Dr. Deborah Duricka is a professor at the University of Alaska; researcher at Neuroversion; and 2022 Solve Ramsay Grant Program awardee. 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). For people with severe gastrointestinal issues, like those with chronic pancreatitis or pancreatic cancer, blocking these nerves can reduce abdominal pain. This procedure involves injecting anesthesia into the celiac plexus.
The celiac plexus block is like another nerve block, the stellate ganglion block, which Dr. Duricka has long studied for treating people with Long Covid or ME/CFS. The stellate ganglion is a bundle of nerves in the neck that regulates autonomic signals in the head and upper chest area. Earlier, Dr. Duricka showed how stellate ganglion blocks reduce Long Covid–associated anxiety, neurological dysfunctions, orthostatic intolerance, poor sleep, post-exertional malaise, and tachycardia. In fact, the stellate ganglion block is one of four treatments being advanced by NIH RECOVER for an upcoming wave of clinical trials (alongside baricitinib, GLP-1 receptor agonists, and low-dose naltrexone).
In this case report, Dr. Duricka enrolled three women, ages 33 to 39 years, who had Long Covid–associated anxiety, fatigue, orthostatic intolerance, and (most important for this study) diarrhea. 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%).
Two participants needed only a single treatment to durably reduce abdominal pain, diarrhea, and poor bowel functions (one woman experienced relief for a year; and the other, for two years). But the third woman needed continual celiac plexus blocks, once every three months, for continued relief. Still, her relief was profound. She said, “This treatment allowed me to be a mom, businesswoman, and wife again.” Interestingly, while the other women had COVID only once, this third woman had COVID multiple times. Because the number of SARS-CoV-2 infections can increase the severity of Long Covid symptoms, this difference may explain why she needed ongoing treatments while the others did not.
This work is important because the risk of gastrointestinal problems, like diarrhea, irritable bowel syndrome, and pancreatic disease, is greater for people with Long Covid than for other people. Also, Long Covid–associated gastrointestinal dysfunction is less well understood than other Long Covid symptoms. Dr. Duricka noted that we have much to learn before routinely using celiac plexus blocks to treat people with severe gastrointestinal symptoms of Long Covid. Importantly, we must understand how stellate ganglion and celiac plexus blocks can work together. The upcoming NIH RECOVER trials on stellate ganglion blocks offer tremendous opportunities to understand how these neural blocks may synergistically help people with Long Covid gastrointestinal symptoms.
This study was published in Frontiers in Neuroscience.
Why This Study Matters:
- 🧠 Indicates key questions for future clinical trials: Suggests that upcoming NIH RECOVER–led clinical trials on stellate ganglion blocks should also test whether combining both neural blocks (celiac plexus and stellate ganglion blocks) may be especially effective for reducing Long Covid symptoms.
- 🧪Validates overlooked symptoms of Long Covid: Addresses gastrointestinal symptoms of Long Covid, which have not received as much attention as other Long Covid symptoms.
- 🧡 Centers Patient Experience: Shares intense personal and positive experiences of three women with severe Long Covid–associated stomach pain and diarrhea.
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