Post-COVID Diarrhea: When to Seek Medical Help - Gastroenterology and Hepatology

Diarrhea issues

Hello Dr.
Chen: Since I contracted COVID-19 at the end of June this year, I have been experiencing gastrointestinal issues starting in July.
Sometimes I suddenly have abdominal pain, but it hasn't led to diarrhea.
In the last two weeks of August, the diarrhea has become more severe.
On August 17, I had a mild episode, and on August 19, it was more serious, but after taking some loperamide, it seemed to improve.
In the following days, my stools were formed but somewhat soft (all brown).
A week later, on August 26, I suddenly had abdominal pain again after eating, and my stool was green.
That day, I immediately went to see a doctor, who prescribed me gastrointestinal medications: Jingtian Weishufu tablets and 100 mg of Dubikang enteric-coated tablets, along with a seven-day course of medication.
Today, August 29, my stool was normal at the beginning but still had some loose stools at the end (still green in color).
I am very anxious! Why am I still experiencing diarrhea even after taking the medication? The doctor mentioned that if the diarrhea continues, I may need a colonoscopy to investigate the issue… I am really scared that I might have a serious illness.
I would like to ask: Could it be that my gastrointestinal tract has not fully recovered, which is why I still have loose stools? But I am taking medication… Should I wait until I finish the seven-day course (I am currently on the third day of medication) to reassess my stool, or should I go back to see the doctor now?

Ms. Huang, 30~39 year old female. Ask Date: 2023/08/29

Dr. Chen Shidian reply Gastroenterology and Hepatology

You should be able to return for a follow-up appointment after completing your medication, and follow a low-fat, low-dairy diet.

Reply Date: 2023/08/29

More Info

Post-COVID diarrhea is a concerning symptom that can arise after recovering from COVID-19. Your experience of gastrointestinal distress, including abdominal pain and changes in stool consistency and color, is not uncommon among individuals who have had COVID-19. This condition, often referred to as "long COVID" or post-acute sequelae of SARS-CoV-2 infection (PASC), can manifest in various ways, including digestive issues.

Firstly, it is important to understand that gastrointestinal symptoms can persist even after the acute phase of COVID-19 has resolved. Studies have shown that a significant number of patients report ongoing digestive issues, including diarrhea, bloating, and abdominal pain, long after their initial infection. This could be due to several factors, including changes in gut microbiota, inflammation, or even the effects of the virus on the gastrointestinal tract.

In your case, the timeline of symptoms you provided indicates a pattern that warrants attention. The fact that you experienced diarrhea and abdominal pain intermittently, along with changes in stool color, suggests that your gastrointestinal system may still be recovering. The green color of your stool could be attributed to several factors, including the consumption of certain foods, bile salts, or rapid transit through the intestines, which can occur during episodes of diarrhea.

You mentioned that you have been taking medications prescribed by your doctor, which is a positive step. However, if you are still experiencing loose stools and abdominal pain after a few days of treatment, it is essential to communicate this to your healthcare provider. They may need to reassess your condition, consider further diagnostic tests, such as a stool test or a colonoscopy, and determine if there are underlying issues that need to be addressed.

When to seek medical help is a critical question. You should consider returning to your doctor if:
1. Symptoms Persist: If your diarrhea continues beyond the course of medication or worsens, it is essential to seek further evaluation.

2. Severe Abdominal Pain: If you experience severe or worsening abdominal pain, this could indicate a more serious condition that requires immediate attention.

3. Signs of Dehydration: If you notice signs of dehydration, such as excessive thirst, dry mouth, decreased urine output, or dizziness, you should seek medical help promptly.

4. Blood in Stool: If you notice blood or mucus in your stool, this is a red flag that necessitates immediate medical evaluation.

5. Fever: A persistent fever accompanying your gastrointestinal symptoms could indicate an infection or another underlying issue that needs to be addressed.

In summary, while it is possible that your gastrointestinal symptoms are a result of your body still recovering from COVID-19, it is crucial to monitor your condition closely. If your symptoms do not improve or worsen, do not hesitate to reach out to your healthcare provider for further evaluation. They can provide you with the necessary guidance and treatment options to help you recover fully. Remember, your health is paramount, and seeking help when in doubt is always the best course of action.

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