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
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)

  • 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.