{
  "abstract": "Persistent gastrointestinal (GI) symptoms after SARS-CoV-2 infection include diarrhea, abdominal pain, dyspepsia, constipation, nausea, and other disorders of gut-brain interaction (DGBIs), but these entities should not be treated as interchangeable. In a meta-analysis of long-COVID studies, any GI symptom was reported in approximately 22% of patients and diarrhea in 10%, although heterogeneity was very high. In a large US Veterans Affairs cohort, post-acute COVID-19 was associated with incident diarrhea (hazard ratio {HR}: 1.58, 95% CI: 1.52-1.65; excess burden 7.99 per 1,000 persons at one year) and irritable bowel syndrome (HR: 1.54, 95% CI: 1.28-1.86). Prospective Rome IV cohorts report lower absolute rates of formally diagnosed DGBIs; one study found persistent DGBI symptoms in 6.6% at six months, with functional diarrhea in 2.2% and irritable bowel syndrome (IBS) in 2.5% at three months. Mechanistic evidence supports intestinal involvement during acute infection and demonstrates associations with epithelial/angiotensin-converting enzyme 2 (ACE2) perturbation, immune activation, barrier dysfunction, altered microbial taxa, and impaired microbial metabolite production. However, persistent viral RNA or antigen, dysbiosis, and gut-lung signaling remain proposed or associative mechanisms rather than established causes of chronic diarrhea. Treatment evidence specific to post-COVID functional diarrhea is sparse. A large synbiotic trial improved a broad \"gastrointestinal upset\" domain in post-acute COVID syndrome, but did not enroll a defined chronic diarrhea or Rome-positive population; probiotic and fecal microbiota transplantation trials showing GI effects were largely conducted during acute COVID-19. Therefore, current care should first exclude organic and medication-related causes, then apply phenotype-based management extrapolated from established diarrhea-predominant irritable bowel syndrome (IBS-D) and functional-diarrhea practice while clearly acknowledging the limited post-COVID-specific evidence. Standardized definitions, pre-infection GI data, appropriate controls, functional microbiome measures, and dedicated randomized trials are priorities for future research.",
  "abstract_shown": true,
  "affiliations": [
    "Molecular and Cellular Biology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA"
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 1,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Fauz Saheb"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/4bd1vgp2jwdzf.bib",
  "cited_by": 0,
  "doi": "10.7759/cureus.117111",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13717138/?tool=EBI",
  "id": "4bd1vgp2jwdzf",
  "issns": [
    "2168-8184"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13717138",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Epidemiology/Public Health"
    ],
    [
      "heading",
      "Infectious Disease"
    ],
    [
      "heading",
      "Pathology"
    ],
    [
      "openalex",
      "2728|Long-Term Effects of COVID-19"
    ]
  ],
  "openalex": "W7214777988",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13717138/pdf/?tool=EBI",
  "pmcid": "PMC13717138",
  "pmid": "42959510",
  "published": "2026-09-28",
  "publisher": "Cureus Inc.",
  "ris": "https://research.draconitic.com/paper/4bd1vgp2jwdzf.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T00:20:37Z",
      "native_id": "PMC:PMC13717138",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13717138"
    },
    {
      "first_seen": "2026-11-01T00:20:52Z",
      "native_id": "MED:42959510",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42959510"
    },
    {
      "first_seen": "2026-11-02T12:21:31Z",
      "native_id": "PMC13717138",
      "source": "pmc",
      "url": "https://doi.org/10.7759/cureus.117111"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "heading:Infectious Disease",
      "subfield": "infectious-disease"
    }
  ],
  "title": "Post-COVID Gastrointestinal Symptoms and Disorders of Gut-Brain Interaction: A Focus on Persistent Diarrhea",
  "title_text": "Post-COVID Gastrointestinal Symptoms and Disorders of Gut-Brain Interaction: A Focus on Persistent Diarrhea",
  "type": "peer-reviewed",
  "updated_at": "2026-11-02T12:21:31Z",
  "url": "https://research.draconitic.com/paper/4bd1vgp2jwdzf",
  "venue": "Cureus",
  "versions": []
}