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.

Hi Debi, I'm so sorry this has happened to you. I have been on a similar journey. Covid 3/2020 and then 2 3/4 years of hell where no one knows what is going on. Which Mayo are you going to? I'm have been going to Mayo Jacksonville, as I live in Florida since Jan 2022. Prior to going to Mayo, I had a functional gastroenterologist do a fecal study. There was a dysbiosis between my good and bad bacteria in my gut. I started eating very clean but that didn't help much in regard to my gastroparesis, although it helps overall. I started a very taylored pre/probiotic and enzyme plan. It took about 6 weeks to see a difference but it really really made a change for my digestive part of long covid. There's a lot of research out there regarding covid wrecking gut bacteria. Look up gut dysbiosis and long covid. And i would encourage you to find a good functional medicine doctor to work with your mayo team. Goodluck

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I had Covid 1/2020, got confirmed with antibody test in May 2020. Have been severely ill since then with all GI symptoms (lost 30 pounds, can't eat, Diarrhea, Constipation, severe abdominal pain and cramps, bloating, gastroparesis, loss of taste, nausea and vomiting). Had every GI, blood, and stool test...nothing. Also suddenly had severe anxiety, so all doctors figured it is in my head. Have treated it with diet and nutrition, enzymes, herbs, mushrooms, acupuncture and lots of Probiotics. Have improved a lot, but still 80% disabled with severe pain at least 6 hours a day, daily diarrhea, still 87 pounds (was 74 pounds).
I am just now finding information on long Covid and Gi symptoms. Where do I go from here? How do I find a doctor who will consider that Covid might be the cause for my illness? Has anyone found any help? Does anyone have a suggestion?
Please, help

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Headaches and joint pain where there had been prior injury.

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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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Covid is not dependent on vaccine symptoms verses Covid symptoms. I have not felt vaccination symptoms but I am currently having covid as despite two vaccines and a booster

I’m having symptoms as I currently have moderate Covid but not because I’m getting vaccine symptoms as I believe the only true vaccine symptom is where they vaccinated a person. A pin prick.

I don’t believe vaccines have any symptoms. I never got vaccine symptoms but I do have Covid at this time and vaccinated or not, I feel awful .

But I figured the chances of being hospitalized with Covid without a vaccine my research shows that 88% of non vaccinated people are likely to get hospitalized while 16% of vaccinated people who get covid are not. I chose the 16% bet.

So far I have not been hospitalized but only been bedridden. I feel awful but not on the brink of being hospitalized. Given the fact that we now have 8 out of 10 Americans vaccinated I figure I’m in good company.

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For the past 3 years I have been through more than I could ever begin to explain here I could write a book. From loosing a soul mate my dad , uncle, 2 aunts, my sister in law and a lot of close friends. I had Covid before it was testable in this country. I spent 30 days isolated in a cabin away deep in the country. I gained my strength and within a week or so I went back to work. Then a fews months go by and I was hit again with it. I again down for a month. Then recovered I get another job. I was fine for a few months and then season change and I go down once more. I tested and tested all negative. I met a man and we moved to a warm state and we were fine until we get the J&J vaccine. The next day we thought I was going to die. With fevers nearing 107° I was delirious. It took me months before I could function. I loose my job once again to Covid but because I tested negative I couldn't get help. We move back to be close to family I found another job to only work 2 months just to get sick and test positive. This lasted for 4 1/2 weeks. I found a job was doing great for 3 months and I want to make a career advancement but I had to be fully vaccinated to work there so I speak to the pharmacist and they informed me I need to have just one booster and I would be completely vaccinated. So I don't I get the vaccine and what do you know I get sick again not bad but I felt like I had the flu a cold And stomach flu all together. Thinking that ok just building a tolerance to the virus. I was good great once more for 3 months and let me tell you. I got sick during Thanksgiving I stopped eating, I could use the bathroom on my own I went 7 weeks with no bowel movement. I couldn't get out of bed until last week. This is the worst I have ever felt . I have seen 3 teledoctors and I have been to the ER and I have seen a gastro and nobody can tell me what is wrong with me. I have a list a mile long of symptoms. I am running out of options and there is so much I need to tell you all but it would take a book. Let's just say I can't get any help they are going to shut off power tomorrow, phones and car by Monday will be gone. This virus doesn't care it will take your life . Vaccinated or not you can get deathly ill. To be continued

