Background Many of the studies on COVID‐19 severity and its associated symptoms focus on hospitalized patients. The aim of this study was to investigate the relationship between acute GI symptoms and COVID‐19 severity in a clustering‐based approach and to determine the risks and epidemiological features of post‐COVID‐19 Disorders of Gut–Brain Interaction (DGBI) by including both hospitalized and ambulatory patients. Methods The study utilized a two‐phase Internet‐based survey on: (1) COVID‐19 patients’ demographics, comorbidities, symptoms, complications, and hospitalizations and (2) post‐COVID‐19 DGBI diagnosed according to Rome IV criteria in association with anxiety (GAD‐7) and depression (PHQ‐9). Statistical analyses included univariate and multivariate tests. Results Five distinct clusters of symptomatic subjects were identified based on the presence of GI symptoms, loss of smell, and chest pain, among 1114 participants who tested positive for SARS‐CoV‐2. GI symptoms were found to be independent risk factors for severe COVID‐19; however, they did not always coincide with other severity‐related factors such as age >65 years, diabetes mellitus, and Vitamin D deficiency. Of the 164 subjects with a positive test who participated in Phase‐2, 108 (66%) fulfilled the criteria for at least one DGBI. The majority ( n = 81; 75%) were new‐onset DGBI post‐COVID‐19. Overall, 86% of subjects with one or more post‐COVID‐19 DGBI had at least one GI symptom during the acute phase of COVID‐19, while 14% did not. Depression (65%), but not anxiety (48%), was significantly more common in those with post‐COVID‐19 DGBI. Conclusion GI symptoms are associated with a severe COVID‐19 among survivors. Long‐haulers may develop post‐COVID‐19 DGBI. Psychiatric disorders are common in post‐COVID‐19 DGBI.

Purpose of Review Gastroparesis is one of the more challenging entities in the landscape of gastroenterology, posing difficulties for both patients and physicians with regard to effective management and therapies. In this article, we reviewed various gastroparesis treatment options, with an emphasis on gastric electrical stimulation (GES). Recent Findings GES has demonstrated a significant reduction of cardinal symptoms in refractory gastroparetic patients, particularly nausea and vomiting, across multiple studies. However, GES has not been shown to conclusively decrease gastric emptying time in these patients. Such finding has led the investigators to analyze the impact of combining GES with pyloroplasty. While this treatment pathway is nascent, its results thus far reveal an amplified improvement of gastroparesis symptomatology in addition to significant reduction of gastric transit, compared to GES by itself. Summary Limited treatment choices are available for refractory gastroparesis. Combining GES with pyloroplasty holds promise but requires further assessment in large-scale trials to fully evaluate the risks and benefits.

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