Mpox gastrointestinal symptoms revealed in new study insights

Medical News: Mpox, a viral infection caused by the monkeypox virus, has gained significant attention over the years due to its unique symptoms and global outbreaks. While much of the research has focused on dermatological and flu-like symptoms, recent studies have shed light on an often overlooked aspect of the disease: its gastrointestinal (GI) manifestations. Researchers from various institutions have come together to delve deeper into these symptoms, and this Medical News report will explore the findings and implications of their systematic study review on mpox-related GI complications.


Mpox gastrointestinal symptoms revealed in new study insights

Understanding Mpox and Its Transmission
Mpox, a member of the Poxviridae family and Orthopoxvirus genus, is similar to viruses like smallpox and cowpox. Although historically confined to Central and West Africa, it gained global prominence after outbreaks in non-endemic countries in 2022. The transmission of mpox occurs through both human-to-human and animal-to-human interactions. Common transmission routes include direct skin contact, respiratory droplets, and contaminated objects. While the focus has traditionally been on skin rashes, fever, and muscle aches, gastrointestinal symptoms have become a growing concern, particularly in recent outbreaks.
 
Key Study Findings on Gastrointestinal Symptoms
A systematic study review conducted by researchers from institutions such as Nova Southeastern University in Florida and Sutter Medical Group in California explored the gastrointestinal effects of mpox, aiming to fill the knowledge gap in this area.
 
The researchers identified and analyzed 33 studies involving 830 patients, revealing a variety of GI symptoms. Among the most common symptoms reported were proctitis (inflammation of the rectum), rectal pain, nausea, vomiting, diarrhea, and abdominal pain. A notable finding was that proctitis was strongly associated with certain transmission routes, particularly anal-receptive sexual contact, highlighting the importance of sexual history in diagnosing mpox patients. Interestingly, the severity of the dermatological or flu-like symptoms did not necessarily correlate with the GI symptoms, emphasizing that mpox patients may experience severe digestive issues even when other symptoms appear mild.
 
Proctitis: A Predominant GI Symptom
Proctitis emerged as one of the most frequently observed GI complications in mpox patients. This condition, characterized by inflammation of the rectum, often leads to rectal pain, bleeding, and tenesmus (the constant urge to defecate). The review found that a significant number of mpox patients experienced proctitis, with studies from the USA, Spain, Germany, and France reporting consistent findings. Patients with proctitis often presented with rectal pain and were diagnosed with the condition prior to the onset of systemic symptoms such as fever and muscle aches.
 
Proctitis in mpox patients has been linked to certain transmission routes, particularly through sexual contact. This finding suggests that healthcare providers should be aware of the potential for GI symptoms in patients who may have been exposed to mpox through sexual activity. Furthermore, it underscores the need for thorough sexual history assessments during patient evaluations.
 
Other Common GI Symptoms: Vomiting, Diarrhea, and Abdominal Pain
In addition to proctitis, the review highlighted other common GI symptoms associated with mpox. Vomiting and diarrhea were prevalent in a significant portion of the patients studied, particularly in younger populations and those with compromised immune systems. One study from Spain reported a case of a pediatric patient who experienced vomiting and diarrhea, raising concerns about broader transmission risks in school environments.
 
Vomiting and diarrhea were also reported in several studies from the USA and Democratic Republic of Congo (DRC), where patients presented with these symptoms following direct contact with infected animals or individuals. The review found that approximately 40% of the 830 mpox patients experienced vomiting, underscoring the importance of recognizing GI symptoms when diagnosing and treating mpox cases.
 
Rare and Severe GI Complications: Rectal Perforation and Proctalgia
While most patients with GI symptoms experienced conditions such as proctitis, vomiting, or diarrhea, the review also identified rare but severe complications. Rectal perforation (RPE), a condition in which a hole forms in the rectal wall, was reported in a small percentage of patients. This rare complication can result in life-threatening conditions if not treated promptly. In one case from the UK, a patient was treated with intravenous antibiotics and made a full recovery, but the risk of RPE underscores the potential severity of mpox-related GI symptoms.

Proctalgia, a sudden, severe pain in the anorectal area, was another rare complication observed in mpox patients. Although not as common as proctitis, proctalgia can cause significant discomfort and may require specialized treatment to manage the pain and underlying inflammation.
 
Public Health Considerations and Implications
The findings from this systematic review have important public health implications, particularly in terms of recognizing and addressing GI symptoms in mpox patients. In addition to the physical discomfort these symptoms cause, they can play a critical role in early detection and diagnosis of mpox, especially in cases where skin rashes or flu-like symptoms are not prominent.
 
The connection between sexual transmission and GI symptoms, especially proctitis, also raises important considerations for sexual health education and STI screening. Public health campaigns aimed at raising awareness of mpox transmission routes should include information on the potential for GI symptoms, particularly among at-risk populations.
 
Healthcare providers, including gastroenterologists, should be equipped to recognize the GI manifestations of mpox and consider them in their diagnostic process. Early identification and treatment of these symptoms can improve patient outcomes and prevent complications such as dehydration, rectal perforation, and sepsis.
 
Conclusion: Expanding Our Understanding of Mpox
The systematic review conducted by researchers across multiple institutions provides valuable insight into the gastrointestinal effects of mpox. While much of the attention has been on skin rashes and flu-like symptoms, this review highlights the importance of recognizing and treating GI symptoms such as proctitis, vomiting, and diarrhea. The findings suggest that GI symptoms may be more prevalent in mpox patients than previously thought, and healthcare providers should be prepared to address these symptoms in their clinical practice.
 
The study review also emphasizes the need for further research into the pathophysiology of mpox-related GI complications, as well as the potential for long-term effects. Understanding how mpox affects the digestive system can improve patient care and lead to more effective treatment protocols in future outbreaks.
 
The study findings were published in the peer-reviewed journal: BMJ Open
Gastroenterology.
https://bmjopengastro.bmj.com/content/11/1/e001266
 
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Read Also:
https://www.thailandmedical.news/news/miami-study-sounds-alarm-that-mpox-can-also-cause-gastrointestinal-complications-and-inflammation-of-the-rectum
 
https://www.thailandmedical.news/news/new-study-reveals-monkeypox-mpox-virus-may-persist-at-oral-and-rectal-sites-after-recovery