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A Gut Feeling: Long COVID and GI symptoms

Apr 29, 2022 | Greg Vanichkachorn | @drvan | Comments (142)

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.

27 Reactions

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drbf | @drbf | Nov 30 2:31pm
In reply to @dinardol "I had Covid in 2022 and started having heart palpitations and dizziness for short periods of..." + (show)
Profile picture for dinardol @dinardol

I had Covid in 2022 and started having heart palpitations and dizziness for short periods of time. I was reinfected a year later and recovered from the infection in about 10 days as I had the first time-and then slowly my life changed. I had spells of severe heart palpitations, spontaneous severe tachycardia and lingering vertigo. I found out after cardiac testing that I developed POTS syndrome. I also had GI sickness every day and struggled to stand long enough to even make myself something to eat. This was all part of the dysautonomia my body was stuck in and damage to the brain gut axis. I now see a neurologist, cardiologist and gastroenterologist who help me along with medication and things to help me.
My symptoms seemed to be improving and then I was infected again last year. My heart thankfully stayed relatively the same with symptoms, but my GI symptoms returned with a vengeance and as a nurse, I know I have exhausted testing, I’m taking a high dose of vitamin D and doing B12 injections etc etc. So the reason I am on this thread is honestly for mental reprieve because I am now reading that long covid worsens after each reinfection. With symptoms I experienced, this seems to be the case. Has anyone noticed long covid symptoms getting worse with each infection? Any advice on how to stay positive? I am unsure how to keep doing my normal routine while being sick, and knowing that a reinfection may make it even worse. I would appreciate any advice or input. To anyone out there who can relate, I would suggest talking to loved ones about how you feel and not keeping it bottled up, reach out for support if you need it because help is always there, and sometimes where you least expect it!

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@dinardol I have POTS and IST...and fibromyalgia. Three flavors of dysautonomia. GI issues come with fibro. Took three years of suffering, test after test, blood work, imaging, etc. Had to go to Mayo to get diagnosis. Now I have to deal with the chuckleheads where I live who thought this was all "anxiety".

My sickest was the first bout of COVID, and that was in December 2022.

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anney | @anney | Nov 30 4:41pm

DR. TIM ROBINSON, longcoviddoctor.com is the ONLY place I've been able to find real help!!!!! For each symptom, he has Part 1. symptoms, causes and the various diagnoses of the symptom. Part 2. Management and treatment. He agrees there's no treatment, but he is wonderfully helpful. At the end of Part 2 for exercise intolerance (which I have). He says, there's no treatment, BUT SOME OF MY PATIENTS TELL ME THAT THEY WERE HELPED BY THESE 2 SUPPLEMENTS, WHICH HE NAMES. A doctor told me that by law, he cannot tell me to try them, but by telling me that some of his patients found the meds helpful, he is really saying: "Give them a try. They may help you.
An English doctor, he was a general practioner for 30 years, retired, joined the English National Health Service, concentrating on Long Covid management and treatment.
I live outside Boston, MA, an American center for health research and hospitals. I've spent literally more than 6 months researching long covid. The government pretends it doesn't exist, and doctors are all "brick walls".
Anney

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