Addressing post-COVID-19 gastrointestinal symptoms

When you think about COVID-19 symptoms, cough, fever or shortness of breath might come to mind. However, many COVID-19 patients suffer from gastrointestinal (GI) symptoms in addition to (or instead of) respiratory symptoms.

“Early on, the CDC list of COVID-19 symptoms did not include gastrointestinal symptoms,” said Dr. Jordan Shapiro, assistant professor of medicine – gastroenterology at Baylor. “It became clear after the first few months that there is a subset of COVID-19 patients with non-respiratory symptoms. We now know that subset is about one-third of COVID-19 patients.”

Gastrointestinal symptoms of COVID-19 can include loss of appetite, diarrhea, nausea and vomiting and abdominal pain. However, not all patients with COVID-19 and GI symptoms have symptoms at initial presentation, according to Shapiro. Some patients will develop symptoms several days into or even after the initial infection has cleared.

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Shapiro has seen patients at the Baylor Medicine Post COVID Care Clinic who have recovered from COVID-19, but experience ongoing loss of appetite, nausea, acid reflux, diarrhea, bloating and abdominal distension.

“Some people don’t immediately realize that their GI symptoms coincided with their COVID-19 infection, and they may not think the symptoms are related to COVID-19 because they’re not respiratory in nature,” Shapiro said.

Post-infectious GI issues are common after other non-COVID-19 viral or bacterial infections, and some patients experience post-infectious irritable bowel syndrome or gastroparesis. Those symptoms tend to have good long-term prognoses, with the majority improving over weeks, months or less commonly, years.

Researchers believe COVID-19 causes GI symptoms, in part, because the ACE2 receptor used by the SARS-CoV-2 virus to infect cells, is found throughout the GI tract. It remains unclear if the duration of post-COVID GI symptoms will mirror that of other post-infectious GI conditions or not.

Shapiro says mild GI symptoms can usually be treated with over-the-counter medication. But he encourages any patients experiencing persistent GI symptoms to see a gastroenterologist, even if they are unsure if the symptoms are related to a COVID-19 infection.

“We can test for other contributing factors to the GI symptoms with a variety of tests from blood and stool samples to breath tests to radiology testing and occasionally endoscopy,” he said. “If everything comes back normal, we have a variety of treatments for the symptoms. There’s no reason to suffer in silence.”

To learn more about the Post COVID Care Clinic or to schedule an appointment, visit the website or call 713–798–2400.

-By Molly Chiu

3 thoughts on “Addressing post-COVID-19 gastrointestinal symptoms

  • August 17, 2021 at 10:08 am
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    Thank you for the article. I’ve been thinking I must have sudden onset intestinal cancer. I had severe covid 19 the end of March and first week of April 2021. Required hospitalization oxygen, plasma treatment a week of rendesiver (Spelling) , steroids for lungs, antibiotics for ear infection and the list goes on. Totally messed up my diabetes control. About 6 weeks ago I noticed a change in the smell of my body, gas expulsion, and the smell of my feces. It’s horrible and smells like sulfur to me. No one else smells it on my skin, but I do when I perspire. Mentioned it to my daughter she said she has the same issue but to her it smells like clorox and cinnamon. She had covid at the same time. My lower bowels hurt almost constantly now. I’ve taken Prilosec for years and suddenly it no longer works. Your article gives me the courage I need to address the issue with my doctor. Again-Thank you.

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  • November 22, 2021 at 10:29 am
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    My son contracted COVID back in October of 2020. He then started to have rectal bleeding in February 2021. He saw a gastroenterologist who performed several blood test and did an endoscopy and found that there was no issues. This has gone on now for over 10 months. I would like to be able to provide my son’s doctor with information on Dr. Shapiro work so that his doctor can provide my son with some direction on how to stop the bleeding and get some relief.

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