Dr Rakesh Patel
Digestive issues after COVID-19 recovery are now a common problem among patients. Problems such as bloating, gaseousness, acidity, acid reflux, constipation, and exacerbation of Irritable Bowel Syndrome (IBS) are being commonly seen in the second wave of the pandemic. The number of patients with these complaints are increasing at an alarming rate.
We all know that the digestive system involves the gastrointestinal tract (GI) along with the Liver, Pancreas, and Gall Bladder. During COVID-19, it is significant to take care as the virus disrupts the functioning of the GI and renders it unable to perform its duties of absorbing electrolytes and fluids from the body. Patients can even end up with bleeding in the gastrointestinal tract or have blood clots in the blood vessels leading to Ischemia (restricted/ reduced bood flow) and Gangrene. The disease may also destroy bowel tissues and reduce intestinal movement. These issues can become more serious if left untreated.
Symptoms
If you experience any of these following symptoms, it important that a complete evaluation, monitoring is done to ensure timely treatment for healing and recovery.
- Acid reflux
- Loss of appetite or increased appetite
- Abdominal bloating
- Upper abdominal pain
- Constipation
- Diarrhea
- Vomiting
- GI bleeding
- Intestinal inflammation
How Does Covid-19 affects GI?
While researchers and healthcare providers are still gathering data to understand the actual cause of the problem. There is evidence that indicates how the virus impacts the digestive system. Most studies show the SARS-CoV-2 virus enters intestinal cells, or enterocytes, and respiratory cells using the Angiotensin-Converting Enzyme 2 (ACE-2) protein as a receptor.
The ACE-2 receptor is embedded in cellular membranes. It helps regulate blood pressure by controlling levels of the protein angiotensin, which encourages blood vessels to constrict and raise blood pressure. The virus enters intestinal cells after its characteristic spike proteins bind to ACE-2. Once inside the cell, the virus uses the cells’ own machinery to produce copies of viral proteins and ribonucleic acid (RNA). When SARS-CoV-2 particles leave an infected cell, it triggers the release of cytokines, small proteins that play a role in inflammation. This process may cause GI symptoms.
GI symptoms can also occur as viruses destroy or damage GI tissues, especially pain, nausea, and diarrhea. Some research shows that COVID19 may also change the gut microbiota, the community of microbes that normally inhabit the intestines or stomach. Once in the GI tract, the virus can also travel through the portal vein, the vein that drains blood from the digestive tract. This can allow viruses to impact the vagus nerve, causing a nauseous sensation.
Things you must do
- Avoid taking nutraceuticals and immune booster medicines
- Be careful about your diet, keep it simple
- Avoid fast food and overeating
- Be active and exercise regularly
Things to include in your meals
Include prebiotics and probiotics in our daily meals keep the gut healthy.
Probiotics are good bacteria that improves the gut health by promoting good immunity and enhancing nutrient absorption. Curd or yoghurt is the best known probiotic.
Prebiotics are the complex carbohydrates which are not digested by our body and it promotes the growth of good bacteria inside the gut. This again promotes the digestion of the food that we eat. Prebiotics are present in fruits, vegetables and whole grains like Oats, Jowar etc. Eating adequate amount of pre and probiotics keeps acidity at bay and improves digestion.
Drinking minimum 2-3 litres of water a day helps in the absorption of nutrients and thereby is important in maintaining a good gut health.
Diet rich in Omega 3 Fatty acids not only helps improving the immune health but also has an anti-inflammatory property that aids in post COVID recovery. Flax seeds, Almonds, Walnuts, Chia seeds, seafood are the good sources of Omega-3 Fatty Acids. Nuts and seafood are also packed sources of Zinc and Selenium that are very effective for post COVID recovery.
Protein is the major component in a COVID recovery diet, aiding speedy recovery. Including milk, milk products, dal, pulses, legumes, Soya and Soya products, Chicken, Fish, eggs in diet is very helpful in post covid recovery.
Irrespective of the presence of comorbidities like diabetes and hypertension, we must be extra cautious for the use of salt and sugar in our daily meals. Many researches suggests that excess use of salt and sugar impairs our immune response and hence increases the risk of infections.
At the end, we must remember that we are still learning and understanding the impact of COVID19 on the human body. The disease is still unravelling its many aspects. One must be vigilant of the symptoms, not ignore the vital signs, switch to a healthy lifestyle and consult the doctor when in doubt.
Dr Rakesh Patel, Consultant Gastroenterology, Fortis Hospital Kalyan & Ms. Rasika Parab, Clinical Nutritionist, Fortis Hospital Mulund.