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In 2019, an outbreak of COVID-19 caused by SARS-CoV2 spread worldwide, affecting millions of individuals. This was colloquially termed the “COVID-19 Pandemic.” As the pandemic progressed, multiple variants of SARS-CoV2 continued to evolve, including the most recent JN1, and spread worldwide, causing a broad spectrum of symptoms affecting multiple organ systems. The purpose of this article is to comprehensively explore COVID-19 through the lens of the Gastrointestinal system (GI) and review the treatments. The prevalence of GI symptoms in COVID-affected patients ranged from 28.2% to 50% throughout the pandemic. The predominant symptoms include nausea, diarrhea, reflux, abdominal pain, and emesis. Interestingly, these symptoms persisted for an extended time, sometimes the most bothersome, even after the resolution of an active infection. Due to the nature and prevalence of these symptoms, it is imperative that we understand the mechanism of interaction of SARS CoV2 and the GI system and its pathophysiology. Despite being the less common transmission route, the fecal-oral route is to be considered when devising public health strategies. The term “Long Covid” has been coined due to the long-term symptoms after active infection, and interestingly, GI symptoms have a significant prevalence. Though unclear, the pathogenesis is thought to be due to gut dysbiosis and dysbiosis of the gut-brain connection.

In this article, we have also discussed the GI symptoms and treatment of COVID infection in inflammatory bowel disease, pediatric population. We have also discussed guidelines by gastroenterology societies for care prior to, during, and after endoscopy, as well as ostomy care in COVID patients.