A Gut Feeling: Long COVID and GI symptoms

Apr 29, 2022 | Greg Vanichkachorn | @drvan | Comments (127)

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.

@tropiclotus555

Where is photo of product??

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Photo will not attach. Genuine Health Organic Gut Superfood, Unflavored & Unsweetened. (Prebiotic with 21 fully Fermented plant-based superfoods to support a healthy gut). 229 g container.

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My 21 year old son tested positive for COVID in 8/22 and his primary symptom was unrelenting abdominal pain (previously no GI issues). He had mild fever for 1-2 days, stomach upset that became intense over several days and kept him from sleeping or eating. He went to the ER and was sent home. Two days later he returned to the ER with a hemoglobin of 6.8 and severe bleeding ulceration of his stomach lining. He was hospitalized for a week. He recovered fully within a few weeks. He had absolutely no risk factors. I was diagnosed with COVID the same week as him and have had mainly neurological symptoms with recovery still in process (hospitalized with inpatient rehab and lengthy PT/ST needs). Same illness, same timeline, same family, two entirely different experiences. My daughter tested positive at this same time and was without symptoms and feeling fine after 2-3 days.

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@feb

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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Did the Xifaxan help? Lowered calories to a healthy 800. Constant severe bloating and heartburn. I had MRI, CAT Scan with dye and drank that cocktail. Showed nothing. I have the script and ready to take it.

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Prior to Covid my body would elimate 2-3x a day, and my wife 1x a day. In 2009 I changed my nutritional intake to Dr. McDougalls starch solution, and within 6 months had cured my Pre-diabetes, weight declined from 275lbs to 180lbs, No HBPs, normal AC1, etc. and NO 'poisious' AMA medications. In the face of family diabetes, paternal grandfather, who died of gangren. I have maintained this health level from 2009 to current day. My wife, being Greek is basically Mediterrean. She still consumes animal meat, and dairy, and has other medical conditions, due to her unwillingness to stop poising her system. 85% of all medical conditions are food related. We are NOT CARNIVORES.

Both my wife and I avoided contracting Covid from the very beging up til 12/26/22. I've had the Covid anti-viral vacinations fPhizer, plus two boosters, including the most recent Omicron. My wife the intial two shoots plus one booster. I and my wife contracted Covid on Dec. 26 2022, and have been experiencing the same GI symptoms including dehydration (cotton-mouth) 24/7, constipation, and stomach pain. Loss of appitite, fever, and fatigue. From 2-3 BMs a day to 1-5 days of constipation, due to COVID, and my wife from daily BMs, to 1-5 days of constipation. My only intake, after 5 days of constipation, was a 2 cup bowl of miso soup. I could not concedar my regular plant based food. Both of our daily water intake had doubled apon COVID and no change in constipation.
I met with one of our HCP (KP) GI specialist, who actually admitted that they have absolutely NO IDEA how to treat Long COVID. My main concern was for the constipation, and how the stoppage was possibly poisoning my system. All food rots.

I was prescribed LUBIPROSTONE 8 mcg TID, on 3/24/23. I am NOT a opiate addict, nor do I have IBS, or any personal or family history of IBS. Clearly the virus has effected the G.I. tract and inhibits it's natural lubercation of, and possibly it's peristalsis action of the colon.

So remember I shared one of the G.I. syptoms is dehydration. I observed after the first 24 hrs., the 2nd dose, my 'Cotton-Mouth' had stopped. Still no full and complete B.M.'s, only a very small amount of liquid and loose fecal matterial was eliminated. On the second day, I consumed a potatoe vegatable soup, and the medication, still the same elimination as prior day. So what was going in was a lot more than coming out. On day 3 the same, so I increased the doseage to 24 mcg., so 3x in a 24 hrs. and the out-put on day 4 was normal in consistancy, not loose. and still not any where near normal of amount prior to COVID infection.

My working theory is that, even if the initial COVID virus is gone that it has left behind a mutated form in the G.I. track.

Per Dr. Vanichkachorn “While we are not sure yet, there are several possible ways the COVID-19 infection could cause gastrointestinal problems,” Dr. Vanichkachorn says. “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 gastrointestinal system’s nerves.”

