According to a new analysis published on March 7, 2023, in Nature Communications, people who have had COVID-19 are more likely than people who have never had COVID-19 to experience gastrointestinal (GI) disorders like heartburn or GERD in the year following infection.
In a press release, senior author Ziyad Al-Aly, MD, chief of research and development at the VA Saint Louis Health Care System and a clinical epidemiologist at Washington University in Saint Louis, stated that digestive issues were among the first ones that the patient community reported. It is becoming increasingly obvious that the GI tract is a virus reservoir.
People with COVID-19 had a 36 percent higher overall risk of having GI disorders than those who had not contracted the virus. Even those with mild to moderate COVID-19 who didn't need to be hospitalized still posed a risk.
According to the study, prolonged COVID use can disrupt the GI system in several ways, leading to difficulties with the liver, acute pancreatitis (pancreatic inflammation), IBS (irritable bowel syndrome), and ulcers in the stomach or upper intestine, stated Dr. Al-Aly in an email.
According to the results, there is a higher chance of constipation, diarrhea, stomach pain, bloating, and vomiting in the months following the COVID-19 infection.
Stomach ulcers and GERD were the most prevalent GI conditions following COVID
A controlled data collection of around 150,000 individuals who tested positive for COVID-19 between March 1, 2020, and January 15, 2021, and who had survived the first 30 days following infection was compiled by researchers.
In the COVID-19 data set, GI outcomes were compared with two control groups of individuals who were not infected with the virus: one group, comprising roughly 5.6 million individuals from the same period, and the other, comprising 5.8 million individuals from March 1, 2018, to December 31, 2019, before the start of the pandemic.
Over 9,600 of those who had COVID-19 infections experienced problems with their liver, pancreas, intestines, or digestive systems. Around 2,600 patients reported having an acid-related condition, such as gastroesophageal or peptic ulcer disease (stomach ulcers), as their primary diagnosis.
After determining the prevalence of different GI problems across all the groups, researchers utilized mathematical models to predict how having COVID-19 may have affected the risk.
It was found that people who had COVID-19 had a higher risk of developing several GI conditions, including the following:
62% greater chance of getting ulcers in the stomach or small intestine lining.
An increased risk of developing acid reflux disease of
35%
The risk of developing acute pancreatitis rose by
46%.
Irritable bowel syndrome is 54% more likely to occur.
The likelihood of stomach lining inflammation is
47% higher.
Unknown causes of upset stomach are
36% more likely to occur.
Fifty-four percent are more likely to experience gastrointestinal symptoms like bloating, abdominal pain, vomiting, and diarrhea.
According to the researchers, infections brought on by the coronavirus responsible for COVID-19 have been linked to 42 million new cases of GI disorders worldwide and over six million new cases in the United States.
According to Al-Aly, these findings corroborate earlier studies on the harmful effects of long-term COVID. "The virus can cause harm, even to people deemed healthy or who have only experienced minor infections. We are witnessing COVID-19's capacity to attack any organ system in the body, occasionally with fatal long-term repercussions.
GI Symptoms Affect 50% of COVID-19 Patients.
According to a review published in November 2022 in Current Opinion in Gastroenterology, digestive symptoms are thought to be present in about half of the individuals with an acute (current) COVID-19 infection.
GI difficulties continue in roughly 10 to 25 percent of these patients six months after the first infection, and 11 percent of persons identify COVID-related GI troubles as "the most irritating symptom," per the review above.
The mouth, throat, esophagus, stomach, small and large intestines, rectum, and anus are all parts of the gastrointestinal system. It also consists of the liver and pancreas, which create enzymes to help with food and liquid digestion.
Gastrointestinal disorders can range from minor stomach discomfort to potentially fatal illnesses, including acute pancreatitis and liver failure.
Pancreatic inflammation, or acute pancreatitis, can develop unexpectedly and linger for several days. According to Johns Hopkins Medicine, the sickness can induce nausea, vomiting, fever, and respiratory failure.
Lingering stomach problems can also be brought on by infections other than COVID.
According to Daniel Friedberg, MD, a gastroenterologist at Columbia University Irving Medical Center in New York City and a longtime COVID researcher, it makes sense that COVID-19 could have chronic GI symptoms from what experts have seen in other disorders.
We knew that post-infection irritable bowel syndrome (IBS) was widespread before COVID-19. According to Dr. Freedbery, post-infection irritable bowel syndrome is a new case of abdominal pain, diarrhea, or constipation that develops after a gut infection with bacteria like salmonella or campylobacter.
He says it's not particularly surprising that there is "post-COVID IBS" just like there is post-infection IBS because the coronavirus likewise affects the gut and creates GI symptoms.
Moreover, those who have recovered from the flu are more likely to experience Gastrointestinal disturbances.
More than 1.1 million women and adults of various ages and colors were also included in the study, which largely involved older white men.
People of various ages, genders, and racial origins "developed long-term Gastrointestinal difficulties after infection," Al-Aly noted in the announcement.
According to Al-Aly, experts have significantly compared COVID-19 to the flu. "We compared health outcomes in those hospitalized with the flu vs those hospitalized with COVID, and we still identified an increased risk of GI issues," he stated.
It's critical to remember that the comparison groups could be better in this type of study, according to Freedbery. "The veterans with COVID were different from those without it in many respects. We are unsure if the variable frequencies of Gastrointestinal symptoms, and not COVID itself, were caused by these other variations. He claims the frequencies of GI symptoms were more comparable between the soldiers with COVID and the veterans with influenza.
The Incidence and Risk of Long COVID Gastrointestinal Symptoms May Have Altered Due to Vaccination and Novel Variants
The authors recognize that the data was older than the COVID-19 variations delta, omicron, and others and that vaccinations weren't readily accessible.
They concluded that those elements could alter some of the study's conclusions.
Therapy for Gastrointestinal Problems Resulting from COVID
According to Al-Aly, these results imply that gastrointestinal problems affect many COVID-19 patients. "GI health must be a fundamental component of post-acute COVID care," he asserts.
According to Freedbery, the treatment for these issues is now symptom-based and does not significantly differ according to whether the symptoms started before or after COVID.
According to him, many of these symptoms will fit the bill for DGBI or a disorder of gut-brain interaction. He cites irritable bowel syndrome as an example of a DGBI that is widespread.
According to Freedbery, DGBI illnesses are most successfully treated with therapies that work on both the brain and the gut, such as psychotherapy or the treatment of concurrent depression.
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