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Continued for the last 3 years.
I have had some of the worst experiences since the beginning of December. It started at Thanksgiving, I started gradually getting sick it was like norovirus and then it mimicks Meningitis painful muscles partial vertigo, dizzy, tinnitus, spinal pain then kidneys start to shut down. Vomiting every thing including water and anti vomit meds and antacids Tums you name it. I was sick . After loosing 46 lbs. In less than a month not being able to shower or clean my home I couldn't stand up without my heart beating out of my chest. My husband has been my lifeline. I can't drive or do anything without assistance. I just had 5 different procedures and testing done on my digestion system from the top and from the bottom only to hear that I have a hernia from getting sick. So still no answer. I went to the ER on the 1 st of January to be ignored when I tell them I have long Covid. They never checked me. I haven't been given the option to get short term disability I was just let go from work due to excessive absences. My husband lost his job for being sick he was listed as a no call no show Even though we both communicated with our supervisor they just told the HR they haven't heard from us so they let us go. Now mide you we have already been down for a month so we haven't had an income for 2 months. We are going to lose everything in the next week and we can not find help anywhere in our county. We are so lost and wanting to throw in the towel. We have family members who treat us like we are o drugs when that is so far from what is going on. I am say this to say There has got to be someone or someway we can get the help we need . There's has to be a rescue out there. We did everything we were told to do by the CDC just to get exiled. I welcome all advice. We have a PayPal setup and a GoFundMe and it's not working. Please Save us from the streets. We need to focus on getting well not more worried about finding aid. Thank you for listening to.my rant. P.s still haven't told you everything of what's happened. L ol

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Have a history of colitis/diverticulitis but have problems on daily basis with diarrhea. This is much worse since month long bout with COVID 10-11/22.

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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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Hello! Just wondering how you are doing now? Did you have to do a second round of Xifaxan? I just completed a 14 day prescription & don’t feel it resolved anything. I’ve had diarrhea issues since Covid in Aug 2021. I’ve had a colonoscopy & EGD to rule out other possibilities.

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@yasmineseropian

I had Covid 1/2020, got confirmed with antibody test in May 2020. Have been severely ill since then with all GI symptoms (lost 30 pounds, can't eat, Diarrhea, Constipation, severe abdominal pain and cramps, bloating, gastroparesis, loss of taste, nausea and vomiting). Had every GI, blood, and stool test...nothing. Also suddenly had severe anxiety, so all doctors figured it is in my head. Have treated it with diet and nutrition, enzymes, herbs, mushrooms, acupuncture and lots of Probiotics. Have improved a lot, but still 80% disabled with severe pain at least 6 hours a day, daily diarrhea, still 87 pounds (was 74 pounds).
I am just now finding information on long Covid and Gi symptoms. Where do I go from here? How do I find a doctor who will consider that Covid might be the cause for my illness? Has anyone found any help? Does anyone have a suggestion?
Please, help

Jump to this post

I feel for you! I have lost 22 lbs and also have issues with diarrhea. It definitely makes you anxious to do anything away from home. I had Covid Aug of 2021 and symptoms have progressed. I also have had all GI tests and just finished a round of Xifaxan. I thought it had maybe helped, but last two days have been bad again.

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I have said this in several blog entries, so forgive me for repeating, but maybe it will help someone new to the blog.

I had mild covid Aug '22, lasting 2 to 3 days. Only tired post covid for several weeks.
Sept '22 I started with severe diarrhea, painful cramping, bloating, loss of appetite, etc lasting 6 weeks with loss of 10 lb.

A friend recommended eating Activia yogurt twice a day, and Loperamide with Simethicone 125 MG daily for the painful gripe. This plan gradually slowed it all down to where I only occasionally feel a mild abdominal gripe.

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