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.
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
Currently experiecning COVID symptoms? Learn our Post COVID Care Clinic.
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.
I am also happy to find an article that discusses this issue. I tested positive for Covid 10 days ago. I did not have lung issues, just an extremely stuffy, head, sore throat, and a slight cough. But a few days ago I started with very painful lower abdominal pains and bloating. Last night the diarrhea began. I have not called my doctor yet but plan to today. It does bring me some relief to know that this very well could be a post side effect of COVID-19. If any of you have any recommendations, please share.
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.
Hello,
Thanks for reading. You can learn more about our Post COVID Care Clinic here: https://www.bcm.edu/healthcare/specialties/the-lung-institute/post-covid-care-clinic or call 713–798–2400 to schedule an appointment.
– Andrew
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.
I am having the same problems and had COVID over Christmas, had an endoscopy last week and didn’t find anything.
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.
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.
Hi there, I’ve just come across your comment replying to this arrival in regards to long covid symptoms. I am a 24 year old female that contracted covid back in December 2021, I didn’t have any severe symptoms more of a bad head cold with a temperature. Once I recovered from covid I noticed a change in my stomach. I seemed to get bloated after everything I ate no matter how much or how little. I also have stomach discomfort after meals I’ve tried every diet under the sun I’ve seen a dietitian, multiple doctors, done multiple blood tests everything has come back fine. My new doctor has referred me to see a gastroenterologist to do an endoscopy. I am very curious to know if you have found any answers and solutions to your symptoms?
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..?
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.
I had Covid 4 weeks ago and it’s been all gastro related. Burping. Bloating. Weird stools. Stomach pain, weird muscle twitches in the stomach? ER doc says he thought gastritis due to Covid also. Been on low fodmap diet for 3 weeks. Helping some. Sugar or any fast carb, seems to make it worse for sure. Anxiety bad with it and doesn’t help matters.
I have same symptoms….except for weird stools, but am nauseous almost every day, but haven’t lost my appetite or lost weight. I have an appt. with Gastroenterologist today. I found eating anything tomato based makes symptoms worse. I drink tons of water, and drink OJ when the nausea starts up. I have so many long Covid symptoms (for 3 yrs now) that it is exhausting to live with. I guess I’ll be happy if the Dr. tells me nothing is wrong….like all the others have, and will have to figure out how to live with it.
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
It is very possible that the anxiety is causing all of your problems. I went through something similar all from anxiety and it took months or maybe more than a year to recover because i couldn’t calm down. Now I’m having gastritis symptoms after covid and wondering if it’s all stress related… again.
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.
Me too, a very unspecific onset of gastrointestinal issues. First bloating after food and loss of appetite. Then came vomiting off and on which has lasted for 2 months. No headaches or respiratory problems. Have had CBC’s, ultrasound, ct scan, ekg, iv treatments and nothing conclusive yet. Will see a gastroenterologist next week. All this from a previously healthy active female with good food choices. This is so frustrating as my fatigue is overwhelming
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.
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.
Thank you for this article. It is difficult to find information on the web for post-COVID GI issues. My husband and I were exposed on Jan 7. I fell sick on the 10th, him on the 12th. My symptoms were pretty mild. I actually tested negative today, but I’m having lingering nausea and diarrhea. He does, too. It’s been on and off. I’ve mostly had an appetite, until today. I feel more nauseous now than during the peak of the infection, and despite having more solid stools over the last couple days, diarrhea is back today. I also think my tinnitus is worse, and my ears have been plugged on and off. Frustrated and feeling ill. Hoping things will improve as it has been just 2 weeks since exposure. We have a trip planned to visit family in Florida in 3 days. Worried we’ll have to cancel.
Omg I have exactly the same symptoms as you after Covid in January. To this day, I also have tinnitus, horrible stomach bloating, nausea on and off. No desire to eat and scared to eat. I fear it’s never going away. It’s been 4 months. Nothing seems to help. I live on Omemprozole, Pepto Bismal and Roland’s. It does nothing.
So glad I found others with my problems since Covid, actually still Nauseas and vomiting occasionally 8 weeks post Covid, can only work part time now,don’t have the energy to do what I did before this Virus
I got covid on Sept 30th, 2022. I had really intense Hunger pains and Loss of Appetite. Very odd combination and terrifying. Nausea, indigestion and heartburn. I have indigestion 24/7. I also had other symptoms such as crazy insomnia and anxiety/panic attacks and burning sensations.
I am currently eating a low histamine diet and treating for MCAS. It is all so awful. I lost my job and really just trying to get better.
All tests have come back negative. Endoscopy too. I wish something would help with the indigestion. It always hurts. And I get nervous to eat. Then I get starving. I am taking a bunch of supplements to try to help.
Same boat as all of you. Head cold, bit of a cough probably covid. Now nauseous bad all the time every day 10 days after I felt better from the cold. Nothing was in chest. Now can’t eat without feeling sick, initially had diarrhea but I’ve lost 12 lbs. anxiety is bad as well. I don’t know what to do now. Trying to eat light foods etc….but I’m feeling lost.
