In the early stages of the COVID-19 pandemic, we learned that the virus impacts more than the respiratory system. The illness can affect the esophagus, stomach, small intestines, and colon, causing abdominal pain and diarrhea. For most people, these symptoms dissipate as they recover. However, scientists are now learning that those symptoms often continue for those suffering from long COVID.
What causes GI issues in patients with long COVID?
While the exact mechanisms driving long COVID are unknown at this time, research suggests it may be related to “dysregulated local or systemic inflammatory responses, autoimmune mechanisms, viral-induced hormonal imbalances, skeletal muscle abnormalities, complement dysregulation, novel abzymes, and long-term persistence of virus and/or fragments of viral RNA or proteins.” It is estimated that around 17 million people in the U.S. have long COVID, or seven percent of all adults in the country.
Long COVID-related GI issues appear to involve the gut-brain axis, or the enteric nervous system (ENS), which includes more than a million nerves in the lining of the entire GI tract. Johns Hopkins explains that these nerves control the digestive process, including swallowing, releasing enzymes that break down food, nutrient absorption, and elimination. Researchers believe that long COVID disrupts the nerves’ ability to communicate with the digestive system to maintain proper GI function.
Common GI symptoms of long COVID
According to the Mayo Clinic, the most frequently reported GI symptoms of long COVID include nausea, constipation, food intolerance, and decreased appetite. Other symptoms include abdominal pain, diarrhea, vomiting, heartburn, irritable bowel syndrome, bloating, incontinence, and trouble swallowing. For long COVID sufferers who did not have GI issues prior to the virus, the new GI symptoms typically begin within approximately 100 days after the infection.
Management strategies
Unlike other illnesses, the duration and severity of long COVID symptoms are difficult to predict. Symptoms may come and go multiple times over a period of years, or they may remain consistent or even disappear altogether. Therefore, one of the best strategies is to maintain optimal health, including gut health. This means cutting back on foods that can negatively impact health, such as processed foods, sugar, saturated fat, salt, and excessive alcohol.
The Mediterranean diet is considered one of the healthiest options. It consists primarily of fruits, vegetables, beans, nuts, legumes, whole grains, and extra virgin olive oil. Red meat should be replaced by healthier options such as salmon, which is rich in omega-3 fatty acids.
Staying hydrated is also vital for managing long COVID GI symptoms. Water is the best option as it helps lubricate the GI tract and facilitates more effective food breakdown and nutrient absorption. It also helps reduce the risk of constipation, soothe indigestion, and alleviate abdominal pain. Fluids that contain caffeine should be limited as they can promote dehydration.
Just as the gut-brain axis controls the GI system, it also plays a role in the emotional and cognitive centers of the brain. Therefore, managing stress is vital for those living with long COVID GI issues. In addition to a healthy diet, exercising regularly, and staying connected with supportive friends and family can help. Individuals should also consider working with a counselor to develop a stress-management program customized to their unique needs.
Finally, individuals with long COVID GI symptoms should inform their primary care physician or gastroenterologist about their symptoms. Long COVID is often overlooked as a cause of GI issues, so it’s important that patients share a detailed list of symptoms and schedule regular follow-up visits.
The healing journey
Survivors of COVID and those with long COVID have a significantly increased risk of developing GI disorders, even if they’ve never had gut problems before getting the virus. While researchers are still learning the mechanisms behind this issue, impacted individuals need to do all they can to maintain their health and manage their GI symptoms. In addition to eating well, staying hydrated, reducing stress, and working with their physician, individuals can leverage resources such as GI Alliance.
GI Alliance provides an online searchable database of GI specialists across the country, allowing individuals to find a physician in their area. The website also offers educational resources that provide in-depth information on all GI-associated conditions, including long COVID symptoms, treatments, and procedures. In addition, the GI Alliance provides information about GI-related screenings, how they’re performed, their benefits, and how to find a screening resource in their community.
Individuals with long COVID GI symptoms don’t have to suffer. Contact GIA today [CTA].
