Incidence and predisposing factors for de novo post-COVID-19 irritable bowel syndrome

Objective: Postinfectious irritable bowel syndrome (IBS) is a known entity. We evaluated the incidence of post-COVID-19 IBS in patients discharged from the hospital and analyzed its correlation with the clinical and laboratory parameters, and treatment during the hospital stay. Methods: Three hundred three COVID-19 hospitalized patients without prior history of IBS were prospectively followed after their discharge and were evaluated as per Rome-IV criteria for IBS. Results: One hundred seventy-eight patients were males (58.7%). The age range was 17-95 years (mean +or- SD, 55.9 +or- 15.8). A total of 194 (64%) had mild COVID-19, 74 (24.4%) had moderate COVID-19, whereas 35 (11.6%) had severe COVID-19 infection. Sixteen (5.3%) patients had concomitant GI symptoms during COVID-19 infection. IBS symptoms were found to be present in 32 (10.6%) patients, out of which 17 (53.13%) had diarrhea-predominant, 10 (31.25%) had constipation-predominant, and five (15.62%) had mixed-type IBS. Post-COVID-19 IBS was more common in the female sex (P < 0.001), concomitant GI symptoms with COVID-19 (P < 0.001), oxygen requirement (P = 0.015), deranged liver function tests at the time of admission (P = 0.002), high procalcitonin (P = 0.013), high C-reactive protein levels (P = 0.035);whereas negative correlation was found with remdesivir treatment (P = 0.047). After performing regression analysis, female sex (P < 0.001), oxygen requirement during hospital stay (P = 0.016), GI symptoms during COVID-19 infection (P < 0.001), and high procalcitonin levels (P = 0.017) were independently associated with post-COVID-19 IBS. Conclusion: GI symptoms during active COVID-19 infection increase the chances of developing post-COVID-19 IBS. The risk of developing post-COVID-19 IBS increases in female patients, those requiring oxygen and having high procalcitonin levels during COVID-19 infection.

Post-COVID-19 irritable bowel syndrome - importance of diet therapy and probiotic therapy

Introduction and Objective: The current challenge for medicine and the related disciplines is the development of methods and algorithms for dealing with the development of new diseases which undoubtedly include post-Covid-19 irritable bowel syndrome (P-IBS). This review is aimed at presentation of up-to-date scientific evidence on the impact of COVID-19 disease on development of post-Covid-19 irritable bowel syndrome. Review methods: The literature was reviewed using search engine data from PubMed, Google Scholar and the Medline databases. Brief description of the state of knowledge: At present, there are no guidelines or recommendations concerning therapeutic management of patients with post-Covid-19 irritable bowel syndrome. Therefore, the general standard of treatment for patients with irritable bowel syndrome (IBS) was reviewed. It is considered that the use of personalized low-FODMAP diet under the control of a clinical dietitian may be a good support in the treatment of IBS. Moreover, it seems advisable to supply personalized probiotic therapy based on the supplementation of strains with proven clinical effect. A new branch of probiotic therapy based on the use of psychobiotics in IBS patients as a form of support therapy also brings high hopes. Summary: The use of personalized low-FODMAP dietary supply and targeted probiotic therapy, including psychobiotherapy, could potentially be an effective method of supporting the treatment of patients suffering from post-Covid-19 irritable bowel syndrome. Currently, there are no guidelines for the routine use of the aforementioned methods. The need for further scientific research into the mechanisms of action and effectiveness of interventions in the context of P-IBS is indicated.

Current knowledge about the connection between health status and gut microbiota from birth to elderly. A narrative review.

The human body is colonized from the birth by a large number of microorganisms. This will constitute a real "functional microbial organ" that is fundamental for homeostasis and therefore for health in humans. Those microorganisms. The microbial populations that colonize humans creating a specific ecosystem they have been collectively referred to as "human microbiota" or "human normal microflora". The microbiota play an important pathophysiological role in the various locations of the human body. This article focuses on one of the most important, that is the enteric microbiota. The composition (quantitative and qualitative) of microbes is analyzed in relation to age and environment during the course of human life. It also highlights eubiosis and dysbiosis as key terms for its role in health and disease. Finally, it analyzes its bi-directional relationship with the microbiota of the lungs, skin and that of the brain, and consequently for the whole central and peripheral nervous system for the maintenance of health in the human body.

The role of faecal microbiota transplantation: looking beyond Clostridioides difficile infection.

Faecal microbiota transplantation (FMT) is the transfer of screened and minimally processed faecal material from a 'healthy' donor to 'diseased' recipient. It has an established role, and is recommended as a therapeutic strategy, in the management of recurrent Clostridioides difficile infection (CDI). Recognition that gut dysbiosis is associated with, and may contribute to, numerous disease states has led to interest in exploiting FMT to 'correct' this microbial imbalance. Conditions for which it is proposed to be beneficial include inflammatory bowel disease, irritable bowel syndrome, liver disease and hepatic encephalopathy, neuropsychiatric conditions such as depression and anxiety, systemic inflammatory states like sepsis, and even coronavirus disease 2019. To understand what role, if any, FMT may play in the management of these conditions, it is important to consider the potential risks and benefits of the therapy. Regardless, there are several barriers to its more widespread adoption, which include incompletely understood mechanism of action (especially outside of CDI), inability to standardise treatment, disagreement on its active ingredients and how it should be regulated, and lack of long-term outcome and safety data. Whilst the transfer of faecal material from one individual to another to treat ailments or improve health has a history dating back thousands of years, there are fewer than 10 randomised controlled trials supporting its use. Moving forward, it will be imperative to gather as much data from FMT donors and recipients over as long a timeframe as possible, and for trials to be conducted with rigorous methodology, including appropriate control groups, in order to best understand the utility of FMT for indications beyond CDI. This review discusses the history of FMT, its appreciable mechanisms of action with reference to CDI, indications for FMT with an emerging evidence base above and beyond CDI, and future perspectives on the field.