What causes severe abdominal pain and bloating during viral infections?

From the Guidelines

Abdominal pain and bloating during viral infections are likely caused by the virus's direct or indirect impact on the digestive system, leading to inflammation and disruption of normal gut function, as seen in patients infected with SARS-CoV-2, where 30-60% experience symptoms such as anorexia, nausea, vomiting, diarrhea, and abdominal pain 1.

Key Factors Contributing to Symptoms

• The gut is the largest immune organ, and its inflammatory response can have a systemic impact, contributing to symptoms like abdominal pain and bloating
• Breakdown of the gut barrier and dysbiosis, or changes in the microbiome, can amplify inflammation and contribute to systemic cytokine release
• The virus's ability to target the gut and alter the renin-angiotensin system (RAS) activity may also play a role in the GI inflammatory response

Managing Symptoms

• Over-the-counter medications like simethicone (Gas-X) for bloating or acetaminophen (Tylenol) for pain can be taken, following package directions
• Avoiding NSAIDs like ibuprofen on an empty stomach is recommended, as they may worsen gut irritation
• Staying hydrated with clear fluids, eating small, bland meals, and applying a warm compress to the abdomen can provide comfort

When to Seek Medical Attention

• Severe, persistent, or worsening symptoms beyond the viral illness
• High fever, bloody stool, or severe vomiting, which could indicate complications requiring specific treatment It is essential to prioritize managing symptoms and seeking medical attention if necessary to prevent complications and improve quality of life, as the relationship between abnormal liver and pancreatic tests and the actual infection is unclear, and the gut's inflammatory response can have a systemic impact 1.

From the Research

Abdominal Pain and Bloating

• Experiencing excruciating abdominal pain and bloating when getting a virus can be related to the imbalance of gut microbiota, also known as dysbiosis 2.
• Research suggests that probiotics, such as Lactobacillus acidophilus, can help modulate the human microbiota and alleviate digestive disorders 3, 4.
• The gut microbial ecosystem plays a significant role in host health, and Lactobacillus has been found to have promising applications in intestinal health and disease 4.

Role of Lactobacillus

• Lactobacillus acidophilus has been shown to have various biological functions, including improving intestinal barrier function, immunoregulation, and metabolic regulation 3, 4.
• The administration of Lactobacillus acidophilus has been found to be effective and safe in the treatment of acute diarrhea, chronic diarrhea, and antibiotic-associated diarrhea 2.
• Lactobacillus species have been correlated with human disease and chronic conditions, highlighting the importance of this genus to human health 5.

Clinical Implications

• Clinical decisions should be driven by evidence-based recommendations, but also consider individual patient factors and clinical reasoning 6.
• The use of probiotics, such as Lactobacillus acidophilus, may be a useful adjunct in the management of gastrointestinal disorders, but more research is needed to fully understand their role in preventing and treating diseases 2, 4.