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Digestive and Stomach Issues After COVID-19: What to Know and Expect

by: Post-COVID Support Team

December 15, 2022

COVID-19 infection, also known as the coronavirus disease, is a viral disease that primarily affects the respiratory system. However, a COVID-19 infection can affect your other organs and bodily functions because of its effects on your immune system. One common symptom in COVID-19 patients is gastrointestinal (GI) issues.

What GI symptoms can COVID-19 cause, and how long do these effects last? Find out more about post-COVID-19 stomach issues and what you can do to alleviate these symptoms.

Symptoms of digestive or stomach issues after COVID-19

These are some common GI symptoms that COVID-19 patients may continue to suffer long after their initial infection:

  • Diarrhoea
  • Nausea
  • Loss of appetite or increased appetite
  • Abdominal distension
  • Constipation
  • Vomiting
  • Abdominal pain
  • Stomach pain and/or stomach cramps
  • GI bleeding
  • Acid reflux

This is by no means an exclusive list of GI symptoms you may experience during or after your COVID-19 infection. Researchers continue to uncover new symptoms as more evidence is uncovered, especially in those who suffer from long-term symptoms known as long COVID.

If you are experiencing any of these symptoms or other GI tract issues, inform your doctor.

What is the gastrointestinal tract?

The gastrointestinal tract consists of the parts of your body that are responsible for chewing, digesting food, absorbing nutrients, and expelling it as solid waste. The GI tract is also commonly referred to as “‘the gut’”.

The body parts that make up your I system are:

  • Mouth
  • Esophagus (connects the mouth to the stomach)
  • Stomach
  • Small intestine
  • Large intestine
  • Rectum
  • Anus

What happens when COVID-19 affects your digestive system?

Experts are still studying how SARS-CoV-2 affects your cells throughout your body. Currently, SARS-CoV-2 has been seen to infect cells through the spike proteins on its surface. These spike proteins bind to proteins on your cells known as ACE2, allowing SARS-CoV-2 access to virtually every cell for an immediate attack.

When COVID-19 infects your GI cells, it replicates its viral proteins to spread the infection further. As the SARS-CoV-2 particles exit the cells, your body’s immune response gets triggered, causing a release of particles known as cytokines as a response to the infection.

Cytokines help your cells communicate and fight infections, but they also cause inflammation. Inflammation can cause diarrhoea, stomach pain, nausea, and vomiting. The antiviral drugs used to treat symptoms of COVID-19 like molnupiravir may also cause nausea and diarrhoea, adding to your digestive issues as you try to recover.

Research suggests that COVID-19 may affect your digestive tract and cause GI symptoms even after your respiratory symptoms have cleared. In fact, studies indicate that post-COVID patients continue to have a detectable virus load in their fecal samples even when the COVID-19 virus is no longer detectable in their respiratory system.

Outcomes of stomach problems after COVID-19

COVID-19 patients who develop digestive symptoms are at a higher risk of developing more serious gastrointestinal manifestations down the line. Currently, it’s believed that having GI symptoms of COVID-19 may make patients more susceptible to bacterial infections. This is because COVID-19’s GI symptoms irritate or damage your stomach or intestinal lining, making these parts of your GI tract more vulnerable.

Research has also shown that patients with digestive symptoms of COVID-19 are more likely to develop the following complications:

How long can COVID-19-Rrelated stomach issues be expected to last?

Studies are still being conducted on the GI complications of COVID-19 and their duration. The Centers for Disease Control and Prevention has suggested that COVID-19 GI symptoms like bloating and stomach pain can last anywhere from five days to two weeks after infection.

If your GI symptoms continue beyond this period, inform your doctor so they can conduct the necessary tests to rule out certain illnesses. Remember to mention any changes in your diet or pre-existing conditions and medications that may be affecting your stomach.

How do I know if my stomach issue is caused by COVID-19?

