COVID-19 Symptom: Stomach Ache

• Stomach aches and related GI issues are common symptoms of COVID-19.
• Symptoms of COVID-19-related stomach issues can include stomach pain, cramps, nausea, vomiting, diarrhea, and loss of appetite.
• The duration of COVID-19 stomach pain varies from person to person and may last longer in those with severe forms of the infection or long COVID.
• Severe COVID-related stomach pain may be initially identified as a more serious condition.
• Treatment for COVID-19-related stomach pain depends on the severity of the symptoms and the underlying cause of the pain.

Among the long list of symptoms reported by patients with COVID-19, stomach pains and aches is quite common. A 2022 study that included 1,000 patients hospitalized with COVID-19 found that nearly 20% presented with stomach pain, while another 16% had abdominal pain upon a doctor touching their abdomen. 1

Read on to learn about the stomach issues that COVID-19 can cause, how they manifest, how they can be treated, and what risks they pose.

Stomach aches and pains are recognized symptoms of COVID-19. These symptoms occur when the virus attacks specific groups of cells in our gastrointestinal tract, impacting organs such as the stomach or the pancreas and disturbing the delicate balance of bacteria that live in our gut. However, stomach aches are not specific to COVID-19 and can occur when our bodies attempt to fight off various viral and bacterial infections. 2 3

It has been found that people with severe COVID-19 are almost 3x as likely to develop stomach symptoms than those who experience the virus lightly. This effect has been suggested to be caused by the ‘gut-lung axis.’ According to this hypothesis, the immune system communicates between the gut and the lungs, influencing disease processes in both organs. This theory suggests that the gut's inflammatory response could contribute to respiratory symptoms seen in COVID-19 patients. 2 4

Stomach pain caused by COVID-19 can be felt in either the upper or lower parts of the stomach, and the pain can be more severe on one side of the body.

While upper stomach pain certainly is one of the more common symptoms of COVID-19, a host of GI-related symptoms that can cause stomach discomfort if you contract the virus. Some COVID-19-related stomach issues have even been found to appear before the classic respiratory symptoms of the condition in patients. 

These symptoms may include:

• Stomach upset
• Stomach cramps
• Nausea
• Vomiting
• Diarrhea 
• Loss of appetite

Diarrhea is especially common and may be a symptom in around 33% of patients admitted to the hospital with COVID-19. You can also read about how you can get diarrhea from COVID-19. 3 5

The duration for stomach issues stemming from COVID-19 varies from person to person. You can expect symptoms to improve once the virus clears. If you had a severe form of the infection, it may take longer for your digestive tract to return to normal function.

However, stomach pain and related symptoms may also be related to long COVID. One study found that people previously infected with COVID-19 were more likely to experience gastrointestinal problems even a year after their infection than those not. The study analyzed the medical records of 154,068 COVID-19 patients in the Veterans Health Administration system. It compared them to 5.6 million patients who had not contracted the virus but were similar in age and other characteristics. The study found that COVID-19 patients were 36% more likely to experience long-term gastrointestinal problems, including issues affecting the digestive system, intestines, pancreas, or liver. More than 2,600 of these patients were diagnosed with acid-related disorders, such as gastroesophageal reflux disease (GERD) and peptic ulcer disease. A total of 9,605 patients experienced such issues that they did not have before their COVID-19 infection - or about 6%. 6

Because mild stomach issues are not as common as some of the other hallmark symptoms of the disease, such as a COVID-19 cough or fever, it’s easy to dismiss stomach pain as something other than COVID-19. Alternatively, severe COVID-related stomach pain may be initially identified as a more serious condition, such as appendicitis, pancreatitis, or gallbladder disease. Because of this, if you are experiencing stomach issues and suspect you may have contracted COVID-19, it’s essential to take a COVID-19 test. 5

Crucially, patients with severe COVID-19 who receive treatment in the hospital have a higher risk of developing some of the more severe gastrointestinal complications of the virus. Some of these, such as pancreatitis or mesenteric ischemia, can be very dangerous, so monitoring your symptoms is crucial. 2

Treatment for COVID-19-related stomach pain depends on the severity of the symptoms and the underlying cause of the pain. Mild symptoms may be managed with over-the-counter medications, such as antacids, to relieve discomfort and reduce inflammation.

In more severe cases, your healthcare provider may prescribe medications such as proton pump inhibitors (PPIs), histamine-2 (H2) blockers, or antibiotics to treat underlying conditions such as gastritis or bacterial infections.

To restore your gut microbiome following a COVID-19 infection, it's important to eat varied, nutritious foods. Probiotics may be taken to help restore the ‘good’ microbes and bacteria that live in your gut and allow it to function healthily. 4 Probiotics can be found in fermented foods like yogurt, kefir, and sauerkraut or supplement form.

To relieve stomach pain, you can avoid certain trigger foods such as spicy or fatty foods, caffeine, and alcohol. Eating smaller, more frequent meals rather than large, heavy meals and avoiding eating close to bedtime may also be helpful.

In some cases, stress and anxiety can contribute to gastrointestinal symptoms, so it's important to prioritize self-care and stress management techniques like mindfulness, yoga, and meditation. 7

Suppose you have been hospitalized with severe COVID-19 and are experiencing gastrointestinal complications. In that case, your healthcare team will work to manage your symptoms and provide supportive care, including intravenous fluids, nutrition support, and pain management 4

COVID-19-related stomach issues are common symptoms of the virus and sometimes the first symptoms to become apparent. Abdominal pain, nausea, stomach cramps, loss of appetite, diarrhea, and vomiting all fall under the stomach symptom umbrella. Severe COVID-19 puts you at a higher risk of developing stomach pain, and hospitalized patients should be mindful of more severe complications. Ultimately, there's no definitive treatment for COVID-19-related stomach upset, but healthy nutrition is essential to help restore gastrointestinal function after the virus subsides.

Q: Is stomach ache a symptom of COVID-19?
A: In people who contract COVID-19, stomach ache is a common symptom. Other commonly reported symptoms include an upset stomach, loss of appetite, diarrhea, and vomiting.

Q: Does COVID-19 cause stomach pain?
A: The COVID-19 virus can cause stomach pain by attacking specific kinds of cells in the intestine and gut flora. This disturbs the intestine and consequently causes pain.

Q: Are some SARS-CoV-2 variants more likely to cause stomach pain?
A: ​​There is currently limited research on whether specific SARS-CoV-2 variants are more likely to cause stomach pain. While gastrointestinal symptoms such as stomach pain have been reported in some patients with COVID-19, these symptoms are not specific to any particular virus variant.

Q: How long does stomach pain from COVID-19 last? 
A: Unfortunately, there’s no one-size-fits-all answer to how long you can expect stomach pain from COVID-19 to last. The duration of stomach pain can vary widely depending on the individual and the severity of the infection. For most people, stomach pains along with other symptoms will subside as the virus clears.

Q: Is it normal to have stomach cramps with COVID-19?
A: Yes, it’s possible to have stomach cramps or abdominal pain as a symptom of COVID-19. However, stomach cramps alone do not necessarily indicate COVID-19, as they can also be a symptom of other conditions such as food poisoning or a stomach virus. 

Q: Can a stomach ache be the only symptom of COVID-19?
A: Yes. It can be the primary or sole symptom in some cases.