COVID-19 And Gastrointestinal Symptoms: What We Know

In late March, I developed one of the driest and most aggressive coughs of my life. It was bad enough that I’d wake up in the night and fight for air. There were several times that my wife actually shook me awake to tell me that it sounded like I couldn’t breathe. I’m a pretty healthy 37-year-old, non-smoking, vegetarian cyclist, and this was the first time in my life that I’ve struggled for air. But I never got a fever. And for that reason alone, I was denied a COVID-19 test at my local hospital.

On top of having one of the worst coughs of my life, I also had some pretty serious diarrhea that felt a lot like a Harry Potter Dementor was sucking my soul out of my anus. All of it seemed like this twisted mix of intense cold symptoms sprinkled with a stomach bug that made me wonder if I’d contracted a new uncharted virus that would also bring the world to its knees. Luckily, I got better. But now, in late April, I am even more convinced that I did contract COVID back in March after reading about a Stanford study suggesting that gastrointestinal symptoms are an additional symptom of the virus.

The study is one of the earliest done on U.S. patients with COVID-19 and was published in the medical journal Gastroenterology. Researchers analyzed data collected from 116 patients who tested positive for the coronavirus at Stanford Health Care from March 4-24. The majority were treated and released from a hospital emergency room or a clinic. Gastrointestinal symptoms were reported by 31.9% of the patients.

So here’s what happened. According to Alexander Podboy, MD, one of the study’s co-authors, the coronavirus pandemic hit the San Francisco Bay Area in early March. Hospitals began canceling elective surgeries and postponing non-emergency patient visits to make room for a surge of coronavirus patients.

As it turns out, says The American Journal of Gastroenterology, there were already studies coming out of China suggesting that gastrointestinal symptoms were a symptom of COVID-19. One study outlined by the Journal from Hubei, China — the province where the virus called SARS-CoV-2 originated — reported that out of 200 people who tested positive for COVID-19, one in five had at least one gastrointestinal symptom, such as diarrhea, vomiting, or belly pain. Nearly 80% also lacked an appetite. Although, I must say, when I was fighting for air, the last thing I was going to fight for was a sandwich.

With their clinics closed and other projects on hold, Dr. Podboy, along with a group of gastroenterology fellows, had time to work together on the study. In an interview with Stanford Medicine about the project, Podboy said, “We were in a unique position to look into this subject of gastrointestinal symptoms among coronavirus patients at Stanford.” So they did what doctors do: started looking into their specialty, and asking questions of COVID-19 patents about how their stomachs were handling it.

What does this all mean? Ultimately, in cases like my own, additional “non-traditional” symptoms are potentially overlooked. The researchers suggest that while this data is early, and from only a single institution, the results do raise the possibility that people exposed to the coronavirus who are experiencing gastrointestinal symptoms — not just those with respiratory symptoms — should also be tested. “It’s possible we may be missing a significant portion of patients sick with the coronavirus due to our current testing strategies focusing on respiratory symptoms alone,” Podboy stated in the interview.

As if that weren’t enough, there is also the troubling matter that in the studies coming out of China, according to WebMD, “Those with digestive symptoms were more likely to have a positive stool test for the coronavirus, which means they had SARS-CoV-2 RNA in their poop. It also took them longer to clear the virus from their bodies, compared to those without gastrointestinal symptoms.”

Naturally, all of this boils down to the same list of recommendations — wash your hands for at least 20 seconds, stay home if you feel sick, cover your cough — with one new addition: WebMD advises that if someone in your house is sick, and you have the luxury of more than one bathroom, you can designate one of them a “sick bathroom.”

With most elective surgeries still on the back burner, the same team of Stanford doctors plan on continuing their research on COVID-19’s gastrointestinal symptoms, so there will be more to come on the topic.

If these studies have taught us anything, it’s this: There’s nothing like surprising symptoms popping up to make us understand how much we don’t understand about COVID-19.

Information about COVID-19 is rapidly changing, and Scary Mommy is committed to providing the most recent data in our coverage. With news being updated so frequently, some of the information in this story may have changed after publication. For this reason, we are encouraging readers to use online resources from local public health departments, the Centers for Disease Control, and the World Health Organization to remain as informed as possible.