Why does my girlfriend have diarrhea and vomiting after being tested positive for COVID-19 infection?

Hi,

Welcome to icliniq.com.

I have reviewed her case history and attached images as well (attachment removed to protect the patient's identity). There are four issues that I can see.

• Recent COVID infection, with gut involvement predominantly.
• Underlying anxiety, sensitive gut, and history of IBS-D (irritable bowel syndrome with diarrhea).
• Persistent gut symptoms, although fever settled? Bleed in stools as well.
• Abdominal pain and painful defecation.

My suggestions will be

• Check her stool DR (detailed report) to see whether there are superadded bacterial infections or not, and there is any blood in her stools on microscopic examination.
• Regarding your concerns about the biliary system being damaged by COVID, it is important to know about her liver function test status and ultrasound abdomen (if it has been done already by the treating physician, that is good).
• She should be on good anti-spasmodic medicine like the tablet Mebeverine 135 mg (antispasmodic) half hour before each meal three times a day.
• For painful defecation, this is likely because of persistent loose stools causing anal erosions or fissures. She can use local anesthesia gel like Lidocaine gel for two to three minutes before passing stools. She should have warm water sit baths with any anti-septic like Dettol. For this, she should sit in warm water with Dettol or any anti-septic twice daily for ten to 15 minutes.
• There should be better control of her anxiety because these symptoms persist for many days or weeks in a sensitive gut.

If she is otherwise doing well, like with no fever and tolerating diet, so less likely that COVID affects her gut.

Hi,

Welcome back to icliniq.com.

I will address your concerns one by one.

• For stool detailed report (DR), your general physician can also order liver function tests. If there is any issue in these labs, he can refer you to a gastroenterologist, otherwise, if that Is normal, it means nothing alarming regarding her biliary system and stools.
• Yes, anti-spasmodic like Mebeverine or any other good alternative available at your end can help with her abdominal cramps and reduce the number of stools to some extent.
• IBS (irritable bowel syndrome) patients may have different textures and colors of stools, but the important point is to rule out bleed and infection as per point one.
• If she is otherwise fine, with no fever, she is eating, has no dizziness, and can walk easily, so less likely to be anything much alarming.
• Keep an eye on her diet. She must not be consuming foods with red or black color much, as this can also change the color of her stools.

Thank you.