COVID-19 and Gastrointestinal Symptoms

A fever, dry cough, and shortness of breath are hallmark signs COVID-19, the illness caused by the new coronavirus. But early research suggests that another common symptom may be often overlooked: stomach upset.

A recent analysis of more than 200 people admitted to three hospitals in Hubei, China -- the province where the virus called SARS-CoV-2 originated -- with mild cases of COVID-19 found that almost 1 in 5 had at least one gastrointestinal symptom, such as diarrhea, vomiting, or belly pain. Nearly 80% also lacked an appetite.

Those symptoms can stem from other common causes, including stomach flu or food poisoning. But if you have COVID-19, GI problems may slow your recovery. And the digestive symptoms may worsen as you get sicker.

Gastrointestinal Link

Once any virus infects your body, it can destroy healthy cells and make multiple copies of itself. COVID-19 mainly attacks the cells lining your airways. This makes it hard for you to breathe and can lead to pneumonia. But researchers think the illness also may harm your digestive tract and liver tissue.

The study in China found that a third of the people with mild COVID-19 had diarrhea. The problem, including watery stool, was usually not severe. The diarrhea lasted for an average of 5 days.

Those with digestive symptoms were more likely to have a positive stool test for the coronavirus, which means they had SARS-CoV-2 RNA in their poop. It also took them longer to clear the virus from their bodies, compared to those without gastrointestinal symptoms.

What You Should Do

If you have diarrhea, nausea, or vomiting, it doesn’t mean that you have COVID-19. But it’s wise to pay extra attention to your symptoms during this pandemic, especially if you have a health condition that raises your chances for an infection or if you live in an area where the new coronavirus is widespread.

Stay home. Most people who test positive for the coronavirus get mildly sick and get better without treatment. Avoid going out unless you must, such as for urgent medical visits.

Have a “sick” bedroom and bathroom. If you can, use a separate bathroom for yourself if you live with others to prevent spreading illness through your poop.

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Wash your hands often. Soap and water for at least 20 seconds is best, especially after you use the bathroom, blow your nose, or sneeze, and before eating or cooking. Next best is a hand sanitizer with at least 60% alcohol.

Clean and disinfect surfaces regularly. This includes the toilet seat and flush handle, bathroom doorknobs, phones, counters, and other things you touch often.

Drink lots of fluids. If you have diarrhea or are vomiting, it’s important to replace the lost fluids. An oral rehydration solution from the drugstore is best because it has salt and sugar that your body loses in diarrhea. Or you can sip watered-down fruit juices or soft drinks, along with salted crackers and broths.

Eat a bland diet. Try foods like bananas, white rice, applesauce, and toast, which can help limit your urge to poop and replenish carbohydrates that your body needs. You can also try oatmeal, boiled or baked potatoes, and baked chicken without skin.

When to Call Your Doctor

If your stomach troubles are due to a GI bug or food poisoning, you usually should feel better within 48 hours. If you don’t, call your doctor. It could be a more serious bacterial infection or an early sign of COVID-19. You should also reach out to them immediately if you:

  • Might be severely dehydrated. Signs include dark urine, extreme weakness, a dry mouth and tongue, and dizziness.
  • Have diarrhea that is bloody or black, or severe belly pain
  • Are feverish, coughing, or feel short of breath

WebMD Medical Reference Reviewed by Brunilda Nazario, MD on April 17, 2020

Sources

SOURCES:

American Journal of Gastroenterology: “Clinical characteristics of COVID-19 patients with digestive symptoms in Hubei, China: a descriptive, cross-sectional, multicenter study,” “Digestive Symptoms in COVID-19 Patients with Mild Disease Severity: Clinical Presentation, Stool Viral RNA Testing, and Outcomes.”

UpToDate: “Acute Diarrhea in Adults (Beyond the Basics).”

Cleveland Clinic: “Mom’s Advice Is Still the Best for Treating Diarrhea.”

CDC: “Coronavirus Disease 2019: What to Do if You Are Sick.”

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