and policymakers
The demonstrated rise in DGBI prevalence and burden after the pandemic highlights a growing public-health and clinical challenge. Health systems should anticipate increased demand for gastroenterology and integrated care that addresses both gastrointestinal symptoms and mental health. Researchers and funding agencies are urged to prioritize studies of the gut-brain axis, the mechanisms linking viral illness to chronic gut-brain disorders, and effective post-COVID management strategies.
Abstract
The Prevalence and Burden of Disorders of Gut-Brain Interaction (DGBI) before versus after the COVID-19 Pandemic
Background & Aims
COVID-19 infection may increase the risk of developing disorders of gut-brain interaction, but the population-level impact and the direct relationship to COVID-19 illness have been unclear. This study used a two-country survey approach to evaluate changes in DGBI prevalence and burden before and after the pandemic.
Methods
Population-based internet surveys with demographic quotas were performed in the UK and USA in 2017 (n=4050) and repeated in 2023 (n=4002). Surveys used the Rome IV diagnostic questionnaire and included measures of somatic symptoms, anxiety, depression, quality of life, and health-care utilization. The 2023 survey incorporated COVID-19 infection and illness history.
Results
Overall DGBI prevalence increased significantly from 38.3% to 42.6% (OR 1.20), with similar patterns in both countries. Domain increases occurred in esophageal, gastroduodenal, and bowel disorders. Functional dyspepsia rose from 8.3% to 11.9% (OR 1.48) and IBS from 4.7% to 6.0% (OR 1.31). Post-pandemic DGBI cases, particularly those with long COVID, reported worse quality of life, higher mood disturbances, more somatic symptoms, and increased health-care use.
Multivariable analysis identified COVID-related factors associated with post-pandemic DGBI: greater number of infections, experiencing abdominal pain or diarrhea during infection, long-COVID, and lack of vaccination.
Conclusion
The prevalence and burden of disorders of gut-brain interaction have risen following the COVID-19 pandemic. Health-care systems and research funders should respond to this post-COVID increase in DGBI by adapting care delivery and prioritizing research to determine the best management strategies.
About this COVID-19 and gut-brain axis research news
Author: Annie Mehl
Source: American Gastroenterological Association
Contact: Annie Mehl – American Gastroenterological Association
Image: The image is credited to Neuroscience News
Original Research: Open access. “The Prevalence and Burden of Disorders of Gut-Brain Interaction (DGBI) before versus after the COVID-19 Pandemic” by Imran Aziz et al., Clinical Gastroenterology and Hepatology.