Long COVID, a condition that affects people who have recovered from COVID-19, has been found to involve many different body systems, including the heart, lungs, kidneys, and gut. While neurological issues, such as brain fog and chronic fatigue, are the most common symptoms, recent studies have shown that people who had COVID-19 have a 36% higher chance of developing long-term gastrointestinal problems, including gastroesophageal reflux disorder (GERD) and irritable bowel syndrome (IBS), along with more benign symptoms like constipation and diarrhea.
Doctors who work in long COVID clinics have reported that there isn’t a clear pattern as to who’ll encounter digestive issues after COVID-19. Some people were hospitalized with COVID-19, some weren’t, some had pre-existing gut disorders that flared up after COVID-19, and others were perfectly healthy until they got sick. Despite being overlooked, gastrointestinal disease is a not-so-rare facet of long COVID.
The most common GI symptoms associated with long COVID include constipation, abdominal pain, and diarrhea, followed by heartburn, nausea, vomiting, and loss of appetite. While gut issues aren’t nearly as common as brain fog or shortness of breath, doctors still see a good amount of people with diarrhea and irritable-bowel type symptoms in long COVID clinics.
Multiple theories exist as to why some people develop gut problems after COVID-19. The most convincing theory is that there’s ongoing inflammation in the intestines. The virus lingers in the GI tract and continues to activate immune and inflammatory responses, while COVID-19 disrupts the gut microbiome. Lastly, COVID-19 may ignite an autoimmune response, which leads to new food intolerances and higher levels of autoantibodies in people with long COVID.
Our understanding of long COVID is all in flux, and doctors are still working to understand just all of the ways long COVID can affect the body. One thing we do know is that the brain and gut are intimately connected, and if one thing goes awry in the body, there’s a good chance there will be a cascade of negative health effects.