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.

woman-stomach-pain

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

18 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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    • April 22, 2022 at 9:59 am
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      I know how it feels I had covid a few week s ago and out the blue everything I eat hurts my stomach now feeling bloated and nauseous every time I eat it’s a horrible feeling in my gut and gives me pain I’m going to try and speak to a doctor as it’s affecting my everyday now

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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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  • January 28, 2022 at 1:34 pm
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    Thank you for your article regarding covid 19 gastro symptoms. I am a 58 year old male who tested positive for covid 19 on the 12th of December. Three days after i tested positive, i had a bout of diarrhoea which triggered all sorts of digestive issues. I started having bloated stomach, worse when i eat, acid refux and terrible stomach discomfort. The bloating was very bad and could hardly eat anything. No nausea or vomiting at this stage. I carried out some blood tests and stool tests, all results were normal. I started myself on Omeprazole 20mg and Gaviscon which gave me some relieve. Two weeks later, i had a bit of spicey food which triggered another bout of diarrhoea, this time with blood. I was diagnosed with extensive diverticular disease four years ago when i had a colonoscopy. The incidence of diarrhoea has increased with no blood. I have had a consultation with a Gastroenterologist who examined me but could not find any major thing going on. I have been booked another colonoscopy in two weeks. I am really worried about what is going on with my body even after six weeks. I was however pleased to read your article which is a bit reassuring as there are not many information out there about the impact of covid 19 on Gastrointestinal symptoms.

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    • February 9, 2022 at 4:36 pm
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      I am having the same problems and had COVID over Christmas, had an endoscopy last week and didn’t find anything.

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    • February 12, 2022 at 4:43 pm
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      I had COVID the first two weeks of January. I had the usual flu like symptoms like headache, body aches and nausea. I Didn’t have any respiratory issues, only a sore throat and mild cough. After recovering I get stomach pains and bloating any time I eat, no matter what I eat. I have an appointment with a gastroenterologist on Tuesday hoping to find some answers and I’ve been stressing that it might be something seriously wrong with me, but this gives me a sigh of relief that it might just be related to COVID.

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    • February 12, 2022 at 9:21 pm
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      I had my 2nd vacination on December 8th and contracted covid around Jan 28th
      Ive had diarrhea ever since and now started having stomach pains and knots in my sstomach. Ive been taking gasx and culturelle but it’s not helping yet. I hope it goes away soon.

      Reply
  • February 9, 2022 at 8:56 pm
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    It is so nice to finally see someone experiencing the things that I have had after Covid. We had Covid from 12-31-21- 01-14-22. I’ve had the worst stomach bloating and issues with constipation, rectal bleeding. I finished my Nexium-14 day treatment but I’m still in so much pain.! How do we relieve the pain? My gallbladder, liver, and intestines are bloated. It hurts something awful. I took a lot meds during Covid so I wonder if that’s a reason for agitation as well..?

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  • February 11, 2022 at 7:59 am
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    I tested positive for covid in mid jan, 2 days after my positive test I was in extreme pain in the top of my stomach and under my ribs, back also. I had non of the respiratory symptoms. The doctor thought it may be gallstones, blood tests not showing any sign to confirm this. still awaiting scan. Doctor thought it was unrelated to covid. 2 weeks on and I’m still experiencing pain discomfort on and off despite reducing the fat in my diet and sticking to a strict healthy low fat diet.
    A second visit today and the suspected diagnosis is gastritis and possibly related to covid. Been prescribed omeprazole to try and settle the stomach lining.
    Fingers crossed it works.

    Reply
  • February 12, 2022 at 7:42 am
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    Hi, all,
    I had covid at the end of February 2021. I had a headache and cough for a couple of days and then the stomach issues began. I have had indigestion, stomach pain, diarrhea, loss of appetitie, and nausea since then – though the nausea seems to have subsided. Like some of you, I am concerned this is a more serious issue, though I have had many tests – CT, MRI, Colonoscopy, Endoscopy – which have all come back negative. I have also tried several meds but nothing seems to work. I just wish I could get to the bottom of this. The symptoms are bad enough, but the worry and anxiety are wreaking havoc on my life.
    Thanks to all for sharing. It helps.
    MJ

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  • February 13, 2022 at 8:53 am
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    I, too, have had a sudden onset of GI symptoms following covid 19. I would encourage anyone who read this to please leave their experience as well to help add to the information. My worst covid symptom during active infection was a horrible chemical bitter like taste in my mouth. About a week after testing positive I began having pain under my right rib. Intermittent mild dull achiness. They suspected gallbladder. Did CT with contrast. No stones. They did ultrasound and shows Mildy distended gallbladder. Positive murphys sign. I’m scheduled for a HIDA scan tomorrow. But the worst symptom has been bad nausea. Might have it severely for a couple days then it lets up for a day or so then maybe off and on the next day. It has been very depressing and life changing for me.

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  • February 14, 2022 at 3:45 pm
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    Thanks for this post. I had covid and was sick for about four days. I am negative now, but continue to experience occasional lower abdominal pain after eating.

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  • February 21, 2022 at 9:22 am
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    Thank you for this information, my whole family of 6 had COVID and “recovered” about 6 weeks ago. This last week however it was like we had it all over again with vomiting, headaches, muscle aches, diarrhea and no interest in food. I was thinking we got some kind of 24 hour flu but it seems to come and go. One day we feel fine, the next, we’re sick again.

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  • March 31, 2022 at 5:51 pm
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    I feel your pain!!

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  • April 25, 2022 at 10:12 am
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    Hi all, it’s reassuring to read some of these messages. I contracted covid at the end of January 2022. Only symptom was a sore throat and tiredness. Since then tho I have had bloating every time I eat I can look 6 months pregnant and also gained 6lb since then to with no change to my diet. Has anyone else gain weight along side the bloating. It’s really getting me down. All bloods were ok. Iron was low ( normal for me).

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  • May 7, 2022 at 4:22 am
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    Hi, my story is pretty much the same! I had Covid last week of December 21, it was quite mild with a low grade fever, some lightheadedness, sore throat and headache. I couldn’t shake off the fever and kept getting lightheaded for months. February 22 I got a bad stomach pain, bloated, feeling full even after eating a grain of rice and thought the worse. Doctor did blood tests, heliobacter test, ct scan, ultrasound, all clear. So started omeprazole, took it for 6 weeks with no difference so stopped. Awaiting gastroscopy but not sure that will show anything either.
    I wish someone can post something to let us know if they got a cure for this abdominal pain.

    Reply
  • May 8, 2022 at 2:53 am
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    I had Covid for about a week and tested negative afterwards. It was a relatively mild case rather like ‘flu – slight headache, aches, cough and phlegm but it cleared up. Afterwards – about ten days – I had nausea and vomitting and some diarrhea which seems to be passing off but it was unpleasant and left me feeling weak and tired with some belly ache. I thought it was something I had eaten but I now think it was probably a long Covid effect. I hope it goes away.

    Reply

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