Sydney nutritionist and food author Lee Holmes (pictured) explained while all too many of us have put on weight in the past six months, there is time to lose it before the height of summer

Why you have nasty stomach issues months after suffering covid

A nutritionist has revealed why people are continuing to suffer from nasty stomach issues months after recovering from Covid – and the easy ways to get your digestive health back on track.

Australian nutritionist  Lee Holmes said she’s seen many patients visit her clinic with lingering gut issues after having Covid including bloating, reflux and flatulence to constipation, diarrhoea and leaky gut.  

One in three people with Covid have suffered from gastrointestinal symptoms. with studies showing those with better gut health had less severe symptoms.

Australian nutritionist Lee Holmes said she’s seen many patients visit her clinic with lingering gut issues after having Covid including bloating, reflux and flatulence to constipation, diarrhoea and leaky gut.

Lee says this is because the gut and respiratory tract share an immune system, known as the gut-lung axis which is detailed further in a number of microbiology studies.

‘This axis is bi-directional, which means if the gut is affected by bacteria, the lungs will be impacted too, and vice versa,’ she explained in a blog post.  

‘There are also around 100 times more receptors in the GI tract than respiratory organs, so the gut may be able to house more viruses when it acquires an infection’ she explained.

Lee said that when a person gets Covid cytokines – small proteins that are crucial in controlling the growth and activity of other immune system cells and blood cells –  enter the body through the lungs.

How a healthy gut can reduce the severity of Covid and the flu  

A study of Croatian children attending daycare saw half of them given probiotics and the other half a placebo – after three months those taking probiotics had a lower risk of respiratory tract infections and experienced less time unwell when infected.

Swedish researchers also conducted a study on 272 adults and found that the group using probiotics experienced the milder cold and flu symptoms and less time infected with a virus.

It also found cases of the cold and flu among participants those who had taken probiotics averaged 6.2 days compared to the 8.2 days those taking a placebo experienced.

As consultant gastroenterologist and UNSW Professor of Medicine Emad El-Omar explains, the gut microbiome’s primary role is to educate our immune system about our environment.

The lion’s share of our immune system – around two-thirds of all immune cells – is concentrated in digestive system which is why UNSW’s Microbiome Research Centre is exploring how the gut microbiome’s make-up affects immune responses and changes with various disease progression.

Source: Dispensaries and NSW Health

Lee says cruciferous vegetable, cauliflower are excellent sources of fibre - which help maintain a healthy gut

Lee says cruciferous vegetable, cauliflower are excellent sources of fibre – which help maintain a healthy gut

This  causes all-over body inflammation and once these cytokines reach the gut, the virus can travel through veins that drain blood from the digestive tract, impacting the all-important vagus nerve, which is responsible for the regulation of internal organ functions, such as digestion, heart rate, and respiratory rate.’

What is the gut-lung axis? 

The gut-lung axis concept argues alterations in the gut may have a profound effect on lung disease. 

Microbes in the gut may be recognised by host immune cells, which can result in systemic cytokine release. 

Cytokine can then enter the lungs and cause all-over body inflammation and once they reach the gut.

 This in turn alters the bacteria within the gut, increasing its permeability and causing more inflammation

Source: Mayo Clinic 

‘Once this occurs, the disease impacts the gut barrier, altering bacteria within the gut, increasing its permeability and causing more inflammation,’ she explains. 

‘Increased intestinal permeability, which is also known as leaky gut, allows the bacteria to circulate, exacerbating the illness. When this happens, we can experience a range of digestive discomfort symptoms, like bloating or flatulence. 

‘To make matters worse, the medications taken for other symptoms of COVID can cause side effects like nausea and diarrhoea.’

Research from the Chinese University of Hong Kong found people suffering with Covid-19 had a ‘significantly altered’ microbiome composition.

Separate research from South Korea found people with a poorly functioning gut are more likely to develop severe Covid-19 because the lack of healthy microbes makes it easier for the virus to infect cells in the digestive tract.

The team from Hong Kong examined blood, stool and patient records from 100 hospital patients with Covid-19 between February and May 2020, and 27 of these patients also provided samples 30 days after the infection had passed.

Researchers also collected samples from 78 people without Covid-19 who were taking part in a microbiome study before the pandemic.

The study concluded the gut microbiome may be involved in the ‘magnitude of Covid-19 severity possibly via modulating host immune responses’.

Lee recommends adding foods including kefir, kimchi ,miso, sauerkraut and yoghurt to your diet

Lee recommends adding foods including kefir, kimchi ,miso, sauerkraut and yoghurt to your diet

The authors found that patients with Covid-19 had depleted levels of several gut bacteria known to modify a person’s immune response.

For example, there was evidence of elevated levels of some bacteria, including Ruminococcus gnavus, Ruminococcus torques and Bacteroides dorei.

Lee also explains that the  gut is the body’s epicentre to health and central to many of the body’s systems, including the immune system.

Probiotic Foods 

  • Kefir
  • Kimchi
  • Miso
  • Sauerkraut
  • Yoghurt


Prebiotic Foods 

  • Banana
  • Cassava
  • Chickpea flour
  • Chicory root
  • Garlic

‘It isn’t surprising that the aftermath of COVID can come in the form of a range of digestive issues,’ she says. 

If you’re suffering after having Covid, Lee recommends a gut-friendly diet filled with omega-3 fatty acids, fruits, vegetables, soups and smoothies.

‘A gut-friendly shopping list should include anti-inflammatory turmeric, gut-healing gelatine, omega-3-rich fish, protein, gut-loving slippery elm and supercharged Love Your Gut Synbiotic Powder,’ she said. 

Gut-friendly coconut oatmeal recipe

Serves 2


  • 50 g (1 3/4 oz/1/2 cup) gluten-free organic rolled (porridge) oats
  • 250 ml (9 fl oz/1 cup) filtered water
  • pinch of Celtic or Himalayan sea salt

  • pinch of ground cinnamon, plus extra for sprinkling
  • 125 ml (4 fl oz/1/2 cup) Coconut Milk
  • 1 handful of mixed fresh berries
  • mint leaves, to garnish


  1. Combine the oats and water in a small saucepan. Bring to a simmerand cook for 12–15 minutes, or until the oats are tender, stirring regularly.
  2. Stir in the salt, cinnamon. Mix the coconut milk through until creamy and smooth.
  3. Serve topped with the berries and mint, and an extra sprinkling of cinnamon.


She also advised reducing caffeine, alcoholic beverages and refined sugar and staying hydrated. 

Lee added that incorporating prebiotics and probiotics to your diet, helps to shift the balance of unhealthy microflora to a microbiome. 

‘Probiotics are live microorganisms found in yoghurt, kimchi and sauerkraut that add healthy microbes to the gut,’ she said.

‘Prebiotics, found in artichokes, asparagus, and chicory root, act as food for the gut’s good bacteria. Prebiotics can improve immune function, reduce inflammation and even help weight loss. Prebiotics and probiotics work harmoniously to help the gut microflora survive and thrive.

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