Diarrhea can be an unexpected symptom following a COVID-19 infection. While often associated with lung problems, the virus can impact the entire body, including the digestive system. This article explores why diarrhea might occur after a COVID-19 infection and offers guidance on managing these symptoms.
The Link Between COVID-19 and the Digestive System
The SARS-CoV-2 virus, which causes COVID-19, extends beyond the respiratory tract, affecting various organ systems, including the gastrointestinal tract. The virus enters human cells by binding to the angiotensin-converting enzyme 2 (ACE2) receptor. These ACE2 receptors are abundant in the lining of the small intestine and colon, making the gut a site for viral entry and activity.
When SARS-CoV-2 binds to ACE2 receptors in the gut, it can disrupt the normal function of intestinal cells, potentially leading to inflammation. This viral activity can contribute to symptoms such as diarrhea, nausea, and abdominal pain. A COVID-19 infection can also alter the balance of microorganisms in the gut, known as the gut microbiome, leading to dysbiosis. This imbalance can prolong digestive issues and impact overall gut health.
Duration and Connection to Long COVID
Diarrhea associated with COVID-19 can manifest during the acute phase of the illness, often lasting three to five days, though severe cases might extend up to 14 days. For many, these digestive symptoms resolve as the body clears the infection. However, diarrhea can persist for weeks or even months after the initial infection, becoming a feature of Post-COVID Conditions, commonly referred to as Long COVID.
This persistent diarrhea is one of several gastrointestinal issues reported in individuals with Long COVID, alongside symptoms like nausea, abdominal pain, and changes in appetite. Research indicates that such prolonged digestive problems may stem from the virus’s lasting impact on gut-brain communication or ongoing alterations to the gut microbiome. People with Long COVID who experience diarrhea often have other persistent COVID-related symptoms.
Managing Symptoms at Home
Home management of diarrhea after a COVID-19 infection primarily focuses on preventing dehydration. Increase fluid intake significantly to replace lost water and electrolytes. Clear fluids such as water, oral rehydration solutions, diluted fruit juices, and broths are recommended. Consuming small, frequent sips can help ensure continuous hydration, especially if large volumes are difficult to tolerate.
Dietary adjustments can also help manage symptoms. Opting for bland, low-fiber foods like bananas, rice, applesauce, and toast, often referred to as the BRAT diet, can help firm stools. Avoiding high-fat, spicy, greasy, or fried foods, as well as caffeine and alcohol, can prevent further irritation to the digestive tract. Over-the-counter anti-diarrheal medications, such as loperamide or bismuth subsalicylate, may offer relief, but consult a doctor or pharmacist before use, particularly if other health conditions are present.
When to Consult a Doctor
While many cases of post-COVID diarrhea can be managed at home, certain signs indicate the need for professional medical attention. Seek immediate care if you experience symptoms of severe dehydration, such as extreme thirst, dizziness, confusion, or significantly reduced urination. A high fever, severe abdominal pain or cramping, or the presence of blood or pus in the stool are also reasons to contact a healthcare provider promptly.
Black, tarry stools also warrant prompt medical evaluation. Consult a doctor if diarrhea persists for more than a few days (typically over two days in adults or 24 hours in children) or if symptoms worsen rather than improve. Discussing persistent or concerning digestive issues with a medical professional can help determine the underlying cause and ensure appropriate care.