Understanding the Link Between COVID-19 and GI Symptoms
COVID 19 or Coronavirus Disease is a global pandemic caused by the SARS-COV-2 virus. Experts indicate the point of origin is geographically referenced to China. The number of confirmed infected persons is continually growing higher. In the United States alone, the statistic for confirmed cases has stretched to approximately 2 million infected as of this writing.  We do know there is an intersection of symptoms between coronavirus and gastrointestinal conditions.
While much about the virus isn’t known, gastrointestinal specialists are doing their best to pinpointing the crossover aspects of COVID-19 and gastrointestinal symptoms.  As a standalone disease, the symptoms of COVID-19 are serious and can lead to mortality. The CDC indicates there are have been just over 110,000 deaths as a result of the COVID-19 virus and/or complications. 
What do we know about COVID-19?
We know the major area of impact is the collapse of the respiratory system. Symptoms of the virus tend to appear within 24-48 hours after virus transmission. The most presented symptoms of those with coronavirus are:
· Difficulty Breathing
· Diarrhea (Common GI Condition)
· Sore Throat
· Loss of Taste or Smell
· Nausea (Common GI Condition)
· Vomiting (Common GI Condition)
· Abdominal Pain (Common GI Condition)
*The highlighted symptoms represent the same also seen in common GI conditions.
What is the connection between COVID-19 and the digestive system?
What medical experts are noticing is that some patients can present with just digestive or gastrointestinal issues alone. Of course, this is cause for concern as the symptoms can be misleading and suggest other health ailments. It can also contribute to the unintentional spread of COVID-19. 
Early studies showed a relatively low instance of gastrointestinal symptoms. However, later, as the disease evolved, a much higher prevalence for vomiting, nausea, and diarrhea was noticed in patient studies.  In China the epicenter for the coronavirus, researchers have been working hard to uncover more information. In certain clinical studies, they found the virus present in the stool of some patients and gastrointestinal tract. In these cases, the most important takeaway is the notation of the absence of respiratory symptoms.  This confirms the presence of a subpopulation of infected persons that may be able to transmit and carry the virus with only gastrointestinal symptomology.
Does COVID-19 exacerbate existing gastrointestinal disorders?
Gastroenterologists are concerned that coronavirus can complicate GI conditions – especially for those taking immune-suppressing drugs to help manage their condition.  Unfortunately, there are still many unknowns about COVID-19.  The recommendation from medical experts includes staying in touch with your treating physician and reporting any risks or changes in your physical health.
It is also advised that patients with preexisting conditions such as IBD continue the medications as prescribed until assessing your risk factors more closely. [5,8] For those showing active symptoms associated with IBD, seek medical attention. For those concerned with recurrent bouts of IBD or Chron’s, you should schedule a visit with your gastroenterologists for further evaluation. They will be able to provide management recommendations and testing for COVID-19. 
Seeking Treatment and Staying Safe
To help facilitate safe practices amidst the pandemic, most gastroenterologists are providing easy-to set up video appointments and consulting. Additionally, we are all working especially hard to keep our patients up to date as more and more information is learned. Medical experts advise staying tuned in to the COVID-19 guidelines set in place by the CDC. Those guidelines include:
· Consistent Hand-Washing
· Avoiding Crowded Locations
· Maintaining the 6ft. Safe Distance Rule
· Staying Home and Healthy
· Keeping with Existing Medication Schedules Unless Advised to Discontinue from a Medical Professional 
What If I have some of the symptoms listed?
For any questions regarding a new condition or a preexisting condition, you should contact a gastroenterologist in your area. They can help you assess your current health and risk associated with COVID-19 or other GI related conditions.
For certain symptoms - SEEK EMERGENCY CARE RIGHT AWAY:
· Uncontrollable Fever
· Persistent, Uncontrolled Vomiting
· Extreme Difficulty Breathing
· Persistent, Uncontrolled Diarrhea
· Uncontrollable Abdominal Pain
· Pain or Pressure in the Chest
· Trouble Remaining Conscious
Understanding the shared symptomology of COVID-19 and GI conditions is still being explored. What we can expect to see in the next few months are increased movements in testing procedures and treatment efficacy for infected persons. We also hope to have some good news concerning the late stage clinical trials of the vaccines currently in development for COVID-19.
For our gastroenterologist patients, we know the fear associated with a potential onset of symptoms matching those found in coronavirus. We are here to help and walk with you in these uncertain times. Our team is committed to adhering to safe practice guidelines, but also providing the best care standards possible at this time. For any questions or concerns, we urge you to contact our offices. Thank you for reading and being a part of our community.