Covid-19 cases on steady decline in Mumbai, but gastro ailments up

The number of cases in the city is on a steady decline, but doctors say they are seeing a lot of Covid-induced Gastroesophageal Reflux Disease (GERD) cases. While doctors said they haven't seen GERD in recovered patients of the Delta variant, they are observing up to four cases a day of the ailment in the third wave.

Dr Roy Patankar, consultant gastroenterologist, Zen Super Speciality Hospital, who has been seeing 2-3 cases a day said, "We have seen an increase in GERD especially in patients with Covid. The Covid infection can cause gastro-intestinal issues leading to vomiting, loss of appetite, nausea, diarrhoea, and pain in the abdomen." He said many multiple combination drugs are used during the treatment of Covid-19 like steroids, antivirals, anti-fungals, antibiotics, etc. which have a serious effect on the gastrointestinal system during the recovery phase. "While we haven't seen many GERD cases in the previous two waves, we are seeing more cases in this wave. One of the major reasons behind this can be a sedentary lifestyle, eating oily and adulterated food, lack of exercise, increase in self-medication during the lockdown in the fear of visiting the hospital," Dr Patankar said.

‘Need wiser use of drugs'

Dr Honey Savla, consultant, Internal Medicine, Wockhardt Hospital said she has seen at least 8-10 Covid patients suffering from reflux acidity issues in a week. "Covid is not just a disease of the lungs and we have understood this time and again. There have been complaints from stomatitis to gastritis to gastroenteritis. Patients are on multiple medications including antivirals, steroids, anti-fungals and even zinc medications that lead to gastritis due to combinations of drugs. We are looking forward to wiser use of drugs," she said.

The Covid infection can cause gastro-intestinal issues including nausea. Representation pic

Agreeing with Dr Patankar, Dr Savla said many patients were seen self medicating for Covid. "People have tried kadhas at home, which has also led to stomach upsets. Work from home has caused tummy trouble due to lack of exercise, more work and unhealthy eating habits. Hence people have complained about GERD, irritable bowel syndrome and reflux acidity," she explained.

Dr Purshottam Vashistha, senior consultant, Gastroenterology, Nanavati Max Super Speciality Hospital said GERD involves frequent acid reflux incidences, wherein the stomach acids flow back to the food pipe, impacting the lining of the oesophagus. "Excessive consumption of multiple drugs, herbal and non herbal medicines during or post-Covid infections has given rise to various gastrointestinal issues - one of which is GERD. We have witnessed a significant rise in digestive issues such as acid reflux, during the pandemic in patients with active or post-recovery of Covid infection," he said.

But Dr Sujit Chatterjee, CEO of Dr LH Hiranandani Hospital said it is difficult to attribute GERD to Covid. "Cannot definitely attribute for Covid but there is an increase in cases," he said.

‘Don't ignore GERD'

Dr Neeraj Tulara, infectious diseases specialist at LH Hiranandani Hospital, Powai, however, said acute gastritis and acute gastroenteritis are some of the very common symptoms of Covid which people usually miss. "Many times it is just simple gastric symptoms even sometimes without fever which ultimately turns out to be Covid. Even persistent hiccups have been one of the very important symptoms of Covid which is missed most of the time. GERD can be a presenting symptom which should not be ignored and patients should be investigated for Covid if it is without any precipitating factor or reason and not settling on its own," he added.

Dr Vashishtha said to prevent gastroenterological problems, one should follow a balanced diet and avoid citrus fruits, coffee and painkillers specially NSAIDS (Non-steroidal anti-inflammatory drugs), some
antibiotics, drinking, smoking and stress, and incorporate exercise in lifestyle along with early dinner and light meals.

Symptoms of GERD

>> A burning sensation in the chest (heartburn), usually after eating
>>Bloating
>>Regurgitation, highly acidic
>>Difficulty in swallowing
>>Chest pain
>>Laryngitis
>>Chronic cough

4
Approx. no. of GERD cases a day doctors are seeing