Esophageal motility disorders after COVID-19 infection, 2025, Žarko Babić et al

[Mij]

Abstract
The COVID-19 infection can cause changes on many organs, but changes in post infection period are not uncommon. The aim of this study is to detect changes in esophageal manometry parameters in post COVID-19 infection period.

We reevaluated 84 patients after clinical recovery from COVID-19 disease, who were diagnosed with ineffective esophageal motility, previous to infection with SARS-CoV-2 virus. All of the patients enrolled were submitted to reevaluation because of chest discomfort, swallowing problems and dysphagia. The potential coexistence of gastroesophageal reflux disease was excluded clinically by upper gastrointestinal endoscopy with narrow band imaging and patohistological analysis and on 24-hours impedance monitoring.

Using high-resolution esophageal manometry, and comparing the results to previous functional evaluation before COVID-19 disease, we detected significant lowering of contractile front velocity (CFV), distal contractile integral, prolongation of distal latency and prolongation of peristaltic break size (Break), and influence of infection on distal contractile integral in post rapid swalllows on multiple rapid swallow test (P < 0.07) according to Chicago 4.0 Classification, in all post COVID-19 patients (P < 0.05).

In this study, the results of 84 patients included indicate the possible influence of SARS-CoV-2 infection on esophageal motility. The authors find the observation on worsening of changes in patients with preexisting esophageal dysmotility as an interesting finding, that deserves to be shared with clinical and scientific communities, especially in the field of esophageal motility research. Further research is needed in order to confirm these results and elucidate possible mechanisms.
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[Yann04]

I have to say I never had reflux in my life before COVID and after COVID I got extremely debilitating reflux that hasnt gone away. I tried all sorts of medicine and the only thing that sort of helps is max dose PPI and even then its not gone away.

This reflux was one of my first symptoms of this post-viral syndrome -> ME/CFS.

 

[Utsikt]

They mention that according to their notes, there were no signs of clinical changes in the diseases of the patients. I’m not sure which diseases they had.

They had a small control group that isn’t mentioned in the abstract.

The second group (called control group) consisted of patients selected blindly and randomly from our pool of patients (selected by random numbers method) with the same esophageal disorder based on symptoms, esophageal monitoring as well as exclusion of other gastrointestinal disorders but who had not contracted COVID-19 infection. The same methods were used to assess symptoms and exclude other GI disorders in both groups. In the control group we had 12 patients (age 21-80y, 7 women and 5 men) which were sampled in the same time period of 30 May 2020 to 30 April 2024. All patients in the control group were set to have esophageal monitoring controls 6 months after the initial testing was done.

 

[Peter T]

Interesting. Has esophageal manometry been reported on in very severe ME/CFS where there are marked feeding issues?

(Aside - I now have oesophageal reflux, but it did not start until over twenty years into my ME/CFS and after I have had one or two probable TIAs, so it perhaps more likely that my issues are not ME related For me it is only an issue if I eat too late before I go to sleep, and now that I take anti acids it is much less unpleasant. However I am not aware of any gut motility issues otherwise. The only thing I have to watch out for is that the regurgitated food can go onto my lungs while I am asleep without triggering any cough reflex, so I have to be strict about not eating too late before going to sleep, or ensure I am well propped up if I do.)