Chronic pain is an independent risk factor for GstrointestinalI diseases in middle-aged and elderly Chinese adults, with depression and sleep duration partially mediating this relationship.
Chronic pain was significantly associated with increased risk of gastrointestinal diseases in cross-sectional analysis.
Chronic pain significantly predicted incident gastrointestinal diseases over a 9-year longitudinal follow-up.
Depression mediated a significant portion of the association between chronic pain and gastrointestinal diseases.
Sleep duration mediated a small but statistically significant portion of the association between chronic pain and gastrointestinal diseases.
Age significantly moderated the association between chronic pain and gastrointestinal diseases, with a stronger relationship in middle-aged adults than older adults.
A dose-response relationship was observed between pain severity and gastrointestinal disease risk.
The study analyzed data from a nationally representative cohort of middle-aged and elderly Chinese adults using both cross-sectional and longitudinal designs.
This research suggests that people who live with chronic pain are significantly more likely to develop gastrointestinal (digestive) diseases over time. Using data from nearly 5,000 middle-aged and older Chinese adults followed for nine years, and a cross-sectional sample of over 8,000 adults, the study found that those with chronic pain had about a 37% higher risk of developing new gastrointestinal conditions compared to those without chronic pain — and in the cross-sectional analysis, they were more than twice as likely to already have such conditions. The link held up even after accounting for other health and lifestyle factors. The study also investigated why this connection exists. It found that depression plays a meaningful role, explaining about 23% of the relationship between chronic pain and gastrointestinal disease — meaning that chronic pain may partly lead to digestive problems by worsening mental health. Poor sleep also played a smaller but statistically significant mediating role (about 3.5%). Additionally, the connection between chronic pain and gastrointestinal disease was stronger in middle-aged adults (roughly 45–60) than in older adults. This research suggests that treating chronic pain in isolation may not be enough to prevent downstream health problems like gastrointestinal disease. Addressing the mental health and sleep difficulties that often accompany chronic pain may be an important part of reducing the broader health burden in aging populations. Integrated care strategies that consider pain, depression, and sleep together could potentially reduce the risk of digestive diseases in this demographic.
Li Q, Li X, Chen W, Zhu Z, Yang Y, Xie Y, et al.. (2026). Chronic pain and risk of gastrointestinal diseases in middle-aged and elderly Chinese adults: The roles of depression and sleep.. Medicine. https://doi.org/10.1097/MD.0000000000047328