Indiana University School of Medicine Newburgh, IN
Muhammad YN. Chaudhary, MBChB1, Shane Khullar, MBChB2, Oluwagbenga Serrano, MD, FACG3 1Indiana University Southwest Internal Medicine Residency Program, Evansville, IN; 2Indiana University School of Medicine, Newburgh, IN; 3Indiana University School of Medicine, Vincennes, IN Introduction: Gastroparesis, a condition characterized by delayed gastric emptying in the absence of mechanical obstruction [1], is increasingly being identified as a potential sequela of long COVID [2]. Idiopathic gastroparesis following COVID-19 infection may result from post viral autonomic dysfunction, inflammation, or altered motility [3]. This case series highlights five patients who developed idiopathic gastroparesis after recovering from acute COVID-19, exploring their clinical presentations, diagnostic challenges, and outcomes.
Case Description/
Methods: Five patients (ages 28–60) presented with persistent gastrointestinal (GI) symptoms, including nausea, bloating, early satiety, and vomiting, within three months of recovering from mild-to-moderate COVID-19.
1. A 28-year-old female developed significant weight loss and chronic nausea two months post-COVID-19. Gastric scintigraphy confirmed delayed gastric emptying, and dietary modifications improved symptoms [2].
2. A 35-year-old male reported early satiety and postprandial fullness. Gastroparesis was diagnosed through a gastric emptying study. Prokinetic therapy provided partial relief [4].
3. A 60-year-old woman with diabetes developed exacerbated bloating and vomiting post-COVID-19. Her symptoms were resistant to standard therapies, requiring jejunal feeding support.
4. A 55-year-old male experienced severe vomiting and abdominal pain post-COVID-19. Scintigraphy confirmed delayed gastric emptying, and he responded to a combination of dietary changes and prokinetics [2,4].
5. A 45-year-old female with no prior GI history reported persistent nausea and reflux. Testing revealed idiopathic gastroparesis, managed with dietary adjustments and symptom-specific medications. Discussion: Post-viral gastroparesis is a recognized but rare outcome, and long COVID appears to increase its prevalence [5]. Possible mechanisms include autonomic neuropathy, inflammation, and direct viral effects on the enteric nervous system [2]. Delayed diagnosis often leads to complications such as malnutrition and poor quality of life [2,5]. This case series emphasizes the importance of early recognition and tailored management strategies, including dietary modifications, prokinetics, and, in severe cases, enteral nutrition support. Idiopathic gastroparesis may be a notable complication of long COVID, with significant implications for patient management. Further research is needed to understand its pathophysiology and to establish effective treatment protocols.
Disclosures: Muhammad Chaudhary indicated no relevant financial relationships. Shane Khullar indicated no relevant financial relationships. Oluwagbenga Serrano indicated no relevant financial relationships.
Muhammad YN. Chaudhary, MBChB1, Shane Khullar, MBChB2, Oluwagbenga Serrano, MD, FACG3. P2068 - Idiopathic Gastroparesis in Patients with Long COVID: A Case Series, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
