Rosacea Linked to Increased Prevalence of Upper GI Disorders

heartburn chest woman
Asian woman haveing The symptoms of acid reflux. Burning sensation in the chest. Her expression indicates pain.
A novel study investigates the relationship between rosacea and GI disorders, particularly those of the upper GI tract.

Patients with rosacea have a higher prevalence of upper gastrointestinal (GI) disorders compared with control individuals, researchers reported in a study published in the Journal of the European Academy of Dermatology and Venereology.

The case-control study included patients diagnosed with rosacea from December 2010 to December 2020 from the Beth Israel Deaconess Medical Center Clinical Data Repository. Each patient was matched for age, sex, and race/ethnicity 1:4 with randomly selected control participants during the same period. Outcomes included esophagitis, gastroesophageal reflux disease (GERD), Barrett esophagus, gastritis, Helicobacter pylori infection, nondiabetic gastroparesis, small intestinal bacterial overgrowth (SIBO), irritable bowel syndrome (IBS), and diverticulitis.

The prevalence of GI diagnoses in control individuals and patients with rosacea was compared with the chi-squared test; multivariate logistic regression analysis was used to calculate the odds ratio and 95% CI after adjustment for potential confounders.

The rosacea group had 3485 participants (mean [SD] age 59.6 [15.2] years; 68.4%women; 85.2% White). The control group had 13,940 participants (mean [SD] age 59.4 [15.1] years; 68.4% women; 85.2% White).

Patients in the rosacea group had a higher prevalence of esophagitis, GERD, Barrett esophagus, gastritis, nondiabetic gastroparesis, SIBO, IBS, Crohn disease, and diverticulitis compared with the control group. After adjustment for potential confounders, patients with rosacea had a significantly increased risk for Barrett esophagus (adjusted odds ratio [aOR], 1.69; 95% CI, 1.20-2.37), IBS (aOR, 1.62; 95% CI, 1.02-2.58), nondiabetic gastroparesis (aOR, 1.49; 95% CI, 1.03-2.14), esophagitis (aOR, 1.30; 95% CI, 1.07-1.57), SIBO (aOR, 1.29; 95% CI, 1.13-1.47), GERD (aOR, 1.27; 95% CI, 1.17-1.38), and diverticulitis (aOR, 1.16; 95% CI, 1.05-1.28).

The investigators noted that the association between rosacea and IBS was significant even after they controlled for additional confounders such as other GI disorders and doxycycline exposure that may lead to IBS-like symptoms.

The study was limited by use of a single institution and reliance on International Classification of Disease diagnoses, and it did not distinguish rosacea subtypes or severity.

“With growing evidence of the gut-skin axis in the pathogenesis of rosacea, future studies are necessary to validate the associations described here and to develop novel strategies to manage rosacea patients for their skin disease as well as their GI comorbidities,” the researchers commented.


Yi JZ, Lukac D, Pagani K, Li S, McGee JS. Rosacea and upper gastrointestinal disorders: a case-control study from a large, urban academic centre. J Eur Acad Dermatol Venereol. Published online October 17, 2021. doi:10.1111/jdv.17758