A SARS-CoV-2 infection can manifest or exacerbate GI symptoms that can also be caused by other conditions, such as irritable bowel syndrome or inflammatory bowel disease. If you are experiencing the following symptoms alongside GI symptoms like nausea or vomiting, consult your doctor and get tests for COVID-19 and the flu:

  • Shortness of breath
  • Fever
  • Coughing
  • Body aches
  • Heart palpitation
  • High blood pressure
  • Chest pain
  • Lower oxygen levels
  • Fatigue
  • Loss of taste and/or smell

However, not all GI symptoms that occur are related to COVID-19. They may instead be an indicator of a serious GI disease, such as irritable bowel syndrome or colon cancer. Seek medical assistance if you experience any of the following symptoms:

  • GI symptoms that result in weight loss
  • GI symptoms lasting over a week (e.g. chronic diarrhoea)
  • Vomiting blood
  • Blood in stool samples

How is COVID-19-Rrelated stomach issue treated?

While there’s no 100% cure for COVID-19, there are certain medications that can reduce its severity and duration for COVID-19 patients. As your COVID-19 infection gradually runs its course, so will your GI complications.

Here are some treatments that your doctor may suggest in the meantime to alleviate pain and help you manage your GI symptoms:

  • Over-the-counter (OTC) medications: In some cases, your doctor may recommend taking OTC drugs such as loperamide or omeprazole to treat symptoms like diarrhoea or gastritis. Do not attempt to take these medications without telling your primary care doctor, as overuse can worsen your GI symptoms due to COVID-19.
  • Making dietary changes: Your doctor may suggest eating a healthy diet and cutting back on processed food to avoid GI symptoms. Foods that are rich, spicy, or acidic may be irritating your stomach lining – causing acid reflux, a bloated stomach, and other digestive issues. You may have to temporarily switch to a diet of bland foods like oatmeal, bananas, and rice so you can keep down nutrients without irritating your gut. Later on, your doctor may also recommend adding certain foods to your diet to repopulate your gut microbiome and help it get healthier, such as yogurt and garlic.
  • Drinking lots of fluids: Because diarrhoea and vomiting cause your body to lose a lot of water, it’s important to stay hydrated. Bland broths, watered-down natural fruit juice, and tea with honey will help you get some nutrients without irritating your stomach. Oral rehydration salts added to water will also help you replace any salt and sugar that you loste as a result of diarrhoea.
  • Getting plenty of rest: It’s important not to rush yourself back to your normal level of activity. COVID-19 can have long-term effects on your physical and mental health, and overexerting yourself can hamper your recovery.
  • Tube feeding: For severe COVID-19 cases where patients have a very low appetite or have difficulty eating without irritating their stomach lining, enteral feeding a.k.a. tube feeding may be recommended.

Be wary of fad diets and supplements with unproven claims for treating COVID-19. These are not proven to be effective against long COVID and its GI symptoms, and they may even make patients feel worse.

While mild to moderate cases of COVID-19 may be managed at home, some patients end up needing hospitalization for inpatient care. If these treatments don’t alleviate your gut problems, seek medical advice from your primary care physician.

What can I do to prevent COVID-19 from spreading in my home?

Because COVID-19 is airborne, it can spread from an infected patient’s mouth or nose through respiratory particles. It can also spread through fecal matter, and less often through infected patients touching surfaces or other people.

Here are some simple ways you can prevent the spread of COVID-19:

  • Getting the COVID-19 vaccine and booster: Being vaccinated helps protect people from getting COVID-19, and it lessens the risk of developing more serious symptoms if you do have a breakthrough infection.
  • Mask indoors and outdoors: Wear a well-fitting face mask to prevent the spread of COVID-19 through respiratory particles.
  • Social distancing: Avoid crowded areas, especially poorly ventilated ones, even if you are masked and fully vaccinated.
  • Wash your hands: Regularly wash your hands with soap and running water for at least 20 seconds, especially if you are preparing food or have just used the bathroom. If water and soap are not available, use hand sanitizer with at least 60% alcohol.
  • Self-isolation for patients: Because COVID-19 can also be spread through fecal matter, it’s important for patients to have their own bedroom and bathroom away from other house members.

The bottom line

Gastrointestinal symptoms like nausea, diarrhoea, and stomach pain are common symptoms suffered by COVID-19 patients. Developing these symptoms can put you at a higher risk for other GI diseases later on, even long after your acute illness.

If you continue to experience GI symptoms for over a week from your COVID-19 recovery, inform your doctor. This may be a sign that you have long COVID or a serious GI illness, and letting them know your symptoms can help them determine the best course of treatment.

If you want to learn more about overcoming long COVID symptoms and how you can navigate the extended COVID journey, meet our team and talk to us.