Covid 19 infection and its subsequent post-viral sequelae (long-Covid) has been associated with a range of clinical symptoms, including the more recently recognized autonomic nervous system dysfunction/orthostatic intolerance. Included in the autonomic nervous system dysfunction spectrum includes non-cardiovascular symptoms specifically gastrointestinal symptoms. We present a case of a long-Covid patient with debilitating symptoms consistent with autonomic dysfunction and gastrointestinal symptoms. We highlight the difficulty of diagnosis and management of this patient and the importance of awareness of presentation to not delay care in this complicated patient population.