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.

@lhabada

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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I contracted COVID while recuperating from hiatal hernia surgery and, of course, my primary symptoms have been gastrointestinal. It’s been 2 months since COVID and I struggle daily with constipation, diarrhea, and abdominal migraines, of all things. It’s been a wild ride and I don’t know from day to day whether I’ll be well enough to work, travel, or even do chores around the house. I live on Zofran, which helps with the nausea — Mirolax which helps with the constipation — and try to keep hydrated during terrible bouts of diarrhea. I appreciate any and all suggestions from those who have been on this Merry-go -Round longer than me.

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I have had similar experience - post 2nd vaccine sévère vertigo (never had before). Then developed severe constipation Q1-2 this year right after 3rd which I attributed to medication change (though my neurologist was doubtful). I have had to manage this constantly since.

In April I developed suddenly constant tinnitus and a feeling of vertigo (drunken sailor) developed. ENT told me there was nothing he could do. I had not had COVID, unless asymptomatic.

And now I have COVID which manifested with diarrhea first, then eye infection with cough, sore throat, fever (all more like a bad cold) over the last 10 days. This after I had the Moderna upgrade a month ago….. Still have tinnitus and drunken sailor stance….

Not sure what to do. But I agree, I believe the vaccine is just as much a cause of these symptoms as possibly COVID itself?

I have never had intestinal track issues or vertigo or ear ringing beforE.

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@steino

I have had similar experience - post 2nd vaccine sévère vertigo (never had before). Then developed severe constipation Q1-2 this year right after 3rd which I attributed to medication change (though my neurologist was doubtful). I have had to manage this constantly since.

In April I developed suddenly constant tinnitus and a feeling of vertigo (drunken sailor) developed. ENT told me there was nothing he could do. I had not had COVID, unless asymptomatic.

And now I have COVID which manifested with diarrhea first, then eye infection with cough, sore throat, fever (all more like a bad cold) over the last 10 days. This after I had the Moderna upgrade a month ago….. Still have tinnitus and drunken sailor stance….

Not sure what to do. But I agree, I believe the vaccine is just as much a cause of these symptoms as possibly COVID itself?

I have never had intestinal track issues or vertigo or ear ringing beforE.

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I have been diagnosed with POTS and have a lot of GI Issues since having Covid Jan 2022. I also felt love ke a drunken soldier.

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@welchllb

Sorry to hear about your severe GI issues. I deal mostly with constipation marbles and then, if I take supplements, the marbles get increasingly, embarrassingly frequent. I drink tons of water.

I don't know if this question belongs in this category. I just had blood work done and suddenly, my cholesterol levels have skyrocketed. I eat very small and infrequent servings of meat, lots of fish, vegetables, fruit, nuts, flaxseed, bran, etc. Wondering if my lack of ability to exercise due to COVID has affected my cholesterol?

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OMG, you describe me perfectly, including the your diet, lack of exercise, GI pattern and sudden increase in cholesterol numbers. Rather discouraging. My GI doctor put me on Linzess (72 mg) last week and has now upped it to 144 mg + prunes. I just started the increased dose. I, also, drink water all day long. No change yet. I'll keep you posted.

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@marcconley

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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Yes I'm having the same issues. I've also suffered with drastically weight loss. All tests come back negative

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The long haul covid brought on Ulcerative Colitis for me. It has been a tough eleven months and two hospitalizations. It has changed my life, turned it upside down but I finally got the help I needed one month ago and I am now starting to get a little better every day on the positive note. The fatigue is still very overwhelming, and I never know what my day is going to be like on a daily basis. I adjust to the symptoms, get as much rest as I can and pray that they can help all of us who deal with this on daily basis. Sincerely Kitty2

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full vaccinated, Covid diagnosed 10/31/22. Was going to have minor procedure done but Covid test pos. Maybe had slight post nasal drip but wouldn’t have even noticed it. Had visitors from Idaho 5 days b4. Husband was clearing throat when they arrived but wife came down with “bad cold” , chest congestion, exhaustion same day I was going to have the procedure. (They left in am). Both tested Covid pos when I let them know. Anyhow, no symptoms except constant ache just below rib cage right side (gallbladder??) and constant intestinal cramping. Did not eat for 3 days and barely drank water bc upper abdominal tenderness and intestinal cramping increase after food or drink. Have lost 10 lbs since. Cramping and pain still constant. Hardly eating still bc cramping intensifies shortly after eating/drinking. What is going on ? No heartburn, no fever, white cell count 8.0, liver functions normal-barely elevated. Anyone else got this??

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@selutopia

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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I know I’m not really “long haul” yet but symptoms have not improved since initial DX. Low grade upper right abdominal “ache” and lower intestinal cramping constantly. Gets worse after eating or drinking anything, including water!

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@bella75

Yes. Almost exactly the same but I also am struggling with nausea and can't eat or drink anything cold as it hurts my stomach.

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The last dr I seen had put me on methylprednisolone for 5 day I had server back pain and a few rashes. But I was pain free in the abdomen, eating I was constantly wanting to munch. I was able to eat full meals I had the occasional jello meal and a few hours later I was able to eat a small portion of food . Compared to going days on end . Well last Wednesday was my last dose . Saturday I started to have issues. Now it’s Tuesday and I been having issues trying to eat something all day . Their wanting to try a shot in the abdomen area and my back to see if it will help since the steroid had a good effect for the abdomen. My back I have multiple herniated disk in my lumbar.

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انا عمري 47سنه وتسببت بكرونا من 8اشهر وانا راضي جد ولااعاني
من اي امراض سوي التهاب بسيط جدا في القولون وبعد الاصابه بشره بدء القولون في تعب شديد انتفاخ قوي ودخول الحمام في بعض الأحيان 6مرات في اليوم و اسهال ليس مائي وبعد الإنتهاء من دخول الحمام احس بجوع شديد جدا وأطر للاكل بقوه وبعد الذهاب الاطباء اعطوني علاجات مكهرات معاويه ومضاد حيوي وبعد العلاجات حالتي سائت اكتر ومغص ودخول متكرر للحمام وعدم راحه وإرهاق وصداع ولا يوجد حل
هل من الممكن أن يتم شفائي

Translated using Google translate:
I am 47 years old, and I caused Corona 8 months ago, and I am very satisfied and do not suffer
From any diseases except for a very simple inflammation in the colon, and after the infection of the skin, the colon began to suffer from severe fatigue, strong bloating, and entering the bathroom sometimes 6 times a day and not watery diarrhea. And an antibiotic, and after the treatments, my condition got worse, cramps, frequent use of the bathroom, discomfort, fatigue, headache, and there is no solution.
Is it possible for me to be cured?

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