Racial and Ethnic Disparities in Pandemic-Onset Disorders of Gut-Brain Interaction: Results From a Nationwide Survey

During the COVID-19 pandemic, the prevalence of disorders of gut-brain interaction (DGBI) in the US increased. The pandemic also led to health inequities among racial and ethnic minorities. Here, we conducted monthly national surveys during the pandemic to examine the association between race/ethnicity and pandemic-onset DGBI.

From March 2021 to May 2022, we recruited a nationally representative sample of adults in the US to complete an online survey with Rome IV questionnaires (9 gastroduodenal and bowel DGBI) along with demographic and comorbidity questions. Participants with a DGBI were asked whether their cardinal symptoms started before or after the COVID-19 pandemic began in the US (March 2020). Our primary outcome was the prevalence of pandemic-onset DGBI. Multivariable logistic regression models identified factors associated with pandemic-onset DGBI. We also tested for an interaction between race/ethnicity and COVID-19 positivity to assess whether the relationship between pandemic-onset DGBI and race/ethnicity varied by COVID-19 status.

Among 71,547 respondents, 26,103 (36.5%) had ≥ 1 DGBI. Across most DGBI, non-Hispanic Blacks and Hispanics had higher odds for pandemic-onset DGBI (e.g., irritable bowel syndrome, functional dyspepsia, functional bloating) versus non-Hispanic Whites. When including interaction terms between race/ethnicity and COVID-19 positivity, most were not significant (p > 0.05), showing that the relationship between pandemic-onset DGBIs and race/ethnicity did not vary by COVID-19 status.

In this US survey, racial/ethnic minorities had higher odds of reporting pandemic-onset DGBI. This association was independent of COVID-19 positivity, suggesting that differences in pandemic-onset DGBI among groups may be related to psychosocial challenges faced by racial/ethnic minorities rather than direct effects of SARS-CoV-2.