A Gut Feeling: Long COVID and GI symptoms

Apr 29, 2022 | Greg Vanichkachorn | @drvan | Comments (80)

Over the past two years, it has become clear that post COVID syndrome (PCS) is more than just fatigue and shortness of breath. Symptoms such as headaches, brain fog, ringing in the ears, and even eye changes have been reported as part of PCS, and it seems that every day we are learning more about possibly related symptoms.

One group of symptoms we are hearing more about lately involves the gastrointestinal (GI) system.  In our COVID Activity Rehabilitation Program (CARP), patients have reported a wide variety of GI issues, ranging from mild nausea and decreased appetite to severe and new constipation and food intolerance.

And what we have seen firsthand has also been documented in medical literature.  A study published in March 2022 found that in 147 patients with no prior GI problems, 16% reported having new GI symptoms roughly 100 days after their SARS-COV2 infection.1 The most common symptoms included:

  • Abdominal pain 7.5%
  • Constipation 6.8%
  • Diarrhea 4.1%
  • Vomiting 4.1%

Similarly, in a study published in April 2022, researchers found that patients with PCS were experiencing Disorders of Gut Brain Interaction (DGBI).2 Symptoms with this condition included:

  • Heartburn
  • Troubles swallowing
  • Irritable bowel syndrome
  • Constipation
  • Diarrhea
  • Bloating
  • Incontinence

While we are not sure yet, there are several possible ways the COVID-19 infection could cause GI problems.  For example, the lining of the gut has a large amount of the receptors that the SARS-COV2 virus uses to invade cells. The general inflammation caused by the infection can also disrupt the normal bacteria that live in the gut and stimulate some of the GI system nerves.

What should you do if you are experiencing GI symptoms as part of PCS?

First, make sure to adequately hydrate and eat a healthy, balanced diet. Fad and extreme diets have not been found to be helpful in PCS. Instead, we recommend a standard Mediterranean diet with a reduction in processed foods. Second, avoid using lots of over-the-counter products to treat your symptoms. Sometimes, this can make the problem worse. Instead, speak to your medical professional first to develop a treatment plan.

Hopefully, with more research, we will be able to offer more treatments that get patients feeling better faster.

  1. JW B, J L, D J, DE F. Prevalence and risk factors for gastrointestinal symptoms after recovery from COVID-19. Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society. 2022;34(3).
  2. R EN, A S, I S, et al. Gastrointestinal symptoms and the severity of COVID-19: Disorders of gut-brain interaction are an outcome. Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society. 2022.

Read more about PCS through the eyes of a MN legislator. Connect with other people like you and share your recovery tips and successes in the Post-COVID Recovery & COVID-19 support group.

Interested in more newsfeed posts like this? Go to the Post-COVID Recovery blog.

5-1-22. COVID symptoms started 01/01/22. Antibiotics did not cure long term COVID. At present (4 mo. later): experiencing: shortness of breath, fatigue, face/forehead/head swell feeling, brain fog, ear ring, heart palpitations, feeling of internal organ swelling with noticeable stomach swell, heartburn. Periods of tiredness; sleeping 11+ hrs. I continue to push thru my exercise routine; however feeling less capable than normal.

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@rfal123

5-1-22. COVID symptoms started 01/01/22. Antibiotics did not cure long term COVID. At present (4 mo. later): experiencing: shortness of breath, fatigue, face/forehead/head swell feeling, brain fog, ear ring, heart palpitations, feeling of internal organ swelling with noticeable stomach swell, heartburn. Periods of tiredness; sleeping 11+ hrs. I continue to push thru my exercise routine; however feeling less capable than normal.

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@rfal123, recovery can be such a long, slow journey punctuated with set backs as well as progress. My ears perked up when you mention "push thru my exercise routine". Activity and exercise can help but overdoing it can set you back. Dr. Van addresses how to pace yourself in this post:
– Early Care Tips for COVID Longhaulers https://connect.mayoclinic.org/blog/post-covid-recovery/newsfeed-post/early-care-tips-for-covid-longhaulers/

What signals do you listen to that tell you when you've done the right amount for you? What symptoms have improved for you over that past 4-5 months?

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I had COVID ,Feb 2022 and sufferred with every symptom listed. Finlly got into a Post Covid Clinic, recommended Baterua Overgrowth test- Hydrogen? GI, calls it SIBO to get insurance to pay. I was extremely HIGH, did my 1st round of XIFAXAN 14 days on and 14 off and repeat if needed. The Xifaxan is an antiboti, costs $2,000 for 14 without insurance. I also have extreme GERD after COVID, which inflamed a reactivation of my AL AMYLOIDOSIS in the Laryengeal area which spread from my sinus to espophegus. I have a retest to see what my SIBO levels are, I will be starting retiement insurance June 1st, which isn't as good.

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I guess that the question is whether the "Long Covid" symptoms will ever let go..? I'm not sure if I'm glad that I'm not alone…..

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Hi,
After reading this article I wish to say that I know of some people who have the severe GI symptoms start not long after their 3rd vaccination and have not had covid.
How does the science world differentiate when the symptoms are covid related or vaccination related?

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Constipation started in July 2020, right at the start of COVID. Been on treatments laxatives, colonoscopy and endoscopy negative. Changed diet and added water still struggling with it. Please comment if you are also having this.

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I was tested negative for Covid in Dec. I was home quarantined for about a week with a bad cold before my wife and I went in to get tested. I started with stomach issues in March, which became worse as time went on, I have COPD so I thought it was a exacerbation of my disease. How do I follow up on this or even proof that I have long Covid?

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I got Covid 10-26-21, started having headache, ears plugged, dizziness. Have checked by ENT and eye doctor, can find anything cause the symptoms. And symptoms still lingering around, comes and goes. Now my primary doctor wants me to go see neurologist. How do I know if it is PCS? Or something else?

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After my Covid infection, I experienced terrible low back pain, and general muscle fatigue throughout my body. Has anyone else experienced these symptoms?

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@uspaopaolong

I got Covid 10-26-21, started having headache, ears plugged, dizziness. Have checked by ENT and eye doctor, can find anything cause the symptoms. And symptoms still lingering around, comes and goes. Now my primary doctor wants me to go see neurologist. How do I know if it is PCS? Or something else?

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Same thing has happened to me it was after I got Covid in December 2021, I have severe dizziness worse than before , very bad pressure in head sleeplessness , lost 52 pds, lost my hair, it’s all Covid related. Sounds like a lot of my symptoms. Good luck to you.

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