Can Lyme Disease Cause Stomach Problems? Gastroparesis and GI Symptoms Explained
Can Lyme disease cause stomach problems? Yes. In some patients, Lyme disease may disrupt the autonomic nervous system, leading to nausea, vomiting, reflux, abdominal pain, bloating, constipation, and delayed stomach emptying known as gastroparesis.
For years, gastrointestinal symptoms in Lyme disease patients were often dismissed as unrelated to the illness.
But growing evidence suggests autonomic dysfunction may play an important role in many of these symptoms.
For an overview of broader symptom patterns, see Lyme disease symptoms.
How Lyme Disease Affects the Digestive System
Lyme disease can disrupt the autonomic nervous system, which regulates digestive motility.
When this system is impaired, patients may develop nausea, vomiting, reflux, bloating, abdominal pain, constipation, food intolerance, and delayed gastric emptying.
This reflects a motility problem—not simply a stomach disorder.
Studies have also identified B. burgdorferi DNA within gastrointestinal tissue in some Lyme disease patients.
A 1999 study reported PCR evidence of B. burgdorferi in gastrointestinal biopsies from Lyme disease patients along with findings of gastritis, duodenitis, and colitis.
Case Report: Severe Gastroparesis in Lyme Disease
A 25-year-old woman with chronic Lyme disease developed progressive gastrointestinal symptoms that became severe.
Her illness began with loss of appetite and progressed to constant nausea, vomiting, reflux, regurgitation, and inability to tolerate solid food.
She underwent gallbladder removal, but symptoms returned.
Eventually, a feeding tube was placed and she required total parenteral nutrition (TPN) to maintain weight.
Imaging showed delayed stomach and small intestine emptying—consistent with gastroparesis.
Despite multisystem illness, Lyme disease was not treated.
Autonomic Dysfunction, POTS, and GI Symptoms
A Mayo Clinic study evaluating children with orthostatic intolerance and POTS found gastrointestinal symptoms were extremely common.
Symptoms included abdominal pain, nausea, constipation, vomiting, diarrhea, bloating, weight loss, fatigue, dizziness, and headache.
The investigators also identified delayed gastric emptying, slow colonic transit, and impaired gastrointestinal motility.
The findings support a connection between autonomic dysfunction and gastrointestinal symptoms.
Although the study did not specifically evaluate Lyme disease patients, autonomic dysfunction is commonly reported in Lyme disease and POTS.
Why These Symptoms Are Often Missed
Gastrointestinal symptoms in Lyme disease are frequently attributed to unrelated digestive disorders, anxiety, or isolated nerve dysfunction.
But Lyme disease may affect multiple overlapping systems including neurologic regulation, autonomic signaling, inflammation, and immune function.
This can create a multisystem illness pattern that is difficult to recognize.
Learn more about medical dismissal in Lyme disease.
Could Persistent Infection Play a Role?
Some studies suggest Borrelia burgdorferi may persist after standard antibiotic treatment.
Animal models have demonstrated viable organisms following antimicrobial exposure.
While the clinical implications remain debated, an important question remains:
Could ongoing infection contribute to persistent gastrointestinal symptoms in some patients?
Clinical Takeaway
Lyme disease may cause gastrointestinal symptoms through autonomic nervous system dysfunction.
Symptoms may include nausea, vomiting, bloating, reflux, constipation, abdominal pain, food intolerance, and gastroparesis.
Recognizing the neurologic and autonomic components of these symptoms may help avoid delayed diagnosis and improve care.
Frequently Asked Questions
Can Lyme disease cause gastroparesis?
Yes. Autonomic dysfunction may impair stomach motility and contribute to delayed gastric emptying.
Can Lyme disease cause nausea and vomiting?
Yes. Gastrointestinal symptoms including nausea, vomiting, bloating, and reflux have been reported in Lyme disease patients.
What is gastroparesis?
Gastroparesis is delayed stomach emptying caused by impaired nerve or muscle function affecting digestion.
How does autonomic dysfunction affect digestion?
The autonomic nervous system regulates gastrointestinal motility. Dysfunction may disrupt stomach and intestinal movement.
Why are gastrointestinal symptoms often missed in Lyme disease?
Symptoms are frequently attributed to unrelated digestive disorders or anxiety rather than neurologic or autonomic dysfunction.
Related Articles
- POTS: An autonomic dysfunction in Lyme disease patients
- Could autonomic dysfunction lead to pain in Lyme disease patients?
- What exactly is POTS – Postural tachycardia syndrome?
- Neurologic Lyme disease presenting as abdominal pain
References
- Manini ML, Barazi A, Khemani D, et al. Gastrointestinal motility evaluation in children with orthostatic intolerance: Mayo Clinic experience. Neurogastroenterol Motil. 2020:e13863.
- Fried M, Abel M, Pietruccha D, et al. The Spectrum of Gastrointestinal Manifestations in Lyme Disease. J Pediatr Gastroenterol Nutr. 1999;29(4).
- Stolk JM, van Nieuwkoop C, van der Voorn M, van Erp S, van Burgel ND. Ticking off diagnoses of abdominal pain: early neuroborreliosis with radiculopathy. Neth J Med. 2018;76(7):336-338.
- Rao SS, Patcharatrakul T. Diagnosis and Treatment of Dyssynergic Defecation. J Neurogastroenterol Motil. 2016;22(3):423-435.
Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.
Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention
In 1999, my 7yo daughter had a known tick attachment. First symptom were persistent ankle pain At age 8, she had chronic constipation, resulting in 4 trips to ER and 2 overnight hospital admissions. More water and fiber were not effective remedies. At puberty at 12, her health collapsed. She had two Lyme bands and got IV treatment Tilt table at 14 got POTS dx. At 28yo, she remains disabled.
You are not alone. This article on autonomic dysfunction affords some insight into the potential role of autonomic dysfunction in Lyme disease.
I have had chronic Lyme for 4 yrs with terrible digestive problems.
I self diagnosed myself with Lymes after no one seemed to be able to figure it out. I had a total of 24 days of doxycycline and was pronounced cured. I originally had severe back pain in my right kidney area that has decreased significantly but still have a burning sensation in the left front flank area where my intestines are along with some joint pain. I’m taking Meloxicam for pain. I’ve been extremely tired and can’t seem to stay awake when in a vehicle. I don’t feel I’m over it and wondering if I’m ever going to feel normal again.
I have Lyme disease patients who are better in 24 days if they get treated at the time of a rash. I have patients who have failed 24 days who benefit from further treatment for Lyme and coinfections.