Differences between fixed day shift workers and rotating shift workers in gastrointestinal problems: a systematic review and meta-analysis

Abstract

This study comprised a review and compilation of literature to gain an in-depth understanding of the impact of rotating shift work on gastrointestinal health. PubMed, CINAHL, and the Cochrane Library were searched for studies published between January 1, 1985, and June 30, 2020. Fixed day shifts were defined as work shifts that began between 7:00 and 9:00 in the morning. Shifts beginning at any other time were classified as rotating shifts. A meta-analysis was performed using Comprehensive Meta-Analysis Software (CMA) version 3. In the end, 16 studies were included in the meta-analysis. An odds ratio (OR) of 1.56 (95% confidence interval (CI): 1.24–1.95), indicating that gastrointestinal problems are more common in rotating shift workers than in fixed day shift workers. Four gastrointestinal problems, namely, irritable bowel syndrome, constipation, indigestion, and peptic ulcers, were then analyzed separately. Significant differences between rotating shift workers and fixed day shift workers were found only for indigestion and peptic ulcers. For indigestion, the OR was 1.72 (95% CI: 1.28–2.30). For peptic ulcers, the OR was 1.66 (95% CI: 1.19–2.30). Thus, research indicates that rotating shift work may increase the risk of gastrointestinal problems, particularly indigestion and peptic ulcers.

Eating on the night shift: A need for evidence‐based dietary guidelines?

“…Various functions of the gastrointestinal system are under control of the central clock, such that motility and gastric emptying slow during the night (Duboc, Coffin & Siproudhis, 2020; Voigt, Forsyth & Keshavarzian, 2019). This, combined with food intake during night time, potentially contributes to the higher prevalence of gastrointestinal complaints reported by shift workers compared to day workers (Chang & Peng, 2021). Limited studies have investigated gastrointestinal symptoms in response to meal modification; a 4‐day simulated shift work protocol in non‐shift workers tested three eating pattern conditions: meal at night, snack at night and not eating at night; they found no difference in gastric upset or bloating across test conditions, although eating a meal versus eating a snack or not eating was associated with increased dizziness and headaches (Gupta et al, 2019).…”

Bowel Health in U.S. Shift Workers: Insights from a Cross-Sectional Study (NHANES)

“…The increasing need for services operating on a 24 h basis, particularly in healthcare and transport, causes workers to routinely work on the basis of shift schedules [ 2 ]. Shiftwork and rotating shift schedules are a challenge to an individual’s biological rhythms and lead to alterations in the biological clock [ 2 , 3 ].…”

“…Subsequent disruptions in the body’s circadian rhythm may negatively affect psychosocial wellbeing and nutrition intake [ 3 ]. Due to frequently changing day routines, shift workers are often forced to eat on an irregular basis [ 4 , 5 ].…”

“…Due to frequently changing day routines, shift workers are often forced to eat on an irregular basis [ 4 , 5 ]. The result is an increased consumption of meals that are high in fat, sugar, processed grains, and animal products (dairy and meat in particular) [ 3 , 6 , 7 ].…”

“…It is now widely accepted that the gastrointestinal (GI) tract has a circadian rhythm that influences bowel movements, secretion of gastric juices, and appetite regulation [ 8 , 9 , 10 ]. Disruptions of the GI tract’s circadian rhythm, in combination with the aforementioned poor dietary choices in shift workers, may predispose this population to an increased risk of gastrointestinal disorders [ 3 , 11 ].…”