-namaskaram

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I got Covid for the 3rd time January 12th. Mild symptoms, runny nose, headache, body ache. I felt a little better for a couple weeks but then felt like my body was falling apart. Constant headaches, muscle aches, pins and needles in my arms and legs, very short of breath, light headed every time I stood up and the worst part other than constant fatigue is the GI issues. Nausea, indigestion, bloated and heavy chest. I have had a physical, xrays, ekg, bloodwork. The doctor hasn't found anything wrong. This has actually put me into such a state of anxiety and depression. Which I have suffered from most of my life. But my symptoms for both were at bay prior to getting covid. Very scary feeling like this everyday.

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@sgb

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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I got sick after my fourth Covid vaccine, after having no reaction at all with the first three. I got a bad cold and a cough that lasted four months. No GI symptoms, though. My doctor gave me an antibiotic for the cough, and then I developed severe pain pretty much all over. I saw a functional medicine doctor who prescribed several supplements and also an anti-inflammatory diet. I got better slowly, but now I can't eat gluten, refined sugar, or dairy (except Greek yoghurt). I got Covid in December, even though I wear a mask everywhere, and thankfully, it was a mild case, like getting a cold. I was actually sicker after the last vaccine than I was with Covid. I took the CVS brand of Maalox last winter and was sick for over a month with terrible upper body pain. I now avoid ALL drugs, both OTC and prescription, and ALL vaccines (I also got bursitis from my last flu shot, so those are out, too). I didn't develop food sensitivities from having Covid; they developed after the fourth vaccine. I'm now getting IV infusions of Vitamin C, magnesium, B complex, and calcium, which I'm hoping will boost my immune system and help me avoid any further flare ups. These infusions are very expensive and not covered by insurance, and neither are any of the supplements I'm taking. Nothing from a functional medicine doctor is covered. BTW, my IV doc is totally against the vaccines.

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I had covid in Jan 2020 and have been sick ever since. Caught covid again in May 2022 and I was vaccinated one year prior with Pfizer vax but second round of covid was worse even though I was vaccinated.

Covid causes Dysautonomia in some people, like me. Dysautonomia has a large category of illnesses of the Autonomic nervous system, including POTS and other heart related, BP, pulse related, breathing and bowel problems too.

Three in a half years of being sickly and feeling sick every day YET NONE OF THE DOZENS OF DOCTORS IVE SEEN KNOW WHAT TO DO. Blood work comes back normal yet I feel like death warmed up.

Dozens of Doctors I’ve seen are clueless and give me no ideas how to fix all this. Many doctors seem apathetic or refuse to admit covid or vaccine caused all this. They want to blame it all on anxiety. Bulloney.
Covid and or the vaccine has caused me 3.5 years of heart problems (skyrocketing BP, arrhythmias, erratic pulse levels), lung problems (I now have asthma and get short of breath), bowel issues with IBS, constant nausea etc due to covid or vaccine or both.
Total lack of energy YET I’ve done EVERYTHING to improve my health YET NOTHING WORKS.

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@joannemm30809

I had covid in Jan 2020 and have been sick ever since. Caught covid again in May 2022 and I was vaccinated one year prior with Pfizer vax but second round of covid was worse even though I was vaccinated.

Covid causes Dysautonomia in some people, like me. Dysautonomia has a large category of illnesses of the Autonomic nervous system, including POTS and other heart related, BP, pulse related, breathing and bowel problems too.

Three in a half years of being sickly and feeling sick every day YET NONE OF THE DOZENS OF DOCTORS IVE SEEN KNOW WHAT TO DO. Blood work comes back normal yet I feel like death warmed up.

Dozens of Doctors I’ve seen are clueless and give me no ideas how to fix all this. Many doctors seem apathetic or refuse to admit covid or vaccine caused all this. They want to blame it all on anxiety. Bulloney.
Covid and or the vaccine has caused me 3.5 years of heart problems (skyrocketing BP, arrhythmias, erratic pulse levels), lung problems (I now have asthma and get short of breath), bowel issues with IBS, constant nausea etc due to covid or vaccine or both.
Total lack of energy YET I’ve done EVERYTHING to improve my health YET NOTHING WORKS.

