Case Report: Celiac plexus block improves gastrointestinal Long COVID symptoms, 2025, Liu et al

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Case Report: Celiac plexus block improves gastrointestinal Long COVID symptoms

Liu, Luke D.; Duricka, Deborah L.

Abstract
Lingering symptoms following SARS-CoV-2 infection, recognized as the clinical entity “Long COVID,” are common. Gastrointestinal dysfunction during and after COVID have received little attention to date and remain largely unaddressed.

We have previously shown that numerous symptoms of Long COVID excluding gastrointestinal symptoms improve or resolve following stellate ganglion blocks (SGB).

Here, we are first to report successful treatment of persistent post-COVID epigastric pain and diarrhea in three patients using celiac plexus block, a procedure commonly used for visceral abdominal pain and implicating the autonomic nervous system in Long COVID-associated GI symptoms.

Web | DOI | PMC | PDF | Frontiers in Neuroscience | Open Access
 
Solve ME: 'Celiac Plexus Blocks Improve Long Covid–Associated Gastrointestinal Symptoms'

In a new case report, Dr. Duricka described how a procedure called the celiac plexus block can reduce Long Covid–associated stomach pain and diarrhea. The celiac plexus (or solar plexus) is a group of nerves in the abdomen that relays signals between the central nervous system and abdominal organs (e.g., intestines, liver, and stomach).
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Each participant first received a stellate ganglion block; then, one or more celiac plexus blocks over the following months. Within two weeks of their first celiac plexus block, all three women had substantially less stomach pain. The pain was completely gone for the first woman, who said, “I have not experienced an episode of unbearable abdominal pain since the treatment.” And the pain was mostly gone for the second woman (80% gone) and the third (70%).
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We noted improvements in rapid heartbeat, dizziness upon standing, anxiety, depression, and fatigue in all three patients, consistent with our previous studies utilizing SGB for Long COVID (Duricka and Liu, 2024, 2025; Liu and Duricka, 2022).
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However, it remains unclear whether these positive clinical responses observed in this case series were due to SGB, CPB, or a combination of both, and whether their effects are independent, additive, or synergistic. It is plausible that alleviation of GI symptoms following CPB could enhance the benefits of SGB on non-GI symptoms.
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It would be nice if someone could bother doing a proper blinded RCT of these blocks.
 
Even if this and SGB were shown to be effective in a blinded trial, it's completely impractical beyond a few patients.

Each patient received sequential bilateral SGBs […] Each CPB was performed using fluoroscopy guided posterior bilateral retrocrural approach
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Patients 1 & 2 report durable relief of GI symptoms, while Patient 3 requires repeat procedures every 3 months to maintain benefit.
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