COVID-19 EXACERBATES EXISTING DIGESTIVE DISORDERS AND TRIGGERS NEW DIGESTIVE SYMPTOMS AND DIAGNOSES: RESULTS FROM AN INTERNATIONAL PATIENT SURVEY

ABSTRACT

Background/Aims: COVID-19 infection can affect nearly every organ system including the gastrointestinal (GI) tract. GI symptoms such as nausea, pain and diarrhea are common and may be due to infection and/or increased stress and isolation from the pandemic. It is well known that stress affects GI function and sensation, particularly in patients with irritable bowel syndrome (IBS). The aim of the study was to elucidate the impact of the COVID-19 pandemic on GI symptoms. Methods: An international online survey (Alchemer) was available via the International Foundation of GI Disorders (IFFGD) website from August 11, 2021- November 17, 2021. There were 57 questions exploring demographics, GI symptom/disorder classification, care delivery, administration and perceptions of COVID-19 vaccination, and health experiences during the pandemic. No compensation was provided for survey completion and patients were able to selectively answer questions, with some questions not analyzed for this report. Results: Survey data was included from 210 patients with GI symptoms (mean age 47.7 yrs, 83% female, 80% Caucasian). Participants' primary GI conditions included 36% IBS, 26% gastroparesis, 6% constipation, and 9% acid reflux (figure 1). Seventy percent reported the pandemic impacted their GI health and nearly 3 out of 4 (73%) reported increased pandemic-related anxiety or depression. COVID-19 was diagnosed in 40 (19%) participants. Nearly 3 out of 4 (74%) experienced new or worsening GI symptoms after a COVID-19 diagnosis. Almost a third (30%) with COVID-19 were diagnosed with post-infection (PI) IBS and 38% were diagnosed with a new GI disorder other than PI-IBS. New GI diagnoses after COVID-19 included gastroparesis (53%), GERD (13%), and diarrhea (7%) (figure 2). Prior to diagnosis of PI-IBS, 58% did not have a GI diagnosis. Almost half (46%) of patients reported new acid reflux symptoms after COVID-19. Almost 3 out of 4 patients (72%) with COVID-19 noticed changes in digestion and/or bowel movements. More than two thirds (67%) noted COVID-related GI symptoms lasted >3 months. Nearly 3 out of 4 (72%) patients felt their GI symptoms were harder to manage after COVID-19. Conclusions: Our results highlight the significant burden of GI illness imposed by the COVID-19 pandemic. COVID-19 exacerbated existing GI conditions, increased anxiety and depression, and led to a wide range of new GI issues, led by but not limited to PI-IBS. New diagnoses of upper GI disorders including gastroparesis and GERD were surprisingly common. Further prospective studies to validate these observations and understand their pathogenesis are warranted. (Figure Presented) Figure 1 Participants primary gastrointestinal condition or disorder prior to the COVID- 19 pandemic. (Figure Presented) Figure 2 New GI disorders diagnosed after being diagnosed with COVID-19