A Gut Feeling: Long COVID and GI symptoms

Apr 29, 2022 | Greg Vanichkachorn | @drvan | Comments (131)

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.

I have dealt with several PCS sequelae. Loss of appetite and decreased motility has been pronounced for a month. I am slowly getting moments of hunger, but now I am getting GERD/acid reflux symptoms. The article that I read from this blog said not to use over the counter medicines. Is there a problem with using famotidine or omeprazole to alleviate these symptoms, if it results in additional food intake, which has empirically been a significant challenge?

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@papounders

I have to avoid oxalate and developed same problem…. Currently going to try small amount of magnesium citrate…. As this seems to help others. Please let me know if you find anything that works.

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Try ordering the Plum brand of baby prune pouches from Amazon. Start with one pouch everyday. If that doesn’t work increase to two pouches. Or if you don’t mind eating prunes whole then buy the plastic container of Sunsweet prunes in the grocery store and eat four or more per day. You cannot skip a day or you won’t go. Once the prunes start working you will go everyday and won’t need any other meds for constipation. This works for post Covid and also people on pain pills as they become constipated from the narcotics and people on chemotherapy…my best friend had cancer and they gave her everything and nothing worked. She finally tried the prunes I had been recommending and never had trouble again even with all the horrrible chemos and pain meds she was on. It also works great on babies and children. I was a nanny and an elder care provider and I have used this for everyone…lots of whom what all their drs prescribed never worked…and the prunes have worked for EVERYONE!!! Let me know how you do!!

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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 would like to understand this also. My daughter developed many long Covid symptoms after having her vaccine. I am desperate to find support and help. It’s a long list of symptoms.

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@selutopia

Had a light case of covid in Dec 2021. In Feb 2022, food sensitivities resurfaced which had been at bay for 10 years. My naturopath confirmed that covid messes with the gut microbiome, and prescribed daily AOR LGlutamine Powder, probiotics, Quercitin, and Genuine Health Fermented Organic Gut SuperFoods. Issue resolved within 2 months whereas 10 years ago it took 2 years. The last 2 supplements were new to me and I suspect helped me alot this time around. Glad to find some research on covid/gut is being done as I know others who also have post covid gut issues - this is the first article I have ever seen that discusses it!

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When you say resolved, does that mean that once you finished the recommended supplements you were cured? Or do you have to continue to tale those things to stay regular? I’ve had a constipation issue ever since I had Covid in January. I already tried some recommended supplements. They helped a little until I had finished the recommended course the the constipation came right back. I am desperate to get past this but also don’t want to be forever taking supplements for it, I want a cure.

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@charlesbrim

I have dealt with several PCS sequelae. Loss of appetite and decreased motility has been pronounced for a month. I am slowly getting moments of hunger, but now I am getting GERD/acid reflux symptoms. The article that I read from this blog said not to use over the counter medicines. Is there a problem with using famotidine or omeprazole to alleviate these symptoms, if it results in additional food intake, which has empirically been a significant challenge?

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Digestive Enzymes helped me with the reflux. I got them from Silver Fern. I’m still struggling with the constipation though 😞

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@acinv

Hi,
I tested positive for COVID with mild symptoms in April. I ended having diarrhea as one of the main symptoms. I had a slight case of GI issues a few days before getting COVID from drinking contaminated rain water while hiking. It normally clears up in few days to a week. This time however, it didn't and got worse during and after COVID. I started taking probiotics a couple of weeks after I tested negative. It helped a bit. But to this day I still suffer from daily bouts of gas, cramps and loose stools. Some days are better then others. Some days I have no symptoms at all. I came across your comments and was wondering if your symptoms are similar and if taking the products that your naturopath helped reduce the symptoms quickly? Are you also cured and free of the GI symptoms today? Are you still taking the same supplements everyday now? Thank you.

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As of today, I don't suffer with bouts of gas, cramps or loose stools. In fact, my stools are much harder, and I am suffering more with constipation than I did prior to co-vid. After writing my first comment, I experienced major GI issues. A hiatel hernia issue which allowed my stomach to grow up thru the hole in the hernia and esophagus into my upper chest between my rib cage and lungs. Emergency surgery after experiencing severe stomach pain saved my life. They inserted a feeding tube which I had for 131 days feeding me only Jevity for nourishment. No liquid or food down my throat during that time. Just had the tube removed within the last two weeks and am slowly starting to eat most foods except for meat, fried foods and carbonated beverages which causes me to feel very uncomfortably bloated. My surgeon suggested this issue may have been caused by the co-vid. Since getting co-vid back in December of 2020, I still have poor taste and smell issues, some shortage of cognitive ability, and something called co-vid quads which has left my legs very weak resulting in balance issues. Wish I could help you with good news but so far, I'm an older than I should be, 83-year-old male. Good Luck.

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@drwilliams

When you say resolved, does that mean that once you finished the recommended supplements you were cured? Or do you have to continue to tale those things to stay regular? I’ve had a constipation issue ever since I had Covid in January. I already tried some recommended supplements. They helped a little until I had finished the recommended course the the constipation came right back. I am desperate to get past this but also don’t want to be forever taking supplements for it, I want a cure.

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As explained to me, covid disrupts the gut, and alot of health issue stem from there (I am seeing more and more research articles confirming this). My reaction was not gut based. However, this supplement, along with LGlutamine, did "cure" my issue and rebuild my gut microbiome. Suggest looking around for a naturopath who deals with gut issues. It does take some time.

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Anyone with complaints of persistent low grade nausea?

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@aw7711

Anyone with complaints of persistent low grade nausea?

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Yes. Mine eventually resolved with time (several months). In the interim, I chewed mint gum (the green on with the #5 on the package) and drank Celestial Seasonings peach herbal tea with fresh mint that I added. It helped. In the afternoon I drank Bigelow lemon ginger herbal tea. Fresh air as well as a cooling towel (Frog Togg) around my neck would slightly improve the nausea. Keep hope alive. You will get through this. It just takes time for most people. Best wishes!! 🙂

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@tracykclagett

Yes. Mine eventually resolved with time (several months). In the interim, I chewed mint gum (the green on with the #5 on the package) and drank Celestial Seasonings peach herbal tea with fresh mint that I added. It helped. In the afternoon I drank Bigelow lemon ginger herbal tea. Fresh air as well as a cooling towel (Frog Togg) around my neck would slightly improve the nausea. Keep hope alive. You will get through this. It just takes time for most people. Best wishes!! 🙂

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Thank you!!

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