Is Constipation a Symptom of COVID-19? Here's What Experts Say

You know your bathroom habits better than anyone. So when you suddenly can't poop the way you normally do because you're constipated, you probably have some questions. And, given that we're in the middle of a global pandemic, it's beyond OK to wonder if COVID-19 could have something to do with it.

But while doctors say that constipation alone isn't a common sign of COVID-19, there are a few things about COVID and its treatments that could cause you to get stopped up. Here's what you need to know about the link between constipation and COVID-19.

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Constipation is a condition where you're not pooping often or having difficulty pooping, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

There's a massive range of things that can lead to constipation, per the NIDDK, including:

• Slow movement of your colon
• Difficulty emptying your colon thanks to a pelvic floor disorder
• A functional gastrointestinal disorder like irritable bowel syndrome
• Certain medications and supplements, including antacids, diuretics, iron supplements, narcotics, and some antidepressants
• Pregnancy
• Getting older
• Traveling
• Ignoring the urge to go
• Changing how much and what you eat
• Not eating enough fiber
• Being dehydrated
• Not exercising enough
• Disorders of the brain and spine, like Parkinson's disease
• Conditions that affect your metabolism, like diabetes
• Conditions that impact your hormones, like hypothyroidism
• Intestinal obstructions
• Anatomic issues with your GI tract

You can consider yourself constipated if you have the following symptoms, according to the NIDDK:

• Fewer than three bowel movements a week
• Poop that is hard, dry, or lumpy
• Poop that is difficult or painful to pass
• A feeling that not all poop has passed

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This is the official list of COVID-19 symptoms, according to the Centers for Disease Control and Prevention (CDC):

• Fever or chills
• Cough
• Shortness of breath or difficulty breathing
• Fatigue
• Muscle or body aches
• Headache
• New loss of taste or smell
• Sore throat
• Congestion or runny nose
• Nausea or vomiting
• Diarrhea

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There is some data that links patients with COVID-19 and constipation, but it's not very strong.

A case study published in the American Journal of Gastroenterology in May 2020 details the story of a man with COVID-19 who went to the hospital with a fever, cough, nausea, stomach pain, and constipation. He had a CT scan, which found that he had a condition called colonic ileus, which is when the intestinal muscles stop contracting. Worth noting: Another patient featured in the case report also had COVID-19 and GI symptoms, but they had diarrhea—not constipation.

A study published in the Journal of Microbiology, Immunology, and Infection in 2020 detailed the symptoms of people with COVID-19 who were hospitalized in Iran. GI symptoms included constipation, stomach pain, diarrhea, nausea, vomiting, and dark, sticky poop that usually indicates internal bleeding. Diarrhea was the most common gastrointestinal symptom, affecting 6.1% of patients.

Some common medications used to treat more severe forms of COVID-19, including the anti-viral drug remdesivir, can lead to constipation in some cases, according to a study published earlier this year in the European Journal of Pharmacology.

In all of these situations, though, constipation wasn't the lone symptom people had of COVID-19. And given how prevalent constipation is in the general population (an estimated 42 million people in the US deal with constipation), it's difficult to say if COVID-19 actually causes the condition or if it's a coincidence when it does happen in COVID-19 patients, John Sellick, DO, an infectious disease doctor and professor of medicine at the University at Buffalo/SUNY, tells Health.

FWIW: Doctors also haven't really seen this in the field. "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, tells Health. "When GI symptoms are present, it is usually diarrhea."

Dr. Sellick agrees. "Usually when I see a patient who says they have new constipation in the setting of an infection, it's because they're dehydrated," he explains. Given that it's summer and hot outside, and that makes you more likely to sweat, your constipation risk can go up if you're not replacing those fluids—whether you have COVID-19 or not, he says.

"Yes, you might have constipation and COVID-19, but it's likely not constipation caused by COVID," Dr. Sellick adds.

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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