What You Need to Know About Post Viral Syndrome & Diarrhea
This article discusses post COVID diarrhea and offers tips for finding the causes and ways to address this issue.
Updated February 14, 2024
Pooping is a taboo discussion topic in many societies, but it is an important body function that is essential to our survival. It is normal to have a solid or soft bowel movement 2-3 times a day without straining or cramping. In healthy people this is achieved through a balanced diet with a lot of fruits & vegetables, hydration and exercise/activity. If you are not having at least one bowel movement daily, or you are have frequent urgent episodes of diarrhea, you may be experiencing an infection, Long COVID syndrome (PASC), stress, or more conditions including illness. Be sure to talk to your doctor about disturbances in your bowel movements.
Research conducted by covidCAREgroup in July, 2021 found that 52% of 750 respondents with Long COVID experience GI disturbances. According to news-medical.net, research on ACUTE COVID-19, patients consistently shows that 20-30% of adults with new onset COVID-19 report GI symptoms such as nausea, vomiting, or diarrhea. In some cases it has shown to be the only symptom of an acute COVID-19 infection.
Basic concepts
Diarrhea is the medical term for loose, watery stools. It is a symptom of an underlying issue rather than a disease in itself. Some symptoms that may accompany diarrhea include:
abdominal pain and cramping
an urgent need to empty the bowels
loss of bowel control
Diarrhea may be acute or chronic. Acute diarrhea lasts only 1–2 days, whereas chronic diarrhea continues for 4 or more weeks. People who experience chronic diarrhea should consult a doctor to try to determine the underlying cause.
Studies that look at the prevalence of diarrhea symptoms following SARS-CoV-2 infections have reported lower rates than those observed in other coronaviruses, with studies reporting diarrhea in up to 50% of patients with SARS and 75% of patients with MERS. However, researchers believe that the currently available data may underestimate the burden of COVID-19 related diarrhea. Few studies conducted to date have included a specific criterion for describing diarrhea, neither in terms of describing the number of evacuations per day nor consistency of stools.
Possible causes
FOOD SENSITIVITIES OR ALLERGIES: If you are experiencing frequent diarrhea you may have new or worsened food sensitivities or allergies. These sensitivities and food/medication/supplement reactions are extremely common and may be temporary or more permanent. These may be more prevalent when your body is stressed by illness. Diarrhea is the way your gut gets those allergens out of your body quickly. This reaction is rooted mast cell activation syndrome (MCAS) causing the overproduction of histamines, the root of inflammation and allergies in post viral syndromes.
ACUTE ILLNESS: If you have explosive diarrhea with a foul smell, you should talk to your doctor about being tested for illnesses like COVID-19 or Clostridium Difficile (C. Diff). C.Diff is a bacteria that is an important component in the gut health, but can get out of control when the balance is off, particularly after taking antibiotics.
STRESS: Stress can also cause a wide range of symptoms, including gastrointestinal problems, such as diarrhea, stress and anxiety can have a significant effect on the health of a person's gastrointestinal tract. When the brain detects a threat, it releases a burst of hormones causing the "fight or flight" response and sends stress signals to the gut via the sympathetic nervous system. The gut responds by releasing its own hormones that slow movements in the stomach and small intestine, while speeding up movements in the large intestine causing diarrhea.
CONSTIPATION: When the intestine or the branches of the vagus nerve that control the function of the intestines become inflamed, peristalsis (the contractions of the intestines that continuously move waste through the body) can be interrupted leading to constipation or blockage, which I covered in another blog (see the link below).
SIBO: Small intestinal bacterial overgrowth) is an imbalance of the microorganisms in your gut that maintain healthy digestion. When too many bacteria, or the wrong kind, populate the small intestine, it can lead to uncomfortable symptoms such as gas and diarrhea.Sep 19, 2021
SERIOUS ILLNESS: According to Emerson hospital experts, some symptoms that are not expected with a stomach bug, COVID-19 or Long COVID may indicate a more serious gastrointestinal condition like colon cancer, stomach ulcers, or Crohn's Disease. Call your doctor or seek medical help if you experience any of these symptoms:
Blood in your vomit or your stool
GI symptoms that lead to weight loss
GI symptoms lasting longer than one week
Refer to this chart to compare symptoms associated with gastroenteritis, COVID-19, flu, and serious GI conditions. It is always best to contact your doctor to discuss any symptoms you are experiencing.