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Joanne,
You have described my life.
I have been sick with long covid since 2020 as well. In January 2021 I got the Moderna vaccine and I hadn’t recovered from it a month later but my primary care told me that I should get the second vaccine as well. Three days after my second vaccine I was in the hospital with severe chest pain. Long Covid has reactivated my Epstein-Barr virus. I also have dysautonomia. Most doctors want to shrug it off as ‘depression’. It is so frustrating! I have tried many different supplements and I am super sensitive to medication‘s, caffeine, etc. Nothing seems to work and I have all of your symptoms but I think the worst of all at this point is the profound exhaustion and PEM. My primary care doc basically washed his hands of me because I won’t go on anti depressants. I did try one earlier on and it just made me even more fatigued. I have not worked since Fall 2021 as I passed out at work on a few occasions.
I wish someone would help us.
No one understands… I feel abandoned by people who used to be friends. We can’t give up hope!

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@joannemm30809

I had covid in Jan 2020 and have been sick ever since. Caught covid again in May 2022 and I was vaccinated one year prior with Pfizer vax but second round of covid was worse even though I was vaccinated.

Covid causes Dysautonomia in some people, like me. Dysautonomia has a large category of illnesses of the Autonomic nervous system, including POTS and other heart related, BP, pulse related, breathing and bowel problems too.

Three in a half years of being sickly and feeling sick every day YET NONE OF THE DOZENS OF DOCTORS IVE SEEN KNOW WHAT TO DO. Blood work comes back normal yet I feel like death warmed up.

Dozens of Doctors I’ve seen are clueless and give me no ideas how to fix all this. Many doctors seem apathetic or refuse to admit covid or vaccine caused all this. They want to blame it all on anxiety. Bulloney.
Covid and or the vaccine has caused me 3.5 years of heart problems (skyrocketing BP, arrhythmias, erratic pulse levels), lung problems (I now have asthma and get short of breath), bowel issues with IBS, constant nausea etc due to covid or vaccine or both.
Total lack of energy YET I’ve done EVERYTHING to improve my health YET NOTHING WORKS.

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Sounds too familar!!!

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@joannemm30809

I had covid in Jan 2020 and have been sick ever since. Caught covid again in May 2022 and I was vaccinated one year prior with Pfizer vax but second round of covid was worse even though I was vaccinated.

Covid causes Dysautonomia in some people, like me. Dysautonomia has a large category of illnesses of the Autonomic nervous system, including POTS and other heart related, BP, pulse related, breathing and bowel problems too.

Three in a half years of being sickly and feeling sick every day YET NONE OF THE DOZENS OF DOCTORS IVE SEEN KNOW WHAT TO DO. Blood work comes back normal yet I feel like death warmed up.

Dozens of Doctors I’ve seen are clueless and give me no ideas how to fix all this. Many doctors seem apathetic or refuse to admit covid or vaccine caused all this. They want to blame it all on anxiety. Bulloney.
Covid and or the vaccine has caused me 3.5 years of heart problems (skyrocketing BP, arrhythmias, erratic pulse levels), lung problems (I now have asthma and get short of breath), bowel issues with IBS, constant nausea etc due to covid or vaccine or both.
Total lack of energy YET I’ve done EVERYTHING to improve my health YET NOTHING WORKS.

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Hi Joanne,
I could have written your post. Everything you wrote is so true. Since I got Covid Dec 19, 2021 my world has been turned upside down. Lots of medical issues, medical bills , lost wages ect. and still you are so right no one has any answers for all of this . Covid brought on a severe case of Ulcerative Colitis and I have been dealing with this for 1 1/2 years. two hospitalizations later among with many other Emergency room , urgent care, clinic visits , tests , scans , later and it is easy for them to give you a drug that makes your disease worse from all the side effects and then they all ask you if you are depressed , who would not be having to deal with all of this , and the fatigue which is something else. No energy, and I would give anything to be able to eat normally again. All they have to offer is more steroids which is not an option for me any more, after fainting and falling on the floor twice at work , I am lucky I did not break any bones or split my head open. I just said no more. I am done with all the drugs. Someone has to have some answers for all of this . This is not fault , but we are treated like it is, we did something to cause this or we are just plain old crazy, I have even heard I am aging, maybe this is cause of all this. Dont give up hope..we have to keep going, and take a day at a time..sometimes its a minute at a time and keep going. I volunteer for studies, maybe that can help someone else down the road. I guess we can be grateful as i know people that did not make it., or are in worse shape than me. What I would not give to be able to eat a hamburger , an order of fries and a Pepsi..maybe someday. Please take care and thanks for your post..you were right on. Sincerely..kitty2

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