POST COVID EFFECTS: IRRITABLE SYNDROME FROM BAD TO WORST

Abstract

Since the emergence of COVID-19, world has witnessed a major catastrophe in the terms of enhanced burden on heath resources, burnout of health professionals and most importantly loss of precious human lives. (1)The psychological health of patients, their relatives and carers has been a huge concern that has also led to escalation of gastrointestinal symptoms. In addition there is an established relationship between mental health and the diseases such an irritable bowel syndrome which is largely functional bowel disorder more common in people having underlying depression. The COVID 19 has been the culprit of multiple problems that has added to the misery of such patients.

Over the last two years, there is   huge influx of irritable bowel syndrome patients to gastrointestinal clinics. They do present with typical symptoms such as diarrhoea alternating with constipation, troublesome bloating and flatulence.(2) Sometimes alarm symptoms have warranted invasive instigations like CT Abdomen and colonoscopy. Post infectious IBS isn’t something new and was first explained by Stewart in 1959 who did explain the persistence of symptoms after recovering from infection. (3)They can be residual symptoms of the infection themselves like gastroenteritis or due to overwhelming and negative thoughts of the patient who has just recovered. Acute GI problems have been report to affect 17% of patients. The symptoms are more common at 6 months affecting 43% of patients .(4)This is a worrisome figure as most the patients are having the symptoms for months to years.

Almost age groups are the victims of COVID and post infectious IBS.It has been observed more in young people especially students who are already stressed about exhaustive routine, meeting essential deadlines, and appearing for exam with suboptimum academic calendar year. There has been an increased burden on them as they are not acclimatized to online learning. Though oenario to manage but when there is a will there is a way.nline learning is non inferior to group education for irritable bowel syndrome according to a randomized controlled and patient preference trial , the enormous stress by itself is the major trigger for it. In addition we have seen the increased trend of IBS symptoms in middle aged females who have to look after their homes

Sir Arthur Hurst (1943) introduced a term “Post-dysenteric colonic irritability” .The gastrointestinal symptoms have been exaggerated in functional bowel disorders with increased medication use. The major problem is that most of the symptoms have been found refractory to conventional treatment. This has been especially more noticeable in our country where people are mostly suffering from worst economic turmoil and have large families to cater for. There has been massive downsizing in most of the organization or people are working on half salaries that has a added to the problem further complicating it.

Post COVID is IBS  a major global problem  and gut brain relationship has been altered to a colossal extent .