Helpful hints
Listen to your body and pay attention to subtle cues, but in matters of the gut, nothing is subtle with this symptom and the cause can be difficult to identify. It is important to understand what is causing the diarrhea to maintain or recover your health.
Look into options such as a low histamine diet.
An excellent starting point is a food-activity-symptom journal so you and your doctor can look for trends and triggers. Be sure to include medications, drinks & supplements in your journal.
At home, immediate nonmedicinal actions you can take are physical and psychological stress management, nutrition, acupressure for intestines, and lifestyle changes to facilitate recovery.
Talk to your doctor about SSRI medications. There is a strong link between gut health and serotonin levels, which can be compromised by post COVID neural inflammation affecting the production and absorption of this hormone.
Things you can do to help yourself
Minimizing physical & psychological stressors is essential in recovery from Long COVID.
Nutrition: Try to eat protein and fresh vitamin rich foods daily and avoid chemicals, preservatives, sugars, fast foods, prepared foods and high histamine foods.
Don’t skip meals. Your body needs protein, vitamin C, and vitamin D to heal from any injury or illness. A low histamine or low carbohydrate (sugar) diet is recommended by doctors treating Long COVID (PASC), and many people report a reduction in symptoms within 1-3 days of the diet change, including decreases in sneezing, itching or hives, irritable bowel syndrome, body pain, along with a reduction in swelling and inflammation.Hydration: A minimum of eight 8 oz glasses of plain water daily is recommended.
Avoid drinks with chemical additives. You can easily make a fresh electrolyte drink yourself by adding a dash of mineral rich Epsom salt and a piece a fruit like a raspberry for flavor instead of spending money on commercial drinks like Gatorade that contain chemicals and sit in plastic bottles for long periods of time. Remember that caffeine and alcohol have dehydrating effects.Sleep hygiene: Getting 7-9 hours of sleep so your body can repair itself.
You need at least 4 hours of uninterrupted sleep to get into the restorative phase of sleep.
Avoid stimulating activities after dinner like thrilling movies or books, arguments, negative news or frustrating stimuli.
If you wake up frequently or with a startle, you may be experiencing drops in your oxygen level, which signal your brain to release adrenaline to force you to take a breath. This could be a temporary inflammation issue or more enduring sleep apnea. Ask your doctor for a sleep study to evaluate your need for a CPAP or BiPAP, a machine that pushes air into your lungs when it senses an apneic episode (periods of not breathing).Stress management: Stress affects every component of your life.
The only thing you can control about stress is your reaction to it. Try to avoid or minimize your exposure to stressful situations: Turn off the news, make family visits that end unpleasantly short, wait for the morning to have intense discussions, let go of things that annoy you but don’t really matter in the big scheme of things, avoid intense conversations or entertainment in the evening.
Exercise within tolerance: Pace yourself and do not push your body to extremes in any way.
For some this may mean seated breathing exercises, walking to the mailbox. Rest when your body says to slow down. Gradually build on your activity endurance as your body cues you to progress. This can be hard to gauge, because when you feel good you naturally do more, but if you do too much you may experience symptom flare ups 1-3 days later as the post exertion inflammation builds. Some people describe this as post exertional malaise, others experience severe recovery setbacks.
Breathwork: You can literally stop the fight or flight reaction by taking slow deep breaths.
Deep slow breathing shuts down the adrenaline flow, slows your heart rate, lowers your blood pressure and decreases stress related histamine release. When you do this, your blood reroutes back to your brain and nervous system to allow you to think clearly. It also allows your body to use its energy and oxygen to heal your inflamed nerves and organs.
Long COVID Support
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Brought to you by covidCAREgroup, connecting the dots of long COVID through education, research and resources.
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