Temple University Hospital Philadelphia, PA, United States
Rishabh Khatri, MD, Jay Patel, MD, Jun Song, MD, Henry P. Parkman, MD Temple University Hospital, Philadelphia, PA
Introduction: Gastrointestinal (GI) cases of functional dyspepsia (FD) are not well documented in patients with COVID-19. FD is characterized by early satiety, abdominal fullness, pain and burning, without structural or functional pathology for 3 months with onset ≥ 6 months prior by the Rome IV criteria. We report a patient with COVID-19 who developed FD as a result of her viral disease.
Case Description/Methods: A 57-year-old-female with a history of well controlled Celiac disease and Vitamin D deficiency presented to the emergency department (ED) after recently testing positive for COVID-19 less than 3 weeks prior via nasopharyngeal swab. Upon arrival, she described symptoms of nausea, vomiting, non-bloody diarrhea, early satiety, abdominal pain, fullness, and burning after meals, and weight. She weighed 63.1 kg compared to her normal weight of 67.6 kg. She was discharged from the ED with instructions to self-quarantine and prescribed anti-reflux medications. 4 weeks later, she followed with our institution via Telemedicine visit for her persistent symptoms endorsing increased frequency (multiple times a week) of early satiety, abdominal pain, burning, and severe nausea after eating, and increased fatigue and weight loss. She underwent esophagogastroduodenoscopy (EGD) and gastric emptying study (GES) to evaluate her symptoms. No structural or histologic abnormalities were found via EGD and mucosal biopsies. GES was normal [2 hour study 53% of the radiolabeled meal remained in the stomach (normal less than 60%); at 4 hours there was 2% of the meal in the stomach (normal less than 10%)]. Her weight at this time was 61.7 kg. Upon follow up 4 weeks later, her symptoms persisted. She was prescribed a proton pump inhibitor at this time. Upon follow up 2 weeks later, her symptoms persisted. With no observable structural pathology on EGD, defect on GES, and negative H. pylori testing, FD was diagnosed according to the Rome IV criteria, as a presumed sequelae of COVID-19. She was prescribed the tricyclic antidepressant, amitriptyline, with improvement in her symptoms at follow up visit 6 weeks later.
Discussion: This patient had persistent dyspeptic symptoms after her initial COVID-19 infection, which presented primarily with GI symptoms. This case illustrates the development of FD after a COVID-19 illness, post-COVID-19 FD. She was treated conventionally for FD, and improved. Thus, COVID-19 may be a possible etiology in patients who have the onset of FD symptoms without other contributing causes.
Disclosures: Rishabh Khatri indicated no relevant financial relationships. Jay Patel indicated no relevant financial relationships. Jun Song indicated no relevant financial relationships. Henry Parkman indicated no relevant financial relationships.
Rishabh Khatri, MD, Jay Patel, MD, Jun Song, MD, Henry P. Parkman, MD. P2491 - Functional Dyspepsia: A Sequelae After COVID-19, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.