Relations between food intake, psychological distress, and gastrointestinal symptoms: A diary study

Clevers E1,2, Törnblom H1, Simrén M1, Tack J2, Van Oudenhove L2. United European Gastroenterol J. 2019 Aug;7(7):965-973. doi: 10.1177/2050640619839859. Epub 2019 Mar 16.


Author information

Department of Internal Medicine & Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Translational Research Centre for Gastrointestinal Disorders (TARGID), KU Leuven, Leuven, Belgium.


BACKGROUND: Gastrointestinal symptoms can be triggered by food intake and psychological distress, but individual-level research on food-symptom and stress-symptom associations is scarce.

OBJECTIVE: We aimed to identify associations between food intake, psychological distress and gastrointestinal symptoms, and their implications for personalised clinical management.

METHODS: Through the mobile phone application mySymptoms, 163 users kept, for a median of five weeks, a diary of food intake, psychological distress and gastrointestinal symptoms. We quantified associations between these on the individual level. The presence of individual-level associations was compared over latent classes of daily symptom patterns.

RESULTS: Various gastrointestinal symptoms had demonstrable food-symptom associations (heartburn: 73%, discomfort: 67%, diarrhoea: 57%, bloating: 53%, and gas: 48%). Food-symptom associations for pain in the abdomen (33%) were concentrated in the latent class of individuals with pain in the morning (68%), rather than those with pain in the evening and night (27% and 10%, respectively, p < 0.001). Stress-symptom relations were also found, although only 18% of individuals reported psychological distress.

CONCLUSION: Personal food-symptom and stress-symptom relations can be detected, and may translate into specific daily symptom patterns. A next step will be to let personal food-symptom and stress-symptom relations serve as the basis for personalised clinical management.

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