S1189 Social Determinants of Health Impact IBS and Other Abdominal Pain-Related Disorders of Gut Brain Interaction

Introduction: The biopsychosocial model has spurred a better understanding of Disorders of Brain Gut Interaction (DGBI). While multiple factors related to the presence or severity of DGBI have been studied, social factors, beyond immediate family or support, have received notably less attention in the literature. We conducted the first systematic review of Social Determinants of Health (SDOH) in abdominal pain-related DGBI (AP-DGBI). Our aim was twofold: (1) To examine if SDOH differ between patients with AP-DGBI and controls, and (2) to examine if SDOH are associated with negative outcomes for AP-DGBI, including symptom severity/frequency, disability/quality of life, and mental health disorders. Methods: We conducted a systematic review of the literature from 1987 to 2024 using PubMed, Embase, PsychInfo, and CINAHL. Search strategies were based on previously published systematic reviews of SDOH in other diseases. Study inclusion criteria included: Published after 1987 when diagnostic criteria for DGBI were established, peer reviewed, primary study population of AP- DGBI, age of participants above 4 years old, sample size ≥50 participants, and included SDOH factors. Study exclusion criteria included: SDOH factors that have been previously studied in DGBI (e.g., adverse life experiences, psychosocial and biological factors), and lack of a control group. Each article was screened by 2 independent reviewers and disagreements were resolved by one senior author not involved in the screening. Results: Of the 4229 studies were screened, 3953 were deemed irrelevant. Out of the 275 full text studies, 173 were eligible. Lower education, income, and unpaid employment were commonly associated with AP-DGBI, although some studies reported higher prevalence among highly educated or higher-income individuals. Marital status showed no consistent association. Living in rural areas, unstable housing, or away from family was linked to greater risk, while stable home environments appeared protective. Reduced social support and non-traditional family structures were more common in AP-DGBI. Associations with race/ethnicity and insurance were inconsistent, though disparities in healthcare access were noted. Food insecurity was also linked to increased risk. Conclusion: Overall, SDOH may contribute to AP-DGBI, but findings vary depending on population characteristics and study design. Further prospective studies are needed to understand the impact of SDOH in children and adults with AP-DGBI.