Association of Substance Use and Gastrointestinal Disease in Homeless Populations
Description
Gastrointestinal (GI) issues are often underreported and poorly understood within homeless populations despite growing evidence that links substance abuse disorders to gut health. GI diseases reviewed include Peptic Ulcer Disease (PUD), Gastroesophageal Reflux Disease (GERD), malnutrition, bowel ischemia, and several others. In this review we investigated the types of drugs used that could be risk factors for driving GI disorders in the homeless. Literature on PubMed and Google Scholar resulted in 24 number of papers focusing on substance abuse and GI disorders in the homeless from populations located mainly within the USA and globally. The homeless population has a high prevalence of substance abuse, particularly nicotine, alcohol, opioids, methamphetamines, and cocaine, which have well-documented effects on GI function. Substance abuse among homeless populations consistently drives gastrointestinal morbidity, most notably oral and gastric ulcers, malnutrition, reflux disease, liver injury, and bowel ischemia. Stimulants activate the sympathetic response, decreasing vagal nerve response, which in turn slows GI function, leading to a wide variety of GI complications ranging from chronic constipation to bowel ischemia. Other drugs over activate the vagal response, leading to overproduction of acid, contributing to PUD and GERD. Additionally, very commonly used drugs such as alcohol and nicotine activate inflammatory markers, TGF-B, IL1, and CRP, predisposing users to more chronic disorders like IBS and cirrhosis. All of the commonly abused drugs within the homeless population are associated with risk for GI diseases.
Citation Information
Gupta, Bhavya; Khan-Garrard, Mariyah; Padmanabhan, Sanyukta; and Carnevale, Kevin A., "Association of Substance Use and Gastrointestinal Disease in Homeless Populations" (2026). Office of Research DMU Research Symposium. 102.
https://digitalcommons.dmu.edu/researchsymposium/2025rs/2025abstracts/102
Association of Substance Use and Gastrointestinal Disease in Homeless Populations
Gastrointestinal (GI) issues are often underreported and poorly understood within homeless populations despite growing evidence that links substance abuse disorders to gut health. GI diseases reviewed include Peptic Ulcer Disease (PUD), Gastroesophageal Reflux Disease (GERD), malnutrition, bowel ischemia, and several others. In this review we investigated the types of drugs used that could be risk factors for driving GI disorders in the homeless. Literature on PubMed and Google Scholar resulted in 24 number of papers focusing on substance abuse and GI disorders in the homeless from populations located mainly within the USA and globally. The homeless population has a high prevalence of substance abuse, particularly nicotine, alcohol, opioids, methamphetamines, and cocaine, which have well-documented effects on GI function. Substance abuse among homeless populations consistently drives gastrointestinal morbidity, most notably oral and gastric ulcers, malnutrition, reflux disease, liver injury, and bowel ischemia. Stimulants activate the sympathetic response, decreasing vagal nerve response, which in turn slows GI function, leading to a wide variety of GI complications ranging from chronic constipation to bowel ischemia. Other drugs over activate the vagal response, leading to overproduction of acid, contributing to PUD and GERD. Additionally, very commonly used drugs such as alcohol and nicotine activate inflammatory markers, TGF-B, IL1, and CRP, predisposing users to more chronic disorders like IBS and cirrhosis. All of the commonly abused drugs within the homeless population are associated with risk for GI diseases.
