12 Oct 21 SM 01

After Recovery: What is the Covid-19-associated gastrointestinal injury?

What is post Covid-19 syndrome?

Post Covid-19 syndrome or long Covid are persistent symptoms that may remain for few weeks to months after recovery from Covid-19. (1,2) As with most infections, your body takes time to heal and recover. This is due to inflammation that may still persist in your body.


Possible symptoms after Covid-19

The Covid-19 virus affects different parts of the body during infection and causes different symptoms that may take a longer time to recover. Some of the most common symptoms may include (1-3):

  • Fatigue
  • Headache
  • Cough
  • Shortness of breath
  • Chest pain
  • Difficulty in concentrating
  • Gastrointestinal/digestive issues


Post Covid-19 gastrointestinal symptoms

One of the most common symptoms that may persist after Covid-19 are gastrointestinal symptoms or symptoms related to the digestive system. Some of these symptoms may include (1-3):

  • Diarrhoea
  • Gastric pain
  • Constipation and bloating
  • Nausea and vomiting
  • Loss of appetite


Gastrointestinal symptoms such as diarrhoea, gastric pain, and constipation may persist as a result of prolonged inflammation in the gut. (4) It is prevalent in other types of viral and bacterial infections as well. (4,5) Nausea and vomiting may be related to the effects on the nervous system and other gastrointestinal symptoms. (4) On the other hand, loss of appetite may occur as a result of the aforementioned gastrointestinal symptoms and / or it might be due to pain, fatigue, shortness of breath and other symptoms that may affect one’s appetite. (4)


How to eat after recovering from Covid-19

  • Maintain a healthy diet

Adequate nutrition is essential to help the body to repair, recover, and to build up your immune system. Eat a healthy diet and vary your food choices in your meals for adequate calorie, protein, vitamins and minerals intake.


  • Drink plenty of water every day

Drink 6 to 8 glasses of water daily. Staying hydrated is important for your immune system as water helps in transporting nutrients.

Malaysian Food Pyramid Healthy Plate Method

Source: Kementerian Kesihatan Malaysia (6)


If you’re having digestive issues:

  • Eat small frequent meals. Avoid eating large amounts of food at one go.
  • Avoid spicy, oily food or any food that may trigger your symptoms.
  • Avoid drinking water with meals.
  • Eat plenty of fruits and vegetables to ensure adequate fibre intake.



  1. Peghin M, Palese A, Venturini M, De Martino M, Gerussi V, Graziano E et al. Post-COVID-19 symptoms 6 months after acute infection among hospitalized and non-hospitalized patients. Clinical Microbiology and Infection. 2021;27(10):1507-1513.
  2. Anaya J, Rojas M, Salinas M, Rodríguez Y, Roa G, Lozano M et al. Post-COVID syndrome. A case series and comprehensive review. Autoimmunity Reviews. 2021;:102947.
  3. Blackett J, Li J, Jodorkovsky D, Freedberg D. Prevalence and risk factors for gastrointestinal symptoms after recovery from COVID‐19. Neurogastroenterology & Motility. 2021;.
  4. Perisetti A, Goyal H, Gajendran M, Boregowda U, Mann R, Sharma N. Prevalence, Mechanisms, and Implications of Gastrointestinal Symptoms in COVID-19. Frontiers in Medicine. 2020;7.
  5. Card T, Enck P, Barbara G, Boeckxstaens G, Santos J, Azpiroz F et al. Post‐infectious IBS: Defining its clinical features and prognosis using an internet‐based survey. United European Gastroenterology Journal. 2018;6(8):1245-1253.
  6.    Malaysian Dietary Guidelines 2020. Kuala Lumpur: Kementerian Kesihatan Malaysia; 2021.

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