Diarrhea from food poisoning

Food poisoning comes in a variety of forms. It could come as E. coli from fecal contamination of food by a fast food preparer who failed to wash his hands after moving his bowels. Or it could come from Salmonella in chicken left unrefrigerated for too long or came in contact with a contaminated surface. Hours to days of nausea, diarrhea, vomiting, abdominal discomfort, and sometimes fever then follow. We’ve all endured at least one, if not several, such episodes over our lives.

It is a distinctly unpleasant business. It can also have long-term consequences such as post-infectious irritable bowel syndrome (IBS): You experience acute food poisoning from, say, Salmonella from a restaurant dish, then are left with several months to years of IBS symptoms: explosive diarrhea, pain, anxiety, sleep disruption. Rarely, kidney failure, arthritis, and death can occur. The offending microbe could be Vibrio cholerae from undercooked shellfish. The microbe could be Listeria monocytogenes from contaminated brie or Camembert cheese, or Bacillus cereus from meats or sauces left at room temperature for too long.

But here is something to ponder: Among the most common offending microbes that cause food poisoning are:

  • Escherichia coli
  • Salmonella enteriditis
  • Campylobacter jejuni
  • Shigella sonnei and related species

All of the above microbes can be normal inhabitants of the human colon, not necessarily associated with any symptoms. Then consider: If these microbial species can live quietly in the colon of a healthy person, why would they make someone sick, sometimes very sick, when ingested orally? Ah, here is where it gets interesting. Even though these microbial species can live without harm in the colon, they are potent pathogens in the upper GI tract, i.e., in the esophagus, stomach, duodenum, jejunum, and ileum. In other words, when fecal microbes venture where they do not belong, acute illness develops. The colon readily tolerates fecal microbes; the upper GI tract does not.

Now, also consider that small intestinal bacterial overgrowth, SIBO, the situation in which fecal microbes have become over-proliferated in the colon, then ascend into the ileum, jejunum, duodenum, and stomach, is defined by the presence of fecal microbes (“Proteobacteria”) in these gastrointestinal regions, essentially mimicking some of the features of food poisoning.

I therefore view food poisoning as an illustration of how detrimental it can be to house fecal microbes in the small intestine where they do not belong. Recall that, from my discussion about GI mucus, the small intestine has a thinner, more fragile, single-layer mucus barrier, in contrast to the thick two