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Covid-19 can cause gut-brain interaction disorders, including irritable bowel syndromesay the researchers.
Gastrointestinal symptoms are common in prolonged covid-19, also known as post-covid-19 syndrome, according to physicians Dr. Walter Chan and Dr. Madhusudan Grover.
Doctor. Walter, assistant professor at Harvard Medical Schooland Dr. Madhusudan, Associate Professor of Medicine and Physiology at Mayo Clinicboth in the United States, carried out a review of the literature on the chronic gastrointestinal effects of covid-19.
The article has been published August 6 in the newspaper Clinical gastroenterology and hepatology.
According to the authors, estimates of the prevalence of gastrointestinal symptoms in covid-19 reach 60%, and these changes may be present in patients with prolonged covid-19, a syndrome that persists for four weeks or more.
In a survey of 749 Covid-19 survivors, 29% reported at least one never-before-seen chronic gastrointestinal symptom. The most common symptoms were heartburn, constipation, diarrhea and abdominal pain. Of the patients with abdominal pain, 39% had symptoms meeting the Rome IV criteria for irritable bowel syndrome.
People with gastrointestinal symptoms after initial infection with SARS-CoV-2 are more likely to experience these same symptoms during prolonged COVID-19. The presence of psychiatric comorbidities, hospitalization, anosmia and ageusia are predictors of gastrointestinal symptoms.
Infectious gastroenteritis may increase the risk of gut-brain interaction disorders, particularly post-infection irritable bowel syndrome, the researchers wrote.
Covid-19 is likely to cause gastrointestinal symptoms through several mechanisms. The infection can suppress angiotensin-2 converting enzyme, which protects gut cells, alter the microbiome, and cause or worsen weight gain and diabetes. It can also disrupt the immune system and trigger an autoimmune reaction, cause the Depression and anxiety, in addition to changing eating habits.
To date, there is no specific treatment for gastrointestinal symptoms associated with prolonged COVID-19, so clinicians should use well-established therapies for gut-brain interaction disorders, the researchers recommended.
In addition to adequate sleep and physical activity, treatment may include diets high in fiber, low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, gluten-free, low-carbohydrate, or exclusion diets.
To treat diarrhea, the researchers listed the following options: loperamide, ondansetron, alosetron, eluxadolineantispasmodics, rifaximin and bile acid sequestrants.
For constipation, they mention fiber supplements, polyethylene glycol, linaclotide, plecanatid, lubiprostone, tenapanor, tegaserod and prucalopride.
To modulate intestinal permeability, the authors recommend glutamine.
Neuromodulation can be achieved with tricyclic antidepressants, selective serotonin reuptake inhibitors, serotonin reuptake inhibitors and norepinephrineazapirones and delta ligands, the authors wrote.
As for psychotherapy, they recommended cognitive behavioral therapy and targeted hypnotherapy.
Some studies suggest the benefits of bacteria Lactiplantibacillus plantarum and Pediococcus acidilactici as probiotic therapies. Additionally, one study showed positive results with a fiber-rich formula, possibly by feeding short-chain fatty acid-producing bacteria, the authors wrote.
Clin Gastroenterol Hepatol. Published on line on August 6, 2022. Full text
Doctor. Walter reported financial ties to the companies iron wood, Takeda and Phathom Pharmaceuticals. Doctor. Madhusudan reported financial ties to the companies Takeda, Donga, Alexza Pharmaceuticals and alphasigma.
Laird Harrison covers science, health and culture. His work has appeared in American magazines, newspapers, radio stations and websites. He is currently writing a novel about alternate realities in physics and teaching writing techniques. at the Writers’ Cave. Discover his work on www.lairdharrison.com or follow him on Twitter at @LairdH .
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