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Post-infection irritable bowel syndrome following Coronavirus disease-19: A systematic review and meta-analysis

  • Systematic review with meta-analysis
  • Published:
Indian Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

Background and Objectives

Persistent gastrointestinal (GI) symptoms and functional gastrointestinal disorders (FGIDs) are increasingly being recognized after Coronavirus disease-19 (COVID-19). Though quite a few studies addressed irritable bowel syndrome (IBS) following COVID-19, the disorders' prevalence varies greatly. We evaluated, (i) overall frequency of post-COVID-19 IBS, (ii) relative risk of development of IBS among COVID-19 patients compared to healthy controls using systematic review and meta-analysis techniques.

Methods

Literature search was performed for studies on GI symptoms and FGIDs after COVID-19 using electronic databases (Medline, Scopus, Cochrane Central Register of Controlled Trials, Google Scholar and Web of Science) till April 28, 2023. We included studies reporting IBS after COVID-19 with any duration of follow-up and any number of subjects. Studies on pediatric population and those not providing relevant information were excluded. Relative risk of development of IBS using Rome criteria among COVID-19 patients compared to healthy controls was calculated. Analysis was done using MedCalc (Applied Math, Mariakerke, Belgium, version 7.2) and Comprehensive Meta-Analysis version 3.3.070 (Biostat Inc. Englewood, NJ 07631, USA).

Results

Of the available studies, 13 (four case-control) reporting on IBS after COVID-19 met inclusion criteria. Among 3950 COVID-19 patients and 991 controls, 7.2% of COVID-19 patients and 4.9% of healthy controls developed IBS. Of the four case-control studies reporting post-COVID-19 IBS, patients with COVID-19 were 2.65 (95% confidence interval [CI] 0.538 to 13.039) times more likely to have post-COVID-19 IBS as compared to healthy controls.

Conclusions

Patients with COVID-19 are more likely to develop post-COVID-19 IBS than healthy controls. The heterogeneity of studies, different criteria used by various studies to diagnose post-COVID-19 IBS and some studies not meeting the six-month follow-up duration of the Rome criteria for diagnosing IBS are limitations of this systematic review.

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Authors and Affiliations

  1. Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226 014, India

    Akash Mathur, Umair Shams, Piyush Mishra, Shikha Sahu & Uday C Ghoshal

  2. Institute of Gastrosciences and Liver Transplantation, Apollo Multispeciality Hospitals, Kolkata, 700 054, India

    Mahesh K Goenka & Uday C Ghoshal

  3. Department of Microbiology, All India Institute of Medical Science, Kalyani, 741 245, India

    Ujjala Ghoshal

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  1. Akash Mathur
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Contributions

AM, study design, data collection and preparation of the first draft of the paper. PM and US, collection of data. SS, collection of data. MKG, UG: intellectual input, editing and revision of the paper. UCG, study design, data collection, analysis and manuscript editing.

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Correspondence to Uday C Ghoshal.

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AM, US, PM, SS, MKG, UG and UCG have no conflict of interest to declare in relation to this paper.

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Mathur, A., Shams, U., Mishra, P. et al. Post-infection irritable bowel syndrome following Coronavirus disease-19: A systematic review and meta-analysis. Indian J Gastroenterol (2024). https://doi.org/10.1007/s12664-023-01486-x

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