If you’ve recently felt green around your gills or heard more talk than usual about stomach upsets, you may have wondered if Omicron or its sub-variant, BA.2, causes an increase in gastrointestinal problems.
Some clinicians have also reported seeing more patients with COVID-19 suffering from gastrointestinal symptoms in recent weeks.
But medical experts say there are several possible explanations – and this is not necessarily due to the COVID-19 strains currently circulating in Canada. Diarrhea, vomiting, and abdominal pain have been recognized as common symptoms of COVID-19 since the onset of the pandemic, while nausea, reflux, heartburn, loss of appetite, and weight loss have also been recognized as potential symptoms.
Dr Sumon Chakrabarti, an infectious disease specialist in Mississauga, Ontario, said he had recently seen a higher proportion of patients with COVID-19 whose primary symptoms were gastrointestinal.
“I’ve seen people who just vomit,” he said.
But, he added, it is not that Omicron necessarily causes more gastrointestinal problems, but rather that it is now easier to detect COVID-19 in these patients than earlier in the pandemic.
“We test people who come sick enough to be admitted, and people also do quick tests at home with any kind of symptom, so there may also be an opportunity to just take them because I’m looking for them.”
Chakrabarti’s hypothesis is supported by data from the UK-based application ZOE COVID Symptom Study, through which millions of people report their symptoms during the pandemic.
Some people with COVID experience gastrointestinal symptoms such as diarrhea and vomiting. However, norovirus and other diseases related to the gastrointestinal tract are also circulating. In this photo, a buyer in Burbank, California, buys toilet paper amid a shortage fueled by the pandemic on November 19, 2020 (Robyn Beck / AFP / Getty Images)
Based on these user reports, there is no evidence that Omicron causes an increase in gastrointestinal symptoms, said lead researcher Tim Spector, a professor of genetic epidemiology at King’s College London.
“It simply came to our notice then. We do not see major changes in symptoms. There is still a lot of upper respiratory tract infection, “he told CBC News.
Pediatricians see symptoms in children
However, some pediatricians say they have seen a certain increase in patients with COVID-19 with gastrointestinal symptoms during the Omicron wave – and some of these symptoms are particularly worrying.
Dr Ana Sant’Ana, a pediatric gastroenterologist at the Children’s Hospital of Montreal, said she had recently seen young patients with blood in their stools or vomit, and some had tears in their gastrointestinal tract as a result of vomiting.
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“We did not see these [symptoms] before, “Sant’Ana said, adding that none of these patients with severe gastrointestinal symptoms had any respiratory symptoms during their hospital stay.
Despite the severity of their symptoms, almost all young patients with COVID recovered quickly after treatment, she said.
“They are resolved in a few days, maybe a few weeks, and they are leaving [out] like New.”
Other stomach infections are on the rise
Apart from COVID-19, there is another reason why more Canadians may be experiencing some unpleasant intestinal symptoms at the moment.
Stomach insects, such as norovirus, are increasingly circulating as life returns to normal, Chakrabarti said, with children often contracting stomach ailments at school and then infecting their families.
There has been an increase in norovirus cases in several parts of Canada. One major risk factor is that children become infected at school and then infect their families. In this image, children leave school in Toronto on April 6, 2021, after schools were ordered to close due to COVID-19. (Evan Mitsui / CBC)
Symptoms of norovirus may include diarrhea, vomiting, nausea, and stomach cramps.
The latest groups of the disease in New Brunswick have affected schools, childcare centers and long-term care homes, while hundreds of people in British Columbia, Alberta, Saskatchewan and Ontario have fallen ill after eating raw oysters.
Children are especially at risk of dehydration from diarrhea and vomiting, whether from COVID-19 or other stomach ailments, and should be closely monitored for signs such as less urination, Sant’Ana said.
It is important to keep them hydrated, and over-the-counter medications can help control vomiting. However, if children are unable to retain fluids due to continued vomiting, they may need inpatient treatment with intravenous fluids, she said.
And – as is well known at this stage of the pandemic – hand washing is an important precaution to prevent the spread of the disease.
Can COVID-19 cause long-term intestinal damage?
There is limited but growing evidence of people experiencing persistent gastrointestinal problems months after COVID-19 infection, including indigestion and post-infectious irritable bowel syndrome (IBS).
A recent pre-release study by US researchers, which has not yet been reviewed, suggests that the virus could disrupt intestinal bacteria and potentially contribute to long-term COVID.
Other infections, including viruses, bacteria and parasites, can impair bowel motility – the contraction of muscles to pass food through the digestive tract – which can lead to IBS and other conditions.
Dr Gil Kaplan, a gastroenterologist and epidemiologist at the University of Calgary, also said some people may have had existing but undiagnosed gastrointestinal problems that have been exacerbated by COVID-19.
Doctors say hand washing is an important habit that must be maintained to prevent the spread of disease. In this photo, people line up to use portable toilets in Montreal on May 5, 2021 (Jean-Claude Taliana / CBC / Radio-Canada)
He is part of a team investigating the effects of COVID-19 on people living with Crohn’s disease and ulcerative colitis, commonly known as inflammatory bowel disease.
“It’s not surprising to me that we’re starting to see things like irritable bowel syndrome and other types of COVID-related conditions that may have been related to other infections in the past, but we just haven’t studied [those infections] as broad as we have with COVID, ”said Kaplan.
It is important that people who experience persistent stomach symptoms talk to a doctor about diagnosis and treatment, he said.
So far, children do not appear to be suffering from long-term gastrointestinal problems as a result of their COVID-19 infections, Sant’Ana said, although this may change in the future.
“It is possible that we will see this a little later than the adults, because in terms of time, the children just have it, so we [haven’t had] time to have symptoms after IBS. “
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