COVID-19: What Your Stomach Could be Telling You

By now, you should know that the most common symptoms of COVID-19 infection are fever, dry cough, and shortness of breath. There’s also growing reports of gastrointestinal (GI) symptoms common among those infected with the virus.

What does this mean for you and your family? We’ve asked Dr. Oriana Mazorra Damas, a gastroenterologist with the University of Miami Health System, what you need to know.

First, this is new information, she says. And it is coming mostly from reports out of Italy and China, that analyzed a small number of cases. More research and data are needed for the U.S. Centers for Disease Control and Prevention to confirm these reports. “One thing we do know,” Dr. Damas said, “is that this virus attaches to the colon and small intestine, which may explain some of the GI manifestations.”

What GI symptoms should people look out for?

The symptoms, which are mostly GI-related, associated with COVID-19 infection include the sudden onset of:

• Loss of appetite
• Diarrhea
• Nausea
• Vomiting
• Stomach pain
• Loss of smell

“Doctors in Italy and China are reporting that up to half of their COVID-19 patients experienced one or more of these GI symptoms,” Dr. Damas says. Among them, the most common complaint (up to 90% of those with GI symptoms, according to some reports) was a sudden loss of appetite. The least reported of these symptoms is abdominal pain.

“These doctors are reporting that up to half of their COVID-19 patients experienced GI symptoms, plus the virus’s respiratory symptoms. Yet, some have GI symptoms without a cough and shortness of breath,” says Dr. Damas. “A recent study suggested that those with only GI symptoms (no respiratory symptoms) had a milder course of COVID-19.”

What should you do if you suddenly experience gastrointestinal symptoms?

Dr. Damas warns that symptoms like nausea, diarrhea, and stomach pain can have many causes. “It’s not a reason to panic,” she says. “Do you also have a fever? If so, call your doctor to see if they recommend COVID-19 testing based on your combined symptoms, your age, the typical function of your immune system, and any known exposure to the virus.”

If you’re experiencing diarrhea or vomiting, your goal is to stay hydrated and try to prevent the spread of any viral or bacterial infection to others. We don’t yet know if this new coronavirus can be transmitted through fecal matter, says Dr. Damas. Still, she recommends that anyone experiencing diarrhea or vomiting follow these safety guidelines.

• Practice social distancing.
• Use your own bathroom exclusively, if possible.
• Put down the toilet seat lid before you flush to reduce airborne germs.
• Regularly sanitize all bathroom surfaces (including handles and doorknobs).
• Thoroughly wash your hands after using the bathroom.

“The most important advice I can give you is to help prevent transmission through your own behavior.”

Dr. Damas

Even if you’re practicing proper handwashing, social distancing, and staying home, you are probably having groceries and other items delivered or picked up at the store. The virus may live on surfaces for several days.

Doctors like Dr. Damas recommend that you:

• Dispose of all outer packaging (boxes and bags)
• Rinse all fresh produce with running water
• Wash all sealed packages (cans, bottles, sealed bags) with soap and water or use disinfectant wipes before you put items away in your cabinets and refrigerator

And patients who are immunocompromised and managing their inflammatory bowel conditions?

“What’s most important is that patients continue to take their medications and receive their treatments, including infusions,” she says. Discontinuing treatment may trigger a flare-up of your disease, which may increase your risk for infection. “Contact your doctor if you have any questions or concerns about your medications, but do not stop your treatment on your own.”

At the University of Miami Crohn’s and Colitis Center, healthcare providers are taking extra precautions to reduce the risk of COVID-19 transmission among workers and patients receiving infusion treatments.

“We’re keeping patients six feet apart and following strict cleaning protocols. We’re minimizing the transfer of materials and paperwork from person to person,” said Dr. Damas. “And we’re using virtual consultations through the Telehealth system to communicate with patients and avoid unnecessary hospital exposures.”

Dana Kantrowitz is a contributing writer for UMiami Health News.

Tags: coronavirus, COVID-19, infectious disease