If you haven’t already heard, the CDC just issued another warning about an E. coli outbreak linked to romaine lettuce. So far, 32 people from 11 states have been infected.
E. Coli can cause cramps, vomiting, diarrhea, and even kidney failure. It can kill you. If you’re a healthy person with no digestive issues, E. coli (or any food poisoning) is, at best, a very unpleasant experience.
But if you have a digestive disease, food poisoning can be much, much worse. This is why you MUST try to avoid food poisoning if you have IBS or SIBO.
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Why is avoiding food poisoning if you have IBS or SIBO so critical?
Food poisoning causes many cases of SIBO and IBS, leading to what’s known as “post-infections” IBS or SIBO. In fact, that’s how mine started.
In about ten percent of people, the body reacts to the toxins in the bacteria with an autoimmune reaction that causes it to attack a protein in the gut called vinculin. When that happens, it throws off the normal muscle contractions of the digestive system. This causes bacteria to become trapped in the small intestine, resulting in SIBO.
If you have post-infectious SIBO or IBS, further food poisoning will cause the same reaction and further damage your digestive system. So it’s imperative to avoid it.
If your SIBO or IBS has a different cause, it’s still harmful to the digestive system to suffer food poisoning. The harmful bacteria can upset the normal flora of your digestive system. It can also cause long-term issues such as chronic urinary tract infections, kidney damage, chronic arthritis, and nerve and brain damage.
Trust me, you don’t want to add those problems to your roster of health issues!
How do I avoid food poisoning?
First, take all the normal precautions you should already be doing daily. Wash your hands before eating, and after using the restroom. If you don’t have access to a hand washing facility for whatever reason (i.e. camping or festivals) use wet wipes and/or hand sanitizer.
Second, it’s a good idea to be more vigilant about what you eat. Before I discovered that food poisoning caused my SIBO, I was somewhat lax about eating things that had been hanging out in the fridge past their expiration date. I try to avoid doing this now even though I end up wasting more leftovers.
For some items, I will still eat it past the expiration date if it looks good, smells good, and is preserved well (think pickles or mustard, which are unlikely to go bad). For cooked foods such as leftovers, I don’t take chances on iffy or week-old leftovers anymore. It simply isn’t worth the risk to my health.
Obviously, you should also avoid any food that has been sitting outside for too long, or where you suspect it hasn’t been handled or cooked safely. Buffets, for example, are probably a bad idea.
What about foreign travel?
What about travel to foreign countries? This is a tough one.
My doctor advised me to avoid traveling to countries where the risk of food poisoning is high, unless absolutely needed. This means I have had to accept that I probably won’t get to visit Thailand, Mexico, Bali, and many other places I would love to go.
For me, it just doesn’t seem worth the risk of making my SIBO and IBS worse. But, being limited in my travel is a huge bummer. Whether you’re willing to limit your travel is a personal decision you’ll have to make based on your risk tolerance.
If you do choose to travel to developing countries where the water is not safe to drink, you should seriously consider taking an antibiotic preventatively. For example, I was told that taking Rifaximin before leaving and throughout my trip would be advised if I were to go somewhere risky.
For travel to countries with less of a risk of food poisoning, upon the advice of my doctor I take a tablet or two of Pepto Bismol per day during my trip. I’m not sure the specifics of this but my doctor said it helps bind everything together in the intestines and helps to prevent food poisoning.
What you don’t want to do is take Imodium as a preventative measure. It is too extreme and paralyzes the digestive system temporarily. You should only use Imodium if you’re actually having diarrhea and need to treat it quickly.
Getting sick can have lasting consequences on the digestive system, as I found out when I got sick ten years ago. Although some of these measures may seem burdensome, it’s critical to healing your digestion to avoid food poisoning if you have IBS or SIBO.
High-risk food culprits
It’s also a good idea to think about what items you regularly consume that are more likely to cause food poisoning.
For example, I’ve stopped eating shrimp almost entirely. Shellfish commonly cause many cases of food poisoning due to the toxins and histamines they are exposed to. Shrimp that have not been deveined (the removal of the shrimp’s digestive system) properly pose a further risk.
Since I don’t want to order shrimp only to see they have not been deveined properly, I just don’t eat them anymore. I’m more hesitant to order clams and other shellfish than I used to be as well. I love shellfish, so sometimes I will still do, but only when I feel the restaurant will likely to handle and prepare the shellfish safely.
Other foods likely to cause food poisoning are lettuce and leafy greens. Lettuce and leafy greens caused 85% of food poisoning outbreaks in the US between1973 and 2012. Make sure you wash them thoroughly and avoid pre-prepared salads. Undercooked poultry also pose risks.
Rice, surprisingly, is another likely culprit. Rice often contains spores of the bacteria Bacillus cereus. Cooking doesn’t destroy Bacillus cereus, and if the cooked rice is left to sit out at room temperature, the bacteria can grow and cause serious food poisoning. I suspect this happens often at buffets, so be extra wary with those.
What should I do if I get food poisoning?
Your first priority should be to seek treatment and get antibiotics.
If you aren’t able to see your regular doctor quickly, be prepared to educate whatever doctor you see about SIBO. Come prepared with sources to show your doctor you need antibiotics, specifically, Rifaximin.
Rifaximin is FDA approved for traveler’s diarrhea, so it actually can be easier to get it to treat food poisoning than for treating SIBO! Rifaximin is mostly absorbed in the small intestine, so it’s gentler than other antibiotics which affect the whole body.
If you are traveling in a place without easy access to doctors, or where you don’t speak the language, it’s a good idea to get antibiotics beforehand to take with you, should you need it. Again, you may have to educate your doctor on the necessity of this.
In addition, do all the things you normally would do when sick. Stay hydrated, make sure you’re getting enough nutrients, and rest.
In conclusion…
You need to be extra vigilant about food safety to avoid food poisoning if you have IBS or SIBO.
Avoiding food poisoning may entail some sacrifices. But in my opinion, it’s worth it to avoid further long-lasting damage.
So remember, when you’re enjoying your Thanksgiving meal tomorrow…avoid the romaine lettuce!
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