ABSTRACT
INTRODUCTION: Irritable bowel syndrome (IBS) is a functional disorder with high prevalenceimpacting on patient’s quality of life. IBS is considered a multifactorial entity, in whichsocioemotional factors and social stress might play a central role in the generation andworsening of symptoms. The mandatory lockdown in response to SARS CoV-2 pandemic,represents a unique scenario of reduced social interaction and complexity, potentially impactingthe IBS-patients’ symptoms evolution. OBJECTIVE: To evaluate the impact of the mandatorylockdown due to the SARS CoV-2 pandemic on the brain-gut axis symptomatology inIBS patients. MATERIAL AND METHODS: All IBS-diarrhea and mixed bowel habits patternsubtype patients, from an existing Rome IV-defined cohort database, were invited to participate(n = 129, mean age 54 [+/-16], 78% female). Patients were assessed via an onlinesurvey or phone interview. The survey included Irritable Bowel Syndrome Severity Scale(IBS-SS), Likert scale, as well as measures of Bristol scale, anxiety and depression andsomatization. Further, patients were asked about comorbidities (pyrosis and/or regurgitation,dyspepsia, chronic fatigue, fibromyalgia, non-migraine headache, weight and eating habits).Most of this data was compared with pre-pandemic existing data. RESULTS: During lockdown,there was a significant decrease in severe IBS patients’ proportion (50.39 % vs 30%, p=0.000) compared to the pre pandemic state. Before pandemic, this cohort of patientshad a mean IBS-SS of 278.54 (+/- 88.64) compared to 212.36 (+/-117.50) during lockdown(difference -65.9 [95% CI: -89.4 to – 42.4];p = 0.000). Likewise, there was a decrease ofone average point on the Likert Scale on global IBS symptoms, pain, and distension, as wellas an improvement in stool consistency (2-point average decrease on Bristol Scale). Similarly,anxiety and somatization scores were improved and there was a significant decrease infibromyalgia and chronic fatigue symptoms during lockdown (in comparison with prepandemictimes). Conversely, headache and pyrosis and/or regurgitation symptoms increasedsignificantly. These effects remained when adjusted for confounders (age, sex, anxiety, anddepression), evidencing that the mandatory lockdown represented an independent protectivefactor for severe IBS-symptoms (OR 0.39, 95% CI 0.18-0.87;p=0.02). CONCLUSION: Incomparison with a pre-pandemic period, there was a significant improvement in IBS-severitysymptoms, anxiety and somatization during the SARS CoV-2 pandemic and mandatorylockdown. Lesser exposure to external stress burden during lockdown could have beeninvolved in a better control of affecting gut-brain axis factors.(Table Presented)(Image Presented)