DGBI Burden, Prevalence Increased After COVID-19 Pandemic, Study Finds

New research is shedding light on notable increases in the prevalence and burden of disorders of gut-brain interaction (DGBI) in the post-COVID-19 pandemic era compared with pre-pandemic levels.^1,2

Findings from the 2-country population-based survey offer the first direct, population-level comparison of the prevalence of DGBI before and after the COVID-19 pandemic and shed light on COVID-19’s long-term impact on both GI and mental health.^1,2

“COVID-19 infection may increase the risk of developing DGBI. However, the extent of this effect on a population level is poorly understood,” first author Olafur Palsson, PsyD, Emeritus Professor of Medicine at UNC School of Medicine, and colleagues wrote.¹

To address this gap in research, investigators assessed data from 2 population-based surveys conducted in the pre- and post-pandemic periods. In 2017, the Rome Foundation Global Epidemiological Survey (RFGES) determined the prevalence and burden of DGBI using a nationally representative general population sample of adults in 26 countries. In 2023, investigators resampled about 2000 people each from the general populations of the UK and USA using the same demographic quotas as the RFGES, but also adding COVID-related questions.¹

Investigators noted this provided them with similar 2-country survey samples collected with identical methodology at 2 different time points, with different participants on both occasions, which enabled them to compare the prevalence and burden of DGBI before and after the COVID-19 pandemic.¹

A total of 4050 individuals from the UK (n = 2027) and USA (n = 2023) completed the survey in the year 2017, while a total of 4002 individuals from the UK (n = 2002) and the USA (n = 2000) completed the survey in the year 2023. Investigators noted the sex and age group distributions of participants were almost identical between the 2017 and 2023 survey samples due to quota-based sampling.¹

Of the 4002 individuals who comprised the post-pandemic cohort, 1974 (49.3%) reported having been diagnosed with COVID-19; most of these had COVID once (n = 1276), with 520 having had COVID twice, and 157 ≥ 3 times.¹

The overall DGBI prevalence, defined as meeting diagnostic criteria for ≥ 1 DGBI, significantly increased from the pre- to post- pandemic era (38.3% vs 42.6%; odds ratio [OR], 1.20; 95% CI, 1.09-1.31), with similar findings independently noted in the UK and USA. Specifically, the rise in DGBI was observed within the esophageal (8.8% vs 10.1%; OR, 1.16) gastroduodenal (11.9% vs 16.4%; OR, 1.45), and bowel domains (30.1% vs 32.5%; OR, 1.12).¹

Investigators noted the 2 most widely investigated DGBI showed large post-pandemic prevalence increases, with functional dyspepsia rising from 8.3% to 11.9% (OR, 1.48) and irritable bowel syndrome from 4.7% to 6.0% (OR, 1.31).¹

Individuals with DGBI in the post-pandemic era, in particular those with long-COVID, reported reduced quality of life and higher mood disturbances, somatic symptom reporting and healthcare use than individuals with DGBI in the pre-pandemic era.¹

On binary multivariable regression analysis, factors independently associated with having any DGBI in the post-pandemic era included younger age (OR, 1.01; 95% CI, 1.00-1.02), female sex (OR, 1.51; 95% CI, 1.24-1.84), anxiety (OR, 1.33; 95% CI, 1.00-1.77), depression (OR, 1.48; 95% CI, 1.11-1.97), medium-to-high somatic symptoms (OR, 2.24; 95% CI, 1.78-2.81) increasing number of COVID-19 infections (OR, 1.21; 95% CI, 1.04-1.42), experiencing abdominal pain (OR, 1.56; 95% CI, 1.17-2.07), or diarrhea (OR, 1.31; 95% CI, 1.00-1.71) during an acute COVID-19 infection, and long-COVID (OR, 1.38; 95% CI, 1.04-1.83).¹

“In summary, this two-country population-based survey shows that there has been a rise in the prevalence and burden of DGBI following the COVID-19 pandemic,” investigators concluded.¹ “Healthcare services and research funding bodies should prepare for the increase in post-COVID and long-COVID with DGBI, and address optimal management for this patient group.”

References

1. Palsson O, Simren M, Sperber A, et al. The Prevalence and Burden of Disorders of Gut-Brain Interaction (DGBI) before versus after the COVID-19 Pandemic. Clinical Gastroenterology and Hepatology. doi:10.1016/j.cgh.2025.07.012

2. American Gastroenterological Association. Study confirms post-pandemic surge in gut-brain disorders. July 30, 2025. Accessed July 31, 2025. https://gastro.org/news/study-confirms-post-pandemic-surge-in-gut-brain-disorders/