Findings from a single center study show that patients with IBS or functional dyspepsia reported experiencing more GI symptoms during the pandemic.

The retrospective study reported in the journal Neurogastroenterology & Motility, included 2592 patients with three common functional gastrointestinal and motility disorders (FGIMD) who were given emergency, inpatient or outpatient care from March 15, 2020 to September 30, 2020. This was compared to data from six months preceding the pandemic (September 1, 2019 to March 14, 2020). Three FGIMD disorders were evaluated: gastroparesis, functional dyspepsia and IBS to study the changes the symptoms, use of medications and utilisation of healthcare during and before the pandemic. About 61% of patients had a past medical history of IBS, 29% reported a prior history of gastroparesis and 46% had functional dyspepsia. Eighty-three patients tested positive for SARS-CoV-2.

Results showed that more patients with common FGIMD reported increase in their GI symptoms during the pandemic when compared to the previous six-month data such as nausea or vomiting (22% vs 16%), constipation (17% vs 13%), abdominal pain (30% vs 23%), diarrhea (13% vs 10%) and weight loss (5.8% vs 4.3%). They also had increased proton pump inhibitor (PPI), H2 blocker, and opioid use.

More patients visited outpatient clinics during the pandemic than in the 6 months before the pandemic (5.68 vs 4.78 visits per patient, respectively). Patients also underwent more colonoscopies (0.10 vs 0.04) and CT imaging (0.23 vs 0.18) during the pandemic; the number of hospitalizations was also higher during the pandemic (0.50 vs 0.36 per patient)

The study also identified diarrhea predominant-IBS (OR 2.37, 95% CI 1.34–4.19, p = 0.003) and current smoking (OR 3.13, 95% CI 1.38-7.09) as independent risk factors for COVID-19, whereas functional dyspepsia (OR 0.46, 95% CI 0.27-0.79) had a negative association with COVID-19.

This study has demonstrated increased healthcare utilization during the pandemic contrary to the expectation of decrease in healthcare utilization as the ongoing pandemic has greatly disrupted non-Covid care. GI symptoms have been reported as part of symptomatology of COVID-19. Although these patients reported increase in their GI symptoms, only diarrhea was found to be positively correlated with COVID-19 in this study. Stress and anxiety from the pandemic, lifestyle changes imposed by lockdown could have played a role in the increase in symptoms, according to the study authors.

Source: Gubatan J, et al. Gastrointestinal symptoms and healthcare utilization have increased among patients with functional gastrointestinal and motility disorders during the COVID-19 pandemic. Neurogastroenterol Motil. 2021:e14243.

Dr J S Rajkumar

Chairman and Chief Surgeon, Rigid Hospitals, ChennaiSenior Consultant, Laparoscopic Surgeon, Al Hayat International Hospital, Dubai