COVID-19 Curbside Consults

Gastrointestinal manifestations of COVID-19

Sara El Ouali, MD, Jean-Paul Achkar, MD, Bret Lashner, MD and Miguel Regueiro, MD
Cleveland Clinic Journal of Medicine February 2021, DOI: https://doi.org/10.3949/ccjm.87a.ccc049

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Tables

  • TABLE 1

    Suggested management of COVID-19–related gastrointestinal symptoms in adults

    Supportive care47,48
    Fluid and salt intake (eg, soup, broth, juice, saltine crackers, low carbohydrate sports drinks) to maintain hydration status
    Oral rehydration therapy for mild dehydration
    Intravenous rehydration for severe dehydration
    Pharmacotherapy47,48
    Nausea and vomiting:

    • Prochlorperazine 5 to 10 mg orally 3 to 4 times daily as needed (maximum of 40 mg/day)

    • Ondansetron 4 to 8 mg orally 3 times daily as needed (off-label use)

    Diarrhea:

    • Loperamide 4 mg orally initially, followed by 2 mg after each watery stool (maximum of 8 mg/day)

    Monitoring for worsening disease course49
    Hospitalization if alarm symptoms:

    • Severe or persistent symptoms

    • Gastrointestinal bleeding

    • Intractable vomiting

    • Dehydration

    • Change in mental status

    Consider consultation with a gastroenterologist for further work-up and management if worsening disease course.
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