Impact of nursing shift patterns on work-related gastrointestinal disorders: a systematic review and meta-analysis

Gastrointestinal diseases are highly prevalent worldwide and are linked to poorer quality of life and increased use of healthcare services. Nursing shift work may disrupt circadian rhythms and contribute to functional gastrointestinal disorders through chronodisruption, sleep impairment, stress, and lifestyle changes. This review aims to analyze the relationship between nursing shift work and the development of gastrointestinal disorders.

A systematic review and meta-analysis of different observational studies was conducted to evaluate associations between nurses' work shifts and gastrointestinal disorders. PROSPERO: CRD420251018324. An extensive search of the Databases (PubMed, Scopus, Web of Science, CINAHL) was carried out between April and May 2025 with no date restrictions applied. The studies included compared the frequency of gastrointestinal outcomes among >50% of practicing nurses working fixed day shifts or rotating shifts (including night work). Study quality was assessed using NOS (cohort/case-control) and JBI (cross-sectional). Risk of bias was evaluated with ROBINS-E. Odds ratios (OR) with 95% confidence intervals (CI) were pooled using fixed or random-effects models depending on heterogeneity.

Seventeen studies (data collection 1998-2023; publication 2003-2024) were included in the review, and 13 were incorporated into the meta-analysis. Most of the studies were cross-sectional and based in hospitals. Rotating shifts were associated with a significantly increased overall risk of gastrointestinal outcomes when compared to day shifts (OR = 1.15; 95% CI: 1.02-1.30; p = 0.02), with moderate heterogeneity (I² = 53%). Subgroup analyses showed significant and robust associations for irritable bowel syndrome (OR = 1.74; 95% CI: 1.27-2.37; I² = 0%) and diarrhea (OR = 2.41; 95% CI: 1.01-5.75; I² = 0%). No significant associations were identified for colorectal cancer or inflammatory bowel disease. Most studies had low risk of bias, although outcome reporting and confounding were frequent concerns.

Rotating shift work among nurses, particularly schedules including night shifts, is associated with a higher risk of gastrointestinal disorders, notably IBS and diarrhea. These findings support the need for occupational health strategies targeting chronodisruption, sleep quality, stress, and healthy lifestyle behaviors in shift-working nurses. They call for improved monitoring of gastrointestinal symptoms and further longitudinal research to identify long-term disease risks.

https://www.crd.york.ac.uk/PROSPERO/view/CRD420251018324, identifier: CRD420251018324.