Association between psychoemotional variables and functional gastrointestinal symptoms in medical students: a cross-sectional study based on Rome IV criteria

This study examined the association between anxiety, perceived stress, and functional gastrointestinal symptoms in medical students. A cross-sectional survey was conducted among 224 students from the School of Medical Sciences at the National University of Asunción, Paraguay. Standardized instruments were used to assess anxiety symptoms, stress levels, and the presence of functional gastrointestinal symptoms based on adapted Rome IV criteria. Statistical analyses included descriptive statistics, bivariate comparisons, correlation analyses, and logistic regression modeling. Results showed that 79.0% of students reported moderate to severe anxiety symptoms, 31.7% presented high levels of perceived stress, and 66.1% had clinically relevant gastrointestinal symptoms. Female students scored significantly higher across all three clinical variables. In addition, perceived stress and gastrointestinal symptoms were associated with a family history of digestive disorders. Stress levels varied by academic year, with third- and sixth-year students reporting the highest scores. A strong positive correlation was found between anxiety and stress (rho = 0.649, <i>p</i> < 0.001), while weaker but significant correlations emerged between these emotional variables and gastrointestinal symptoms. Notably, 87.5% of students attributed their gastrointestinal discomfort to psychological causes such as stress or anxiety, suggesting a high level of insight. These findings underscore the clinical relevance of the gut - brain axis and support the need for integrated biopsychosocial approaches in university health programs. Promoting emotional regulation and early identification of stress-related symptoms may improve students' psychological well-being and contribute to the development of healthier, more resilient future health professionals.