Is Diarrhea a Symptom of COVID-19?

Diarrhea is a common COVID symptom. COVID typically causes respiratory symptoms like cough, shortness of breath, and stuffy or runny nose. Many people do not commonly associate COVID with diarrhea or other GI symptoms. However, research shows that 27% of people with COVID have gastrointestinal (GI) symptoms, including diarrhea, nausea, stomach pain, and vomiting.

How long does the COVID diarrhea last? Diarrhea typically persists for about five days in people with COVID. Some people develop long COVID, though, in which symptoms can last several weeks, months, or years after infection. Read on to learn why COVID causes diarrhea and how to treat it.

Why COVID Causes Diarrhea

The specific reasons why COVID can lead to GI symptoms, including diarrhea and nausea, are not entirely known. Some evidence suggests an inflammatory response to SARS-CoV-2 (the virus that causes COVID), side effects from drugs, and psychological distress may contribute to GI symptoms.

SARS-CoV-2 primarily spreads from person to person. An infected person emits respiratory droplets when they cough or sneeze. You might develop COVID if you inhale one of these droplets, most likely if you are within six feet of an infected person.

It's unclear whether feces transmit the virus. Scientists can trace the genetic material of SARS-CoV-2 in the feces of people with COVID, and the virus is present in untreated wastewater.

Inflammatory Response

SARS-CoV-2 attaches to angiotensin-converting enzyme 2 (ACE2), located on the surface of your cells. The virus binds to this protein to enter your cells. COVID might cause diarrhea if SARS-CoV-2 binds to ACE2 on the cells in your gut, causing inflammation.

Research has found this inflammation can disrupt the gut microbiome, or the balance of "good" and "bad" microbes in your intestines. These microbes typically support healthy digestion, but an imbalance might lead to intestinal dysfunction. You may develop diarrhea and other GI symptoms as a result.

Medication Side Effects

Some people develop diarrhea as a side effect of drugs that treat COVID, including:

• Actemra (tocilizumab)
• Olumiant (baricitinib)
• Paxlovid (nirmatrelvir/ritonavir)

Psychological Distress

COVID can greatly affect mental health, regardless of whether you have an active infection. Research has found that uncertainty and concerns about health were sources of anxiety, especially at the start of the COVID pandemic. This anxiety may result in and worsen GI symptoms. A study published in 2020 found that 30% of 239 people who tested negative for the virus experienced diarrhea.

How Long COVID Diarrhea Lasts

Diarrhea can be uncomfortable, although it's typically a mild symptom in the absence of shortness of breath. Diarrhea typically lasts about five days in people with COVID. GI symptoms, including diarrhea, may persist for weeks, months, or years if you develop long COVID.

Research has shown no increase in mortality with the presence of GI symptoms in COVID. People with GI symptoms might have a lower mortality rate and reduced hospitalization discharge time than those with non-GI symptoms.

COVID Diarrhea vs. Food Poisoning

COVID might present similarly to food poisoning if you have GI symptoms, including diarrhea, nausea, stomach pain, and vomiting. An at-home or polymerase chain reaction (PCR) test can confirm a COVID diagnosis.

Other symptoms that might indicate COVID include:

• A loss of smell and taste
• Cough
• Fatigue
• Fever and chills
• Headache
• Muscle aches
• Runny or stuffy nose
• Sore throat
• Trouble breathing

Treatment for COVID Diarrhea

You can typically manage COVID diarrhea at home if you have mild symptoms. It's important to watch what you eat and drink to prevent worsening symptoms. Many people find relief by following a bland diet, which includes white bread, crackers, and pasta. Avoid alcohol, caffeine, dairy products, and greasy, fatty, fried, and spicy foods.

Drink plenty of fluids, especially ones with electrolytes, to prevent dehydration. Opt for fruit juice, sports drinks, soup broths, and soft drinks without caffeine. If you are at high risk for dehydration, look for rehydration solutions with glucose and electrolytes.

When To Contact a Healthcare Provider

COVID diarrhea can be dangerous if it causes dehydration or lasts longer than one or two days. Dehydration symptoms include decreased urine output, dark-colored urine, dry mouth, excess thirst, and skin that does not bounce back when you pinch it. You may develop a rapid heartbeat and headaches.

Contact a healthcare provider right away if you have:

• A fever of 102 degrees or higher
• Dehydration symptoms
• Frequent vomiting
• Severe abdominal and rectal pain
• Stool that's black and tar-like or contains blood and pus

A Quick Review

GI symptoms, including diarrhea, commonly occur with COVID. An inflammatory response to SARS-CoV-2, side effects from drugs that treat COVID, and psychological distress may result in or worsen diarrhea.

Make sure you drink plenty of fluids to prevent dehydration and eat a bland diet to help alleviate diarrhea. Contact a healthcare provider if you have bloody stool, severe abdominal and rectal pain, and vomiting.