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A Gut Feeling: Long COVID and GI symptoms
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.
- 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).
- 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.
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I had the 4th Covid vaccine in April, 2022, and got a bad cold and cough afterwards. The cough lasted 4 months, so I finally took amoxicillin. Within a couple days I developed a backache, which progressed to pain in my shoulders, arms, and legs. I could barely walk. I saw a functional medicine doctor, who put me on an anti-inflammatory diet and lots of supplements. I slowly got better after physical therapy (to prevent a frozen shoulder). I am now intolerant of gluten, dairy, and refined sugar. I had Covid last December and thankfully, it was a mild case. I was a lot sicker after the vaccine than with the actual virus. I'm sure the vaccine combined with the antibiotic caused my food intolerances. I've had way too many antibiotics in my life due to chronic sinus infections. And in the last few years, I've had way too many vaccines (flu, Covid, pneumonia, etc.) I'm happy to report that as long as I stay on the diet I feel good, but it was a big lifestyle change. I'm now afraid to take any drugs at all. Haven't even had an aspirin in a year.
Clear spike protein: nettocynase enzyme 2000 units 2xs per day , bromelain 500 Mg per day curcumin 500 3xs per day
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3 ReactionsHello there. I had my first bout with Covid April 2023, I am vaccinated and boosted with Pfizer. Since April until August 2023 I’ve tested positive with Covid and Flu A and B six times. My main symptoms are horrible GI problems, (gas, diarrhea, loose stool, rumbling stomach, sharp pains that wake me up from sleep. Headache, lightheadedness, body aches and extreme fatigue. Has anyone ever heard of this Covid/flu recurrence? When I took a blood test to see if I had Covid antibodies it showed I had pass Covid and present Covid.
Flu A or B each time, not at the same time.
rdcourtney, Wow! 6 times. I can't imagine. and I have never heard of that Covid & Flu A & B combo. Covid does so many strange things to the body . One of my doctors is fully vaccinated, had Covid and is left with horrible GI problems as well. Praying for you. I'm so sorry you are battling this.
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3 ReactionsI had Covid August of 2021. I have dealt with GI issues ever since similar to your’s (diarrhea, gas, pains). My GI doc ran all kinds of tests and all were negative. He diagnosed me with Covid induced IBS-D. I currently take dicyclomine and Rx Imodium. They do seem to help, but mornings are my worst. I hope you can find some relief…it’s not fun.
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3 ReactionsThis is what you are dealing with:
https://hms.harvard.edu/news/most-important-question-about-long-covid
Viral persistence, marked by ongoing SARS-CoV-2 shedding, likely causing the virus to continuously provoke the immune system, which, in turn, leads to chronic inflammation. One study found persistent viral RNA in the feces of a subset of individuals months after clearing the original infection. These individuals also reported lingering GI symptoms months after COVID diagnosis. Another study found spike protein continuously circulating in the plasma of people with long COVID.
Gut microbiome disruption. Research suggests that depletion of certain anti-inflammatory gut bacteria during and immediately following SARS-CoV-2 infection may result in lingering inflammation and contribute to the development of long-term symptoms of long COVID.
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8 ReactionsPost Covid nausea:
I am 4 weeks post covid and still with severe nausea and lack of appetite. Have had abdominal ultrasound, endoscopy without significant findings. I am living on zofran and phenergan which makes you feel awful. What is being done for post covid and has anyone found a solution that's helped?
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1 ReactionI had to greatly restrict my diet. Currently I am on a low fodmap diet to heal my gut. Gluten and meat really make things worse for me. I subscribed to the thrive market in order to find pea only based plant protein. I like beyond beef brand. I also was told to drink kefir by my Mayo doctor. I actually started making my own with lactose free milk. It is pretty easy to do. Lastly, your brain and gut are connected by the vagus nerve. Mindfulness, meditation, breathing are key to calm your gut down. Looking back on what you are describing, I felt so awful that I didn't even know it was nausea or my stomach. So you are way ahead of the game! Continue to listen to your body and hang in there. It gets better slowly.
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1 Reactionthank you. how long did it take you