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. 2025 Mar 10:e70020.
doi: 10.1111/nmo.70020. Online ahead of print.

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

Christopher V Almario  1   2   3 , So Yung Choi  4 , William D Chey  5 , Brennan M R Spiegel  1   2   3
Affiliations

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

Christopher V Almario et al. Neurogastroenterol Motil. .

Abstract

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.

Keywords: COVID‐19 pandemic; disorders of gut‐brain interaction; prevalence.

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