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A case of COVID-19 diarrhea relieved by bile acid sequestrant administration.
Shirohata, Akira; Ariyoshi, Ryusuke; Fujigaki, Seiji; Tanaka, Katsuhide; Morikawa, Teruhisa; Sanuki, Tsuyoshi; Kinoshita, Yoshikazu.
  • Shirohata A; Department of Gastroenterology, Steel Memorial Hirohata Hospital, 3-1 Yumesaki-cho, Hirohata-ku, Himeji, Hyogo, 671-1122, Japan. whiteflag0229@gmail.com.
  • Ariyoshi R; Department of Gastroenterology, Steel Memorial Hirohata Hospital, 3-1 Yumesaki-cho, Hirohata-ku, Himeji, Hyogo, 671-1122, Japan.
  • Fujigaki S; Department of Gastroenterology, Steel Memorial Hirohata Hospital, 3-1 Yumesaki-cho, Hirohata-ku, Himeji, Hyogo, 671-1122, Japan.
  • Tanaka K; Department of Gastroenterology, Steel Memorial Hirohata Hospital, 3-1 Yumesaki-cho, Hirohata-ku, Himeji, Hyogo, 671-1122, Japan.
  • Morikawa T; Department of Gastroenterology, Steel Memorial Hirohata Hospital, 3-1 Yumesaki-cho, Hirohata-ku, Himeji, Hyogo, 671-1122, Japan.
  • Sanuki T; Department of Gastroenterology, Steel Memorial Hirohata Hospital, 3-1 Yumesaki-cho, Hirohata-ku, Himeji, Hyogo, 671-1122, Japan.
  • Kinoshita Y; Department of Gastroenterology, Steel Memorial Hirohata Hospital, 3-1 Yumesaki-cho, Hirohata-ku, Himeji, Hyogo, 671-1122, Japan.
Clin J Gastroenterol ; 15(2): 393-400, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1670005
ABSTRACT
Patients with coronavirus disease 2019 exhibit various gastrointestinal symptoms. Although diarrhea is reported in many cases, the pathophysiology of diarrhea has not been fully clarified. Herein, we report a case of coronavirus disease 2019 with diarrhea that was successfully relieved by the administration of a bile acid sequestrant. The patient was a 59-year-old man whose pneumonia was treated by the administration of glucocorticoids and mechanical ventilation. However, beginning on the 30th hospital day, he developed severe watery diarrhea (up to 10 times a day). Colonoscopy detected ulcers in the terminal ileum and ascending colon. The oral administration of a bile acid sequestrant, colestimide, improved his diarrhea quickly. Ileal inflammation is reported to suppress expression of the gut epithelial apical sodium-dependent bile acid transporter. It decreases bile acid absorption at the distal ileum and increases colonic delivery of bile acids, resulting in bile acid diarrhea. In summary, the clinical course of the case presented in this report suggests that bile acid diarrhea is a possible mechanism of watery diarrhea observed in patients with coronavirus disease 2019.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Case report / Prognostic study Topics: Long Covid Limits: Humans / Male / Middle aged Language: English Journal: Clin J Gastroenterol Year: 2022 Document Type: Article Affiliation country: S12328-022-01598-5

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Case report / Prognostic study Topics: Long Covid Limits: Humans / Male / Middle aged Language: English Journal: Clin J Gastroenterol Year: 2022 Document Type: Article Affiliation country: S12328-022-01598-5