Oh bloating, gassy, what a crappy feeling. Pain, a lot of burning. How long does this go on? I’ve seen some people had it for months and still do.
I feel for you all.
I had covid for the 2nd time in August 2022. Very different from my first bout in March 2020 when I had a horrible metallic taste in my mouth for 10 days with loss of taste and smell and hair loss lasting 7 months and the right side of my body was also inflamed for months.
The 2nd bout was like a mild flu for 2-3 days and I took Paxlovid. Ever since then I’ve had a burning abdominal pain on my left side, 8 months now and no sign of relief. It’s most intense along the colon and in the lower left quadrant in the mornings but sometimes lasts all day with occasional back pain. Colonoscopy indicated nothing of concern and my doctor isn’t taking the complaints seriously. Hoping for some kind of treatment to surface.
I have had all of the symptoms described above since Aug 2021. After my 2nd covid shot I experienced a week of headaches, diarrhea, nausea and stomach pain. I was diagnosed as being constipated. After taking many laxatives and seeing several doctor’s my gastric tic issues have not subsided. I have lost 15 pounds which I could not affford to lose and have no been able to get out of this constant state of feeling miserable day after day. Thanks for all your postings.
Ever since covid (i didnt get vaccine), I have had razor blades in my stomach and intestines and referring elsewhere 🙂 Had a million tests done. If I get a stomach virus or me GERD acts up, it feels like knives in me. I don’t know what these things have done to us and I don’t know if we ever will…hopefully they will just pass sooner or later…i’m going on a year with the symptoms…good luck
and yes, really like razor blades so I feel your pain.
Interesting that I am not alone. I had covid July 22, and heart and exhaustion issues until December 22. Worked with my Dr who says long covid. Heart issues better and been tested and no problem. Now-in the beginning of January started gastro issues. Terrible problems, and my mornings are dedicated to sitting and waiting for them to abate. Again, Dr thinks long covid, but I had a CT scan (returned all “normal”) and it is now 3 1/2 months later and I still have problems. I have an appt with a gastro specialist next month and hope they can help. Meanwhile, I have to schedule my life around gastro issues.
Please see a gastroenterologist. I did so only to learn that I have pancreatic insufficiency and now take pig enzymes to replace the ones my body no longer produces and I’m feeling much better.
I had Covid in May 2022. I have been dealing with nausea, vomiting and headaches since. I have had many scans and tests, endoscopy, and colonoscopy but it has not turned anything up. Now I am wondering if this may be related to long covid….
I had covid in December 2021 didn’t have it bad more of a head cold but once I recovered I had extreme stomach bloating after anything I ate, weird stool, crazy insomnia. Did multiple blood tests all came back “normal” and many different diets nothing worked. Been dealing with these symptoms for a year and four months now. Seeing a gastroenterologist to do an endoscopy.
I was diagnosed with covid Feb. 2022. Since getting covid I experienced on and off diarrhea for a few months. Starting in Nov 2022 I’ve had diarrhea every day multiple times a day. I saw a GI doctor in Jan 2023 and have had stool samples, blood work and other tests that have all come back negative. I’ve finally come to the conclusion that it must be related to covid. This is the most frustrating thing ever, having my life revolve around my stomach issues.
This has been my life since December 2022. Very mild case of Covid, took 2 weeks to show negative though. All gut stuff since. GI issues ranging from pain, bloating, diarrhea, constipation, burping, belching, gas, nausea, weird stools, etc etc. Had very test done under the sun. No answers except my gut has bad bugs due to Covid infection and or vaccine. There are millions with same crap 💩
I agree-very frustrating and life altering. My problems started the end of December 2022 and while tapering off now, have been significant. Have been tested for parasites, lactose intolerance, upper barium enhanced scan-and all show nothing is wrong. While I am grateful for that, something is wrong if I need to plan my day by getting up 2-3 hours early in the morning before I can leave the house (and this is the IMPROVED version). I hope yours improves soon. Slowly things are getting better here, but by no means “normal”. Gastro Dr recommended probiotics, low fodmap diet, fiber powder-and had nothing else to offer. ANd yes-I am convinced it is part of long covid-I saw many others with issues when I researched, and my Dr. is the one that suggested the answer initially. Good Luck.
I should mention, in addition to the comment I just printed, that the gastro dr. “thinks” it is IBS, rather than some worse problem. For this I am glad, but it still is a problem.
Yes. Same here. Diagnosis= IBS. It’s a blanket term for we have no clue what’s wrong with you. Lol. I got the same after 6 stool tests, CT scan of abdomen, 100 different lab tests and 6 consults. I would “suggest”. Magnesium, Melatonin, Zinc GI, digestive enzymes with every meal and some fasting to heal the lining. Bone broth “homemade” great also. It will pass, but as you look deeper, you will see SO many people suffering from GI stuff. It’s crazy but makes sense. Your ACE2 receptors line your gut. Covid attacks those just like in the lungs. Some people just get the gastro version. I also was Dec 22 strain. It hurt a lot of people.
I’m going to be growing broccoli sprouts packed with Sulforaphane and trying those, nothing to lose as they
are so beneficial to health in so many ways anyway.