While primarily known as a respiratory illness, COVID-19 also affects the digestive system. Many individuals searching for information on “covid poops” are experiencing gastrointestinal (GI) symptoms. These digestive issues are a recognized part of the infection for a significant number of people, with symptoms like diarrhea, nausea, or abdominal pain being part of the body’s response to the SARS-CoV-2 virus.
Gastrointestinal Symptoms of COVID-19
The most frequently reported gastrointestinal symptom of COVID-19 is diarrhea. This is characterized as watery stool and can occur, on average, three to four times a day. Some case reports have described the stool as being yellow or green, a result of it moving too quickly through the intestine for proper fat absorption. The duration of this diarrhea is often between three and five days, though more severe cases can last longer.
Beyond diarrhea, individuals may experience other digestive complaints like nausea, vomiting, and a general loss of appetite. Some people also feel abdominal pain, which can be located in the upper or lower abdomen. Studies have shown that the frequency of any GI symptom among those with COVID-19 can range significantly, from as low as 2% to over 50% in some cohorts.
For some individuals, these digestive issues are the first signs of an infection. Research indicates that GI symptoms can appear a few days before the more classic respiratory symptoms like coughing or fever. In a smaller subset of cases, estimated to be around 20%, gastrointestinal symptoms may be the only manifestation of the illness.
The Gut-Virus Connection
COVID-19 can cause digestive issues because of how the SARS-CoV-2 virus enters human cells. The virus uses angiotensin-converting enzyme 2 (ACE2) receptors as docking points to infect the body. While these receptors are well-known for being in the lungs, they are also found in large quantities throughout the lining of the gastrointestinal tract, making the gut a target for the virus.
When the virus binds to these receptors in the intestinal lining, it can directly infect the cells. This process disrupts the normal function of the gut and leads to an inflammatory response that triggers symptoms like diarrhea and pain. The infection can also interfere with the intestine’s ability to absorb water and nutrients properly, leading to watery stools.
This direct viral invasion can also alter the balance of microorganisms in the gut, a condition known as dysbiosis. The community of bacteria and other microbes in the intestines plays a part in immune function and digestion. A disruption to this ecosystem can further contribute to the gastrointestinal symptoms experienced during the infection.
Viral Shedding and Transmission Risk
Research has confirmed that the SARS-CoV-2 virus is present and shed in the feces of infected individuals. Studies have found viral RNA in stool samples, sometimes even after respiratory symptoms have resolved. This means individuals can continue to shed the virus through their stool even when they feel better, which has implications for household hygiene.
The presence of the virus in stool raises the possibility of fecal-oral transmission. This pathway involves the transfer of microscopic particles of feces from one person to the mouth of another. A practical step to mitigate this risk is to close the toilet lid before flushing, which helps reduce the spread of aerosolized particles, or “toilet plume,” that can contain the virus.
Thorough handwashing is another important practice. Washing hands with soap and water for at least 20 seconds after using the restroom is an effective way to remove viral particles. This hygiene measure helps prevent the transfer of the virus from hands to the mouth or to surfaces that others might touch.
Managing Symptoms and When to Seek Help
Mild gastrointestinal symptoms from COVID-19 can often be managed at home. The primary focus should be on preventing dehydration caused by diarrhea and vomiting. It is important to drink plenty of fluids, such as water, broth, or oral rehydration solutions that contain electrolytes. Sticking to a bland diet can also help avoid further irritation of the digestive system.
The BRAT diet is often recommended because its foods are low-fiber and easy to digest, which can help make stools firmer.
- Bananas
- Rice
- Applesauce
- Toast
You should also avoid foods that are spicy, fatty, or high in dairy or sugar. Over-the-counter anti-diarrheal medications may be used for mild cases, but it is wise to consult a healthcare provider first.
Certain symptoms, however, warrant immediate medical attention. Contact a doctor for signs of severe dehydration, such as dizziness, confusion, a rapid pulse, or not urinating for eight hours. Other red-flag symptoms include severe abdominal pain, a fever of 102°F or higher, or blood in the stool. If diarrhea lasts for more than a couple of days, seeking professional medical advice is also recommended.