Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan.
Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
J Gastroenterol Hepatol. 2021 Jul;36(7):1820-1827. doi: 10.1111/jgh.15346. Epub 2020 Dec 1.
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.
背景与目的:功能性胃肠疾病是一组应激敏感的肠脑疾病。COVID-19 疫情在公众中造成了巨大的压力和焦虑。为应对 COVID-19 紧急情况而采取的严格措施,包括身体距离,也对身心健康造成了影响。我们调查了 COVID-19 大流行对功能性消化不良(FD)和肠易激综合征(IBS)患者胃肠道和心理症状的影响。
方法:2020 年 5 月 26 日至 27 日,我们在日本对一组随机分配的小组参与者进行了在线调查。每位受访者都回答了一份关于压力、身体距离和对 COVID-19 担忧的问卷。通过罗马 III 标准诊断 FD 和 IBS,使用医院焦虑和抑郁量表评估胃肠道症状和心理症状。
结果:共纳入 5157 名受试者,其中 FD 占 8.5%,IBS 占 16.6%,FD-IBS 重叠占 4.0%。对于胃肠道和心理症状,FD-IBS 重叠组的得分最差,其次是 IBS 组,然后是 FD 组。在 COVID-19 大流行期间,11.9%的受访者报告胃肠道症状恶化,2.8%报告症状改善。FD-IBS 重叠、心理疾病合并症和工作/学校压力与症状恶化显著相关。年轻、乘坐公共交通工具通勤和在家工作/学习与症状改善相关。
结论:COVID-19 大流行对 FD/IBS 患者产生了负面影响,受访者表现出 FD-IBS 重叠综合征是与胃肠道症状恶化相关的最重要的独立因素。医生在 COVID-19 后时期需要特别关注 FD/IBS 患者。
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