COVID 19 and the Gut Connection!

We know that COVID 19 virus presents with flu like symptoms such as fever, cough difficulty breathing etc. This is how COVID 19 can affect the gut and some facts about it here: 

• Almost 15-20% of the COVID 19 patients can present with digestive symptoms like lack of appetite, loose stools, vomiting, abdominal pain
• Rarely, they can present with digestive symptoms alone without any respiratory symptoms

Above symptoms could also be seen in common digestive problems. Stress can cause a lot of digestive symptoms. However, stress does not cause fever!

• ACE-2 is the receptor that the virus uses to infect the cells in the body and there are plenty of these receptors in the gut in addition to the lungs, kidneys and blood vessels
• About 50% of the patients with COVID 19 can have stool which contains the virus RNA/genetic material, not clear if this could mean it can spread through stool
• About 70% of patients with digestive symptoms can have stool virus. Usually they have loose stools up to 4 times a day and the average duration was 5 days 
• COVID 19 can be present in the stool for 11 days on average after resolution of respiratory symptoms
• COVID 19 can affect the liver with elevated liver enzymes just like most other viruses. This seems to be a temporary phenomenon.

Steps to take:

• Wash your hands thoroughly with soap and water after passing stool
• Close the toilet lid while you flush the toilet, to avoid the 'toilet plume' which can suspend the viral particles in the air. Not clear as to how long the virus can remain suspended in the air, because they are heavier 
• If you have diarrhea and fever, probably best to use a different roll of toilet paper 
• Clean the toilet seat as well as the flush handle after passing stool 
• Do not touch your face after the process without washing your hands
• Avoid using the toilet immediately after someone else has used it. Best to give it some time for the air to circulate. 

This data is a constantly updating. This information is current as of the date of writing this article (4-13-2020)

As always, wishing you great gut health! Stay safe. 

The information presented here is not a substitute for your doctor's advice and discuss with your doctor if specific questions. This is for informational purposes only. 

Author

Krishna Rayapudi MD DABOM Krishna Rayapudi MD DABOM is board certified in Gastroenterology and Obesity Medicine. Trained in world-class facilities with world-class mentors. Managed thousands of patients in all practice setups possible, with experience in seven different US states. You learn more about his practice at www.gastrooffice.com.