This article explores the profound impact of gender-based violence (GBV), including intimate partner violence (IPV), on gastrointestinal (GI) health. It highlights how survivors of abuse—especially women—are disproportionately affected by chronic digestive symptoms, with studies showing they are 1.5 to 2 times more likely to report GI complaints. IPV includes physical, sexual, emotional, and psychological abuse, and its consequences extend beyond physical harm, often resulting in disorders of gut-brain interaction (DGBIs) such as irritable bowel syndrome (IBS).
Trauma affects the brain-gut axis, altering pain perception and stress responses, which can lead to visceral hypersensitivity. This makes it crucial for gastroenterologists to consider a patient’s trauma history, especially when diagnostic tests are inconclusive. Psychological abuse is often under-recognized but significantly contributes to GI dysfunction.
GI practitioners are urged to adopt trauma-informed care, a framework emphasizing awareness, safety, and patient empowerment. Providers should approach patients with compassion, offer autonomy, and avoid retraumatization. Special care should be taken during endoscopic procedures, as sedation and positioning may trigger flashbacks or distress.
Particular attention should be given to vulnerable populations including women, immigrants, veterans, minors, and those with disabilities or prior trauma. Screening should be discreet, culturally sensitive, and supported by certified interpreters when needed.
When determining care for patients, emphasis should be placed on the importance of not minimizing or attributing all symptoms to trauma. Instead, comprehensive evaluations should be paired with appropriate referrals for mental health or social services. Gastroenterologists play a key role in identifying abuse, offering support, and creating safe spaces for disclosure and healing. The article encourages providers to be proactive by including abuse resources in discharge materials and fostering clinical environments grounded in dignity, respect, and trauma-informed principles.
Christina Awad, MD, is the director of hepatology at the Brooke Army Military Medical Center. She serves on the ASGE Diversity & Inclusion Committee and is involved with the Leadership Education and Development (LEAD) group.