I had Covid more than two years ago and I still from suffer crippling bowel problems 

For the past two and a half years, Abbey Robb has had to take “precautions” every time she leaves the house.

The 44-year-old clinical hypnotherapist has been plagued with stomach problems – including bouts of uncontrollable diarrhea – since she contracted Covid in September 2020, and now makes sure she’s eaten very little before going out and using the toilet.

But despite taking these preventative measures, in early 2021 the ten-minute walk to her local grocery store turned into a horribly humiliating experience.

“I still cringe when I think about it,” Abbey recalled. “I was only five minutes away from home on my way back when I suddenly experienced an overwhelming and unstoppable urge to go. Every step home felt like it took forever – I still don’t know how I made it.’

The long-term impact of Covid has been a “nightmare,” she says. In addition to diarrhea, she occasionally suffers from vomiting, nausea, and heartburn, none of which she had experienced before she contracted the virus.

“As a single woman trying to work, enjoy a social life and date, it was absolutely awful,” she recalls.

“It’s a battle to keep it from taking over my life.”

And she’s not alone. New research suggests that 36 percent of people who have had Covid are at increased risk of developing gastrointestinal (GI) disorders such as diarrhea and nausea within a year of infection, compared to people who have not had the virus.

The findings were based on the medical records of 154,068 people who have had Covid, which were compared to 5.6 million records of those without the virus. The researchers at Washington University in the US estimate that the virus has contributed to more than six million new cases of gastrointestinal disease in the US and 42 million new cases worldwide.

A 2020 study by St George’s Hospital in South West London produced similar results. The researchers found that about 100 days after discharge from hospitalization for Covid, 16 percent of patients reported new gastrointestinal symptoms at follow-up appointments.

Although covid is primarily a respiratory illness, causing symptoms such as fever, cough and shortness of breath, it is widely believed that it can also cause diarrhea, nausea, vomiting and abdominal pain in some patients.

A 2020 analysis of 60 studies involving 4,243 patients found that 17 percent of Covid patients had gastrointestinal symptoms. However, how Covid causes long-term stomach problems is not yet understood.

‘The exact mechanism of how Covid affects the stomach is currently being explored in several studies,’ explains Dr Mark Faghy, Associate Professor of Respiratory Physiology at Derby University, who studies recovery patterns in people with long-term Covid.

“It’s most likely due to the virus spreading through the body through the bloodstream — including to the gut.”

Another possible explanation is that the immune system becomes “confused” by the virus and begins to attack itself, including the gut (as in other inflammatory bowel diseases), adds Danny Altmann, professor of immunology at Imperial College London and trustee of the charity Long Covid Support, which provides aid to those affected.

Or it could be a post-viral reaction, causing symptoms of irritable bowel syndrome (IBS) to appear after the acute infection.

“We know that sometimes people get erratic bowel disease after they’ve had a bug and then have ongoing flare-ups,” explains Dr Chuka Nwokolo, honorary professor of gastroenterology at Coventry University Hospital.

“Maybe some of the patients with post-Covid syndrome suffer from this.”

Long Covid is defined as symptoms lasting more than 12 weeks after initial infection.

More than 200 long Covid symptoms have been recorded, according to a 2021 University College London study, and as many as two million people in the UK are believed to be affected.

About 700,000 people have been diagnosed in the past 12 months, says Professor Altmann.

Abbey caught Covid after flying home from the Netherlands, where she had visited a friend. Her first symptoms were sneezing and sniffling.

But as the weeks progressed, she found herself developing chronic fatigue and shortness of breath, as well as a series of stomach problems such as nausea and diarrhea, which interrupted her work for months.

‘When I finally had an appointment with my GP – online – several weeks after I first developed symptoms, he told me the virus wouldn’t show up on any test by then, but he was certain I had Covid and wrote it as it says in my file,” she says.

“He told me there was no treatment, which was frustrating because the symptoms — especially the stomach — were terrible.

“It felt like I had IBS permanently and I also got reflux. And the symptoms seemed to persist day after day.”

Abbey’s GP didn’t think her gastrointestinal symptoms were Covid-related, but when they didn’t improve, he referred her in September 2021 for a colonoscopy – the procedure involves inserting a small camera into the gut to monitor it. However, there were no signs of abnormalities.

To ease her symptoms, Abbey was prescribed omeprazole — a type of proton pump inhibitor (PPI) that reduces the amount of acid produced by the stomach.

This helped “but there would still be days when I was totally knocked out or ran to the toilet,” she says.

‘I had to rely on supermarket deliveries because I couldn’t leave the house.’

It’s important that if you experience a long-lasting change in bowel habits that you get them checked, Dr. Nwokolo says. “The universal advice is not to self-diagnose, but to see a GP to make sure there is no alternative GI diagnosis.”

Once other possible causes have been ruled out, treatment for post-Covid gut will depend on the symptoms, says Dr Steven Mann, gastroenterologist consultant at the Royal Free NHS Trust in London.

‘That could be nutritional advice, anti-diarrhoea medication or the use of probiotics to improve the intestinal flora [an infection can upset the balance of good bacteria, causing symptoms such as diarrhoea],’ he says.

‘If the quality of life is seriously compromised, we can consider something to calm the intestinal nervous system, such as a low dose of the drug amitriptyline.

“This is known as a neuromodulator [normally used to treat depression] that ‘resets’ the thermostat to reduce gut sensitivity and help with symptoms.’

Abbey, meanwhile, has had to learn to work around her symptoms.

“I work on Zoom a lot, which means I can be at home,” she says. “But on days when I see clients in person, I’m very careful about my diet — I’m not allowed to eat the night before.”

“I take a lot of probiotics, make fermented foods like sauerkraut to create good bacteria in the gut, and I stick to regular foods like fruits and vegetables — nothing processed.”

“I’ve come to realize that if I want to feel good, I have to be very careful about what I eat.

“When I stick to foods I know I can tolerate, sometimes I feel better. But that’s not always the case. As a therapist, I know how to use reserves to deal with this – but it’s not a nice way to live.’