Should You Worry About 'Restless Anus Syndrome' After Contracting COVID-19?

We know that people can experience a wide range of new, returning, or ongoing health problems after experiencing COVID-19. The Centers for Disease Control and Prevention (CDC) lists a range of post-COVID conditions on its website.

A study published in JAMA in April 2021 that looked at the long-term symptoms among healthcare workers who had recovered from mild COVID-19 found that the four most common lingering COVID-19 symptoms include loss of smell, loss of taste, lasting fatigue, and shortness of breath.

One symptom that does not make it on the CDC list or appear in research documenting lingering symptoms as of April of 2022 is the attention-grabbing "restless anal syndrome." That is likely because there has been only one case of restless anal syndrome confirmed worldwide since the start of the pandemic.

Restless Anus Syndrome and COVID-19 History

In September 2021, a BMC Infectious Diseases case report described the case of a 77-year-old man who started noticing symptoms related to a constant need to move his bowels after recovering from COVID-19. The case report detailed how the man, who lives in Japan, sought treatment for "deep anal discomfort" after spending 21 days in the hospital with COVID.

The man said the discomfort gave him an "essential urge to move" his bowels. But, even when he did, he still didn't feel relief.

The case report said that the man's symptoms got worse when he was resting, felt better when he exercised, and got worse again in the evening. He had a colonoscopy that detected hemorrhoids, but that didn't explain his symptoms. Neurological tests found no issues with the reflexes of his tendons in his anus, nor did they uncover any problems with the sensation in his perineum (the area between the anus and genitals) and spinal cord.

Doctors dubbed his condition restless anus syndrome, linking his symptoms in the paper with restless legs syndrome—a disorder that causes uncomfortable or unpleasant sensations in the legs and an irresistible urge to move them, according to the National Institute of Neurological Disorders and Stroke (NINDS).

The symptoms of restless legs syndrome are similar to what the man experienced in his anus. With restless legs syndrome, a patient typically feels the urge to move in the late afternoon or evening, and symptoms are usually worse at night when someone is resting. Symptoms can also happen when someone has been inactive and sitting for long periods of time.

Symptoms of COVID-19

The symptoms of COVID-19 are well-documented. According to the Centers for Disease Control and Prevention (CDC), people with COVID-19 have had a wide range of symptoms reported that include:

• Fever or chills
• Cough
• Shortness of breath or difficulty breathing
• Fatigue
• Muscle or body aches
• Headache
• New loss of taste or smell
• Sore throat
• Congestion or runny nose
• Nausea or vomiting
• Diarrhea

While the CDC's list doesn't include restless anus syndrome, it does point out that it does not include "all possible symptoms."

Should You Worry About Getting Restless Anus Syndrome?

It's easy to read about one man's case and panic that it will happen to you if you contract COVID-19. But infectious disease expert Amesh A. Adalja, MD, a senior scholar at the Johns Hopkins Center for Health Security, told Health that's unlikely.

"I've personally never seen anything like this," said Dr. Adalja. "Restless leg syndrome has been reported as a rare complication of COVID-19 in some case reports, and this is an even rarer variant."

As for why this might have happened, Dr. Adalja said that SARS-CoV-2, the virus that causes COVID-19, can spread to the nerves, "possibly causing dysfunction."

Dr. Adalja said that he "highly doubts" people will develop a complication like this from COVID-19. But, said Dr. Adalja, you should "seek medical attention" if it happens to you. As for the man, the case report said that he was prescribed 1.5 milligrams a day of the anxiety medication Clonazepam, which "resulted in the alleviation of restless anal discomfort."