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.

@cld8

thank you. how long did it take you

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I have been tending to my diet since May of 23. I rarely have nausea now. I have to really over exert for that to happen. It felt like my food wasn't digesting at all. I was bloated and distended especially with meat. I am slowly trying to add that back in.

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thank you, hope this passes soon. On 5 weeks!

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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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Same here, the inflammation is unbelievable! every organ in my body (Guts) feel NOT HAPPY and just when I think I have it under control - it's back...Breathing is still labored but a lot better since some of the inflammation is subsiding but wowza - what a ride this has been...I am ready to get off though - enough already..

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"Instead, we recommend a standard Mediterranean diet with a reduction in processed foods."
I changed to Dr. McDougall's (https://www.drmcdougall.com/) Plant based-Starch solution in 2009 to current, which cured my Diabetes II, weight declined from 280 lbs to 175 lbs, No HBPs, normal AC1, etc. and discontinued all 'poisonous' AMA medications, ie. Metformin (FDA Recall). I've maintained my health up til 12/27/22....makes NO difference in my L.C. G.I. issues.

"Second, avoid using lots of over-the-counter products to treat your symptoms."
I've had NO other choices given by medical people (K.P.)!

"Instead, speak to your medical professional first to develop a treatment plan."
These IGNORANT Kaiser Permanente M.D.'s ARE the one's prescribing the over-the-counter meds and colonoscopies. I've met with two different G.I. specialist, that admitted they have ABSOLUTELY NO IDEA how to deal with Long COVID G.I. tract issues.

I have had to do my own research and treatment since these USELESS MORONS (K.P.), refuse to think out side their 'Dark cosmic black AMA holes' they keep their heads up.

I came across conversations regarding 'Probiotics', since one of the LCGI theories has to do with a imbalance of the micro-biodome created by the virus. Oh, BTW the K.P. Ass-Wipes REFUSED to order the extra-strength version, which requires a doctor. So I had to come out of pocket for a lesser strength. (https://www.visbiome.com/pages/about-visbiome). I've been taking (https://www.visbiome.com/collections/capsules/products/visbiome-capsules), for approximately 5 weeks and 3 weeks into this treatment I noticed a decline in my stomach pain, from a high level of pain 7-9 down to a 2-3 pain level. I contracted Covid 12/27/22 and experienced a 'general' irritation of my stomach, constipation, and diarrhea. Unfortunately, the constipation and diarrhea has not abated. I have had the 2 initial COVID injections, and 2 boosters, the omicron being last one, prior to contracting COVID in 12/2022. I will NOT be taking any further injections.
Note: I do not have any financial connections to Visbiome.

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Thank you for this information. I just had my 3rd bout with Covid. I have been suffering from neurological symptoms of long Covid for 2 years. After the first, I experienced difficulty evacuating which subsided in about a year. A second bout didn’t cause that symptom too badly. But this third bout has left me miserable…queasy, reduced appetite, especially earlier in the day, and awful constipation. Only a dulcolax suppository, with great discomfort, helps me a little.
At least I know this symptom has been researched. I am about a month passed Covid round three. My neurological symptoms of LC persist, and now I wonder how long these GI issues will last. Thank you for shedding some light.

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I think Covid triggers food sensitivities. Since having Covid I have developed non celiac gluten sensitivity. I cannot eat ANY wheat/gluten. If I do it feels like someone has poured cement into my intestines that has hardened in to concrete. The constipation was horrible. I finaaly found a great functional medicine doc. She had me start taking 1000mg of magnesium/day. The relief was almost instant, and I have finally had great 4 months and counting. My functional doc also ordered an array of various CYREX tests. The one that has really changed my life is the dairy reactivity test. My butyrophilin reaction was 4x the high end of the normal range. I have been taking thyroid med for the past 25 years , just to stay in the higher end of the normal range. My doc advised me to cut out all the dairy for 6 weeks. I did that, and my GI issues improved even more. In addition to that, my doc ordered the Labcorp advanced thyroid profile. After being of of dairy for 6 weeks, my thyroid is now operating exactly in the middle of the thyroid health range. It has always been in the 4.6 range. It is now about 1.4. It has never been this perfect. In addition I have more energy than I have had in 30 years. I am 71 yr. old. I do not know what triggered the butyrophilin reponse> All I know is NO MORE DAIRY For me. The other interesting thing is that a high reaction to the butyrophilin in milk can also indicate M.S. Many M.S. patients go into remission by stopping all dairy. 85% of the caucasian population has some level of reaction to butyrophilin. This was proven is Europe by doing a random sample and test of the public blood bank supply. It seems that the trigger has been the Holstein milk that is so widely used through out Europe and the U.S. Holstein milk is the highest in milk fat of any dairy cow. Butyrophilin resides in the fat membrane of the milk fat molecule. There is also numerous other disease links including autism in children that is suspected to be triggered by butyrophilin.

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@dkw

I think Covid triggers food sensitivities. Since having Covid I have developed non celiac gluten sensitivity. I cannot eat ANY wheat/gluten. If I do it feels like someone has poured cement into my intestines that has hardened in to concrete. The constipation was horrible. I finaaly found a great functional medicine doc. She had me start taking 1000mg of magnesium/day. The relief was almost instant, and I have finally had great 4 months and counting. My functional doc also ordered an array of various CYREX tests. The one that has really changed my life is the dairy reactivity test. My butyrophilin reaction was 4x the high end of the normal range. I have been taking thyroid med for the past 25 years , just to stay in the higher end of the normal range. My doc advised me to cut out all the dairy for 6 weeks. I did that, and my GI issues improved even more. In addition to that, my doc ordered the Labcorp advanced thyroid profile. After being of of dairy for 6 weeks, my thyroid is now operating exactly in the middle of the thyroid health range. It has always been in the 4.6 range. It is now about 1.4. It has never been this perfect. In addition I have more energy than I have had in 30 years. I am 71 yr. old. I do not know what triggered the butyrophilin reponse> All I know is NO MORE DAIRY For me. The other interesting thing is that a high reaction to the butyrophilin in milk can also indicate M.S. Many M.S. patients go into remission by stopping all dairy. 85% of the caucasian population has some level of reaction to butyrophilin. This was proven is Europe by doing a random sample and test of the public blood bank supply. It seems that the trigger has been the Holstein milk that is so widely used through out Europe and the U.S. Holstein milk is the highest in milk fat of any dairy cow. Butyrophilin resides in the fat membrane of the milk fat molecule. There is also numerous other disease links including autism in children that is suspected to be triggered by butyrophilin.

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Hi, sorry to hear about the gut issues. I understand somewhat. I went through several different GI issues these last two years. I developed symptoms that mimicked Crohn's disease and had those for several months. I also had to stop using Soy milk. The symptoms went away. This virus tends to mimic other autoimmune diseases. In my experience, these finally go away. I do not know if other people have had this experience? Hang in there.

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