Auswirkungen der COVID-Pandemie auf die Besorgtheit von Patient:innen mit funktionellen gastrointestinalen Symptomen

Zusammenfassung

Funktionelle gastrointestinale Erkrankungen wie das Reizmagen- (funktionelle Dyspepsie, FD) und das Reizdarmsyndrom (RDS) sind stressassoziiert. Die seit 2020 grassierende COVID-19-Pandemie hat Ängste und Stress in der Bevölkerung ausgelöst. Distanzierende Maßnahmen zur Bekämpfung der Pandemie beeinflussen die psychische Gesundheit. Das Ziel dieser Studie war die Untersuchung der Auswirkungen des dritten Lockdowns 12/2020–01/2021 auf die Besorgtheit von Patient:innen mit FD oder RDS.

Patient:innen mit der Diagnose FD oder RDS, die im Jahr 2020 in einer universitären Ambulanz oder in einem Krankenhaus der Regelversorgung im Süden Baden-Württembergs behandelt wurden, nahmen freiwillig an einer anonymen Online-Umfrage zu Begleiterkrankungen, Besorgtheit um COVID-19 und Stresserleben teil.

106 Patient:innen (♀=67, ♂=38, 1 divers) nahmen an der Umfrage teil. Davon hatten 16 FD (♀=9, ♂=6, divers=1), 80 RDS (♀=52, ♂=28) und 10 beides (♀=6, ♂=4). Depressive und Angsterkrankungen waren die häufigsten Komorbiditäten in der FD- (jeweils 25%) und RDS-Gruppe (jeweils 20%). Im Vergleich von Teilnehmenden mit FD und RDS zeigten jene mit RDS signifikant höhere Werte für eine Zunahme der Magen- und Darmbeschwerden während der Pandemie (p=0,007), eine häufigere Vorstellung beim Arzt während der Pandemie, einen stärkeren sozialen Rückzug aufgrund gastrointestinaler Symptome (p=0,05) und höhere Werte für die Befürchtung, dass eine Impfung gegen COVID-19 die Magen- und Darmbeschwerden ungünstig beeinflussen könnte (p=0,05).

In Zeiten der Pandemie scheint eine interdisziplinäre Zusammenarbeit in der Versorgung von Patient:innen mit FD oder RDS mehr denn je vonnöten, um Besorgnisse zu adressieren und eine gute Behandlung anzubieten.

Abstract

Functional gastrointestinal disorders such as functional dyspepsia (FD) and irritable bowel syndrome (IBS) are stress-associated. The COVID-19 pandemic, which has been rampant since 2020, has caused anxiety and stress in the population. Distancing measures to combat the pandemic have affected mental health. Our objective was to examine the impact of the 3rd lockdown in Germany in December 2020 and January 2021 on the apprehension of patients with FD and IBS.

Patients diagnosed with FD or IBS treated in a tertiary or primary care hospital in the South of Baden-Württemberg in 2020 voluntarily participated in an anonymous online survey. Questions about concomitant diseases, concern about COVID-19 and stress perception were answered.

A total of 106 patients (♀=67, ♂=38, 1 diverse) participated in the survey. Of these, 16 had FD (♀=9, ♂=6, diverse=1), 80 had IBS (♀=52, ♂=28), and 10 had both (♀=6, ♂=4). The average age was 43.6 years. Depressive and anxiety disorders were most frequently reported comorbidities in both the FD (25% each) and IBS group (20% each), followed by joint wear and tear (FD: 13%, RDS: 14%). In a direct comparison of participants with FD and IBS, those with IBS showed significantly higher scores for an increase in gastrointestinal (GI) symptoms during the pandemic (p=0.007), more frequent presentation to a physician during the pandemic, and greater social withdrawal due to GI symptoms (p=0.05). In direct comparison, those with IBS showed higher scores for fear that vaccination against COVID-19 would adversely affect GI symptoms compared to FD (p=0.05).

In times of the pandemic, interdisciplinary collaboration in the care of patients with FD or IBS seems more necessary than ever to address concerns and provide good patient care.

Schlüsselwörter

Reizdarmsyndrom - Reizmagensyndrom - funktionelle Dyspepsie - Angsterkrankung - Depression - Lockdown

Keywords

IBS - functional dyspepsia - physical distancing - anxiety - depression - lockdown

Publication History

Received: 29 October 2021

Accepted: 21 January 2022

Article published online:
17 February 2022

• Literatur

• 1 Drossman DA, Hasler WL. Rome IV-Functional GI Disorders: Disorders of Gut-Brain Interaction. Gastroenterology 2016; 150: 1257-1261 DOI: 10.1053/j.gastro.2016.03.035. (PMID: 27147121)
• 2 Enck P, Aziz Q, Barbara G. et al. Irritable bowel syndrome. Nat Rev Dis Primers 2016; 2: 16014 DOI: 10.1038/nrdp.2016.14. (PMID: 27159638)
• 3 Weibert E, Stengel A. The Role of Psychotherapy in the Treatment of Irritable Bowel Syndrome. Psychother Psychosom Med Psychol 2019; 69: 360-371 DOI: 10.1055/a-0829-6990. (PMID: 30731513)
• 4 Layer P, Andresen V, Allescher H. et al. Update S3-Leitlinie Reizdarmsyndrom: Definition, Pathophysiologie, Diagnostik und Therapie des Reizdarmsyndroms der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) und der Deutschen Gesellschaft für Neurogastroenterologie und Motilität (DGNM). AWMF 2021. In: . 1-253
• 5 Drossman DA, Talley NJ, Leserman J. et al. Sexual and physical abuse and gastrointestinal illness. Review and recommendations. Ann Intern Med 1995; 123: 782-794 DOI: 10.7326/0003-4819-123-10-199511150-00007. (PMID: 7574197)
• 6 Oshima T, Fukui H, Watari J. et al. Childhood abuse history is associated with the development of dyspepsia: a population-based survey in Japan. J Gastroenterol 2015; 50: 744-750 DOI: 10.1007/s00535-014-1014-3. (PMID: 25416144)
• 7 Zipfel S, Stengel A, Junne F. Psychotherapy in Times of the COVID-19 Pandemic – A Brief Reflection. Psychother Psychosom Med Psychol 2020; 70: 269-271 DOI: 10.1055/a-1180-0529. (PMID: 32688419)
• 8 Leach CR, Rees-Punia E, Newton CC. et al. Stressors and Other Pandemic-related Predictors of Prospective Changes in Psychological Distress. Lancet Reg Health Am 2021; DOI: 10.1016/j.lana.2021.100069. (PMID: 34518825)
• 9 Chan ACY, Piehler TF, Ho GWK. Resilience and mental health during the COVID-19 pandemic: Findings from Minnesota and Hong Kong. J Affect Disord 2021; 295: 771-780 DOI: 10.1016/j.jad.2021.08.144. (PMID: 34517251)
• 10 Williams SN, Armitage CJ, Tampe T. et al. Public perceptions and experiences of social distancing and social isolation during the COVID-19 pandemic: a UK-based focus group study. BMJ Open 2020; 10: e039334 DOI: 10.1136/bmjopen-2020-039334. (PMID: 32690752)
• 11 Liu X, Luo WT, Li Y. et al. Psychological status and behavior changes of the public during the COVID-19 epidemic in China. Infect Dis Poverty 2020; 9: 58 DOI: 10.1186/s40249-020-00678-3. (PMID: 32746940)
• 12 Shi L, Lu ZA, Que JY. et al. Prevalence of and Risk Factors Associated With Mental Health Symptoms Among the General Population in China During the Coronavirus Disease 2019 Pandemic. JAMA Netw Open 2020; 3: e2014053 DOI: 10.1001/jamanetworkopen.2020.14053. (PMID: 32609353)
• 13 Oshima T, Siah KTH, Yoshimoto T. et al. Impacts of the COVID-19 pandemic on functional dyspepsia and irritable bowel syndrome: A population-based survey. J Gastroenterol Hepatol 2021; 36: 1820-1827 DOI: 10.1111/jgh.15346. (PMID: 33197076)
• 14 Alzahrani MA, Alshamrani AS, Ahmasani IM. et al. Coronavirus disease 2019 pandemic stress and its effects on irritable bowel syndrome patients in Saudi Arabia. Medicine (Baltimore) 2020; 99: e23711 DOI: 10.1097/MD.0000000000023711. (PMID: 33371119)
• 15 Fliege H, Rose M, Arck P. et al. The Perceived Stress Questionnaire (PSQ) reconsidered: validation and reference values from different clinical and healthy adult samples. Psychosom Med 2005; 67: 78-88 DOI: 10.1097/01.psy.0000151491.80178.78. (PMID: 15673628)
• 16 Levenstein S, Prantera C, Varvo V. et al. Development of the Perceived Stress Questionnaire: a new tool for psychosomatic research. J Psychosom Res 1993; 37: 19-32 DOI: 10.1016/0022-3999(93)90120-5. (PMID: 8421257)
• 17 [Anonym]. 2021 https://www.ema.europa.eu/en/documents/product-information/comirnaty-epar-product-information_de.pdf