Indiana University Southwest Internal Medicine Residency Program Evansville, IN
Muhammad YN. Chaudhary, MBChB1, Inshal Jawed, MBBS2, Muhammad Umair Qadir, MBBS2, Shafaq Jabeen, MD3, Umme Farwa, MD4, Aizaz Anwar Khalid, MBBS5, Oluwagbenga Serrano, MD, FACG6 1Indiana University Southwest Internal Medicine Residency Program, Evansville, IN; 2Dow Medical College, Karachi, Sindh, Pakistan; 3Karachi Medical and Dental College, Karachi, Sindh, Pakistan; 4Jinnah Sindh Medical University, Karachi, Sindh, Pakistan; 5Peshawar Medical College, Karachi, North-West Frontier, Pakistan; 6Indiana University School of Medicine, Vincennes, IN Introduction: A group of patients recovering from a recent COVID-19 infection experience ongoing symptoms, which are called long COVID or post-acute COVID syndrome. Along with fatigue and breathing problems, people with long-term COVID-19 often develop GI problems. Examples are frequent diarrhea, continual abdominal pain, nausea, dyspepsia, loss of appetite, and a change in bowel habits lasting over several months after SARS-CoV-2 infection. The reasons behind the illness might be persistent viral antigens, an imbalanced post-COVID microbiome, and immune system damage. Methods: We reviewed studies that detailed GI problems that lasted after COVID-19. From 2020 to 2025, the PubMed, Google Scholar, WOS, Cochrane Library, and Embase databases were consulted for studies that followed patients for at least four weeks after a COVID-19 diagnosis, reviewing their GI health. Information on GI issues for COVID survivors and controls, including their frequency and duration, was collected. The study showed moderate quality. Pooled long-COVID GI symptom rates were estimated with a random-effects meta-analysis. Results: Nineteen studies covering over 10,000 COVID-19 cases were analyzed. GI symptoms were reported in about 22% of long COVID patients (95% CI: 10–41%), with 12% experiencing GI issues during acute infection, suggesting some developed new or persistent symptoms. Common long COVID GI complaints included appetite loss and functional dyspepsia (20% each), loss of taste (17%), abdominal pain (14%), diarrhea (10%), and nausea (6%). Many met criteria for post-infectious IBS. Stool analyses revealed post-COVID gut dysbiosis, with reduced beneficial bacteria and lingering viral proteins in some patients. Heterogeneity was high (I² > 95%). Few post-viral syndromes have shown such widespread GI involvement. Discussion: About 20% of long COVID patients experience persistent GI symptoms, commonly including appetite loss, digestive issues, and IBS-like complaints, highlighting the need for GI evaluation in post-COVID care. New chronic GI symptoms after SARS-CoV-2 infection warrant assessment for causes such as post-infectious IBS or bile acid malabsorption. While many symptoms resolve without treatment, dietary changes, probiotics, and bile acid binders may help. Ongoing research and long-term monitoring of COVID-19 survivors are essential to guide effective management of these GI complications.
Disclosures: Muhammad Chaudhary indicated no relevant financial relationships. Inshal Jawed indicated no relevant financial relationships. Muhammad Umair Qadir indicated no relevant financial relationships. Shafaq Jabeen indicated no relevant financial relationships. Umme Farwa indicated no relevant financial relationships. Aizaz Anwar Khalid indicated no relevant financial relationships. Oluwagbenga Serrano indicated no relevant financial relationships.
Muhammad YN. Chaudhary, MBChB1, Inshal Jawed, MBBS2, Muhammad Umair Qadir, MBBS2, Shafaq Jabeen, MD3, Umme Farwa, MD4, Aizaz Anwar Khalid, MBBS5, Oluwagbenga Serrano, MD, FACG6. P3429 - Persistent Gastrointestinal Symptoms Following SARS-CoV-2 Infection: A Systematic Review of Post-Acute Sequelae, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
