COVID-19 patients more likely to develop gastrointestinal disorders

Reviewed by Emily Henderson, B.Sc.Mar 20 2023

COVID-19 is associated with an increased risk of developing long-term gastrointestinal disorders, including irritable bowel syndrome. This is what has been shown by a research published in the journal Gut, carried out by scholars of the University of Bologna and the IRCCS AOU S.Orsola Bologna.

The data we collected show that those who have contracted COVID-19 experience gastrointestinal symptoms more frequently than those who have not been affected by it. Given the vast spread of COVID-19 globally, we should therefore expect an increase in diagnoses related to gut-brain interaction disorders."

Giovanni Barbara, full professor at the Department of Medical and Surgical Sciences, University of Bologna and coordinator of the study

It is well known that viral infections can affect the gastrointestinal system and specifically promote the development of irritable bowel syndrome. This condition tends to be chronic, characterized by a number of intestinal disorders affecting the colon, including altered bowel motility, bloating, and abdominal cramping. Until now, however, it was unclear whether coronavirus infection could also lead to these consequences.

The researchers then conducted a prospective survey with the aim of assessing the prevalence of gastrointestinal symptoms and gut-brain interaction disorders in patients hospitalized for SARS-CoV-2 infection. The study involved 2183 patients hospitalized in 36 facilities in 14 countries: Italy, Bangladesh, Cyprus, Egypt, Israel, India, Macedonia, Malaysia, Romania, Russian Federation, Serbia, Spain, Sweden, and Turkey. Patients who had contracted COVID-19 were evaluated upon admission to the hospital and then followed up for the next 12 months, comparing their condition with that of patients not infected with the coronavirus.

The data collected and analysis carried out by the scholars thus showed that patients hospitalized for COVID-19 more frequently reported the presence of gastrointestinal symptoms (59.3%) than the control group (39.7%). And new diagnoses of irritable bowel syndrome also emerged more frequently, which were found to be associated with the coexistence of allergies, breathing difficulties during hospitalization for COVID-19, and chronic intake of proton pump inhibitors (gastroprotectant drugs that block acid production in the stomach). In addition, at 6 months and 12 months after hospitalization, higher levels of anxiety and depression were reported among those who had COVID-19.

"We know that the SARS-CoV-2 virus can also infect the gastrointestinal tract, and this confirms the possibility that COVID-19 can lead to the development of irritable bowel syndrome," explains Giovanni Marasco, a researcher at the Department of Medical and Surgical Sciences at the University of Bologna and first author of the study. "Traces of the coronavirus were indeed found in the small intestine even six months after infection: this leads us to believe that the prolonged state of inflammation and activation of the immune system may lead to the development of the gastrointestinal symptoms that were observed."

The study was published in the journal Gut under the title "Post COVID-19 irritable bowel syndrome." Giovanni Marasco, Cesare Cremon, Maria Raffaella Barbaro, Giulia Cacciari, Daniele Salvi, Alessandro Venturi, Claudio Borghi, Marco Zoli, Paolo Gionchetti, Pierluigi Viale, Vincenzo Stanghellini, and Giovanni Barbara participated for the University of Bologna and IRCCS AOU S.Orsola Bologna.