The Association Between Childhood Maltreatment and Adult Intestinal Disorders: A Three-Level Meta-Analysis

Over recent decades, research has steadily accumulated evidence on the relationship between childhood maltreatment (CM) and adult intestinal disorders, yet the findings remain inconsistent across studies. To address this, a three-level meta-analysis was conducted to quantitatively synthesize existing data, assessing both the overall association and its specificity across disease subtypes and maltreatment types. A comprehensive literature search identified 22 studies (comprising 498,709 participants and 75 effect sizes) from PubMed, Embase, Web of Science, Scopus, ScienceDirect, and PsycINFO databases up to April 2026. Pooled results revealed a significant positive association between CM and the risk of adult intestinal disorders (OR = 1.53, 95% CI [1.35, 1.74]). Notably, this association exhibited substantial specificity: irritable bowel syndrome was consistently linked with nearly all maltreatment types (OR range: 1.44-1.91), while functional dyspepsia showed no statistically significant association. Inflammatory bowel disease is not significantly associated with childhood abuse. Neither Crohn's disease nor ulcerative colitis showed a significant association with any form of abuse. Sensitivity analyses affirmed the robustness of effect sizes, with no significant publication bias detected. This three-level meta-analysis highlights CM as a notable risk factor for specific adult intestinal disorders, highlighting the need to integrate early-life adversity into etiological models and trauma-informed clinical care for intestinal conditions.