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Covid-19: is restless anus syndrome a new symptom? – Why Doctor?

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THE ESSENTIAL

  • This disease is called “restless” because only walking or running can relieve pain while rest worsens it.
  • The man underwent a colonoscopy which revealed internal hemorrhoids but no other lesions.
  • The patient would suffer from a dysfunction of the central nervous system which would have caused this syndrome.

Soon two years after the official appearance of SARS-CoV-2, the disease that results from the infection, Covid-19, continues to surprise. On September 23, the review BMC Infectious Diseases reported the case of a 77-year-old Japanese man who presented with restless anus syndrome following Covid-19. The lack of anal discomfort before the infection prompted researchers to suggest it was caused by the virus.

A new symptom

The spread of the virus to the nervous system has been demonstrated on several occasions, causing various symptoms such as loss of taste and smell, delirium, encephalitis, acute cerebrovascular events or even Guillain-Barré syndrome. “However, the understanding of the neuropsychiatric sequelae associated with Covid-19 is still in its infancy, and the potential mechanisms underlying these various symptoms are not yet fully understood.”, Note the researchers. Thus, cases of insomnia, depressed mood, post-traumatic stress disorder and cognitive impairment have been reported in patients after discharge from hospital.

In this scientific article, the authors report a new symptom that would result from infection with the virus: restless anus syndrome. The Japanese man’s case was noted several weeks after his release from the hospital because of the Covid-19. He reported deep, restless anal discomfort, about 10 cm from the perineal region. This disease is called “restless” because only walking or running can relieve pain while rest worsens it. The man underwent a colonoscopy which revealed internal hemorrhoids but no other lesions. Nothing else was detected. The administration of an anxiolytic made it possible to constantly alleviate this pain, but it still persists 10 months after the start of treatment.

Nervous system dysfunction

This disease results from a dysfunction of the central nervous system resulting in both sensory and motor symptoms. It is a variant of restless leg syndrome. The patient fulfills the four essential characteristics of it, with the nuance that the symptom was localized in the anus and not in the leg: the desire to move, a worsening of the symptoms with rest, its improvement with the exercise and deterioration in the evening.

For researchers, this case “may reflect the associative impacts of Covid-19 on the neuropsychiatric state” patients. To better understand them, it is necessary to monitor the evolution of these cases in the long term.

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