Abstract
BACKGROUND: The association and interaction between SARS-CoV-2 (COVID-19) infection and irritable bowel syndrome (IBS) has not been adequately explored. We sought to determine whether a mechanistic relationship exists and whether vaccination against COVID-19 plays a role in this relationship. METHODS: Using the Veterans Affairs (VA) electronic healthcare database, we obtained a random sample of veterans in October 2022 for this cross-sectional study. Demographic characteristics of the participants (e.g., age, sex, race), prior COVID infection, COVID vaccination status, and IBS diagnosis were extracted from the VA medical records. Univariate and multivariate logistic regression analyses were performed to determine potential associations between the listed factors and IBS diagnosis. RESULTS: A total of 9,112 veterans were analyzed. In univariate analysis, race, COVID infection, and vaccination were significantly associated with IBS. In multivariate regression analysis, only the effects of COVID infection and vaccination were statistically significant. The odds ratios for development of IBS among veterans with COVID infection versus those without was 1.94 (95% CI: 1.53-2.45), and for vaccinated versus unvaccinated, was 1.49 (95% CI: 1.18-1.89). Further analysis showed that vaccinated veterans who did not contract COVID infection had a lower risk of developing IBS compared to unvaccinated veterans who contracted COVID. CONCLUSIONS: The results of this study suggest that veterans with COVID infection are almost twice as likely to develop IBS compared to those who have never had COVID infection. Vaccinated veterans have a lower risk of contracting COVID and subsequently, a diminished chance of developing IBS. Overall, vaccination of veterans with protection against COVID diminishes the risk of IBS development.