Is Constipation a Symptom of COVID-19?

Could there be a link between COVID-19 and constipation? We asked experts to explain.

People with COVID-19 experience a range of symptoms with varying degrees of severity. If gastrointestinal (GI) issues are present, they usually manifest as nausea, vomiting, or diarrhea, according to the Centers for Disease Control and Prevention (CDC). Sometimes, though, constipation may occur with the virus, but a direct causal relationship has not been determined.

"Constipation isn't something I've seen as a COVID symptom," infectious disease expert Amesh A. Adalja, MD, senior scholar at the Johns Hopkins Center for Health Security, told Health. "When GI symptoms are present, it is usually diarrhea."

Constipation as a condition is fairly common, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) reports. About 16 out of 100 adults have symptoms, and the number increases to 33 out of 100 for those over the age of 60. So, it's difficult to say if COVID-19 actually causes the condition or if it's a coincidence when it does happen in people with COVID-19, John Sellick, DO, an infectious disease doctor and professor of medicine at the University at Buffalo/SUNY, told Health.

Still, if you find yourself with COVID-19 and are constipated at the same time, you might wonder if there's a connection. In some cases, the virus may lead to constipation, indirectly.

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Why Constipation May Be Present With COVID-19

Many factors can lead to constipation, which is characterized by fewer than three bowel movements per week, stools that are hard, dry, or difficult to pass, and a feeling that the bowel hasn't been fully emptied, according to the NIDDK. Medical conditions, including irritable bowel syndrome, disorders of the brain and spine, intestinal obstructions, and diabetes, as well as behavioral or life cycle changes such as pregnancy, aging, stress, and disruptions to exercise and diet can disturb your natural GI cycle. Also, medications, including some given for COVID-19, can provoke constipation, according to a 2021 study reported in Drugs & Therapy Perspectives.

These conditions may already exist in an infected person, so pinpointing the exact reason for the constipation is challenging.

"Usually when I see a patient who says they have new constipation in the setting of an infection, it's because they're dehydrated," said Dr. Sellick. "Yes, you might have constipation and COVID-19, but it's likely not constipation caused by COVID-19."

If you happen to be sick during the warmer months, you're more likely to sweat, and your constipation risk can increase if you're not replacing those fluids. Infection, itself, can lead to dehydration, according to Johns Hopkins Medicine. This can set off a vicious cycle: the disease causes fluid loss, and fluid loss can worsen the disease.

When the world shut down, people's habits changed—and this alone could have caused GI problems for those with COVID-19 and without. In a 2021 study published in BMJ Open Gastroenterology, 170 out of 678 participants reported "new-onset" constipation during the lockdown. Researchers cited less water consumption and lack of physical activity as reasons for the high incidence. When exercise is limited, blood flow and muscle contraction are reduced, making digestion less efficient.

Common COVID-19 GI Symptoms

Though there may not be a direct connection between COVID-19 and constipation, GI symptoms are prevalent, sometimes appearing before respiratory issues such as cough, congestion or difficulty breathing.

According to a 2021 study published in the journal BMC Infectious Diseases, almost half (47.9%) of the 507 people with COVID-19 evaluated had at least one GI symptom. Nausea and/or vomiting was the most common symptom (31.6%), followed by diarrhea (17.8%) and abdominal pain (9.9%).

How To Alleviate Constipation

Diet and exercise are your best strategies for getting your colon back on track, according to the NIDDK. Fiber is crucial to relieving constipation. Adults should get 22 to 34 grams of fiber a day. In addition, you should drink water and other liquids, such as naturally sweetened fruit and vegetable juices and clear soups, to help the fiber work better, says NIDDK.

The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDC, WHO, and their local public health department as resources.

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