Stress, Diet, and Sleep Shape Irritable-Bowel-Syndrome-Specific Symptoms: The Lockdown "Cocoon Effect"

Area of Science:

• Gastroenterology
• Epidemiology
• Public Health

Background:

• Irritable bowel syndrome (IBS) is a prevalent gastrointestinal disorder affecting ~10% of the population, characterized by abdominal pain and altered bowel habits.
• Its pathophysiology involves a complex interplay of environmental and patient-related factors.
• The COVID-19 pandemic induced widespread lifestyle changes, prompting an investigation into their impact on IBS.

Purpose of the Study:

• To analyze the influence of pandemic-related lifestyle shifts and multidimensional stress on IBS manifestations.
• To identify environmental factors associated with the occurrence and resolution of IBS symptoms.

Main Methods:

• An online survey was conducted during the 2020 COVID-19 lockdown among 2735 participants.
• The survey collected data on socio-demographics, lifestyle (diet, alcohol, smoking, physical activity, sleep, work), stress levels, and IBS symptoms (Rome IV criteria) pre-pandemic and during lockdown.
• Multivariate analyses assessed the association between environmental variables and IBS symptom changes.

Main Results:

• Symptom improvement was reported by 46.2% of IBS patients; 4.8% developed new IBS symptoms.
• IBS resolution was linked to reduced stress, increased fiber intake, and more sleep.
• Risk factors for IBS occurrence included reduced physical activity, increased anti-inflammatory effects, anxiolytic use, and work-related stress. Reduced alcohol consumption was protective.

Conclusions:

• The pandemic-induced lifestyle changes created a "Cocoon Effect," beneficially impacting nearly half of IBS patients.
• Environmental factors, particularly stress, diet, sleep, and alcohol consumption, are crucial modifiable drivers in IBS pathophysiology.
• These findings underscore the significant role of lifestyle modifications in managing IBS symptoms.