Can a recent Coronavirus disease 2019 (COVID-19) infection cause abdominal pain?

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Last updated: May 2, 2025View editorial policy

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From the Guidelines

Yes, a recent COVID-19 infection can cause stomach pain, as evidenced by the study by Cholankeril et al. 1, which reported that 8.8% of patients experienced abdominal pain. Gastrointestinal symptoms are common in COVID-19, with approximately 10-20% of patients experiencing abdominal pain, along with other digestive issues like diarrhea, nausea, vomiting, or loss of appetite. These symptoms occur because the virus can infect cells in the digestive tract through the ACE2 receptors, which are present throughout the gastrointestinal system. The inflammation caused by the infection can directly irritate the stomach and intestines, leading to pain and discomfort.

Key Findings

  • The study by Cholankeril et al. 1 found that 31.9% of patients reported gastrointestinal symptoms, with a median duration of 1 day.
  • Another study by Jin et al. 1 reported that 11.4% of patients experienced gastrointestinal symptoms, including nausea, vomiting, or diarrhea.
  • The presence of gastrointestinal symptoms was associated with a higher risk of severe or critical disease, as reported by Jin et al. 1.

Management of Symptoms

For mild stomach pain related to COVID-19, over-the-counter medications like acetaminophen (Tylenol) may help, taken as directed on the package (typically 500-1000mg every 6 hours, not exceeding 4000mg daily) 1. Staying hydrated and eating bland, easily digestible foods can also help manage symptoms. However, if you experience severe abdominal pain, persistent vomiting, inability to keep fluids down, or signs of dehydration, you should seek medical attention promptly as these could indicate complications requiring medical intervention.

Important Considerations

  • Patients with gastrointestinal symptoms should be monitored closely for signs of severe or critical disease, as reported by Jin et al. 1.
  • The presence of gastrointestinal symptoms can be an indicator of liver injury, as reported by Yao et al. 1.
  • Patients with pre-existing gastrointestinal or liver conditions should be closely monitored for exacerbation of their condition.

From the Research

Gastrointestinal Symptoms in COVID-19

  • COVID-19 can cause gastrointestinal symptoms, including diarrhea, vomiting, nausea, and abdominal pain, as evidenced by studies 2, 3, 4.
  • The SARS-CoV-2 receptor ACE2 is highly expressed in the gastrointestinal tract, which may contribute to the development of gastrointestinal symptoms 2, 4.
  • Abdominal imaging findings in COVID-19 patients include bowel wall thickening, hepatic steatosis, and splenic infarcts, although these findings are nonspecific 3, 5.

Abdominal Pain in COVID-19

  • Abdominal pain is a common gastrointestinal symptom in COVID-19 patients, reported in several studies 2, 3, 4, 6.
  • The exact mechanism of abdominal pain in COVID-19 is unknown, but it may be related to the infection of the gastrointestinal tract by SARS-CoV-2, gut microbiome changes, or systemic inflammatory response 2, 6.
  • Abdominal pain can persist for several months after COVID-19 recovery, and its prevalence declines over time 6.

Relationship Between COVID-19 and Gastrointestinal Tract

  • The gastrointestinal tract can be a target for SARS-CoV-2 infection, and the virus can cause alterations in the gut microbiome 2, 6.
  • The relationship between COVID-19 and the digestive system is complex and multifactorial, involving various mechanisms such as cytokine storm and systemic inflammatory response 4, 6.
  • Further research is needed to understand the effects of SARS-CoV-2 on the gastrointestinal tract and liver, and to determine the pathophysiology of persistent gastrointestinal symptoms in COVID-19 patients 4, 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Potential effects of SARS-CoV-2 on the gastrointestinal tract and liver.

Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie, 2021

Research

Abdominal imaging in COVID-19.

World journal of radiology, 2021

Research

Gastrointestinal symptoms in COVID-19: the long and the short of it.

Current opinion in gastroenterology, 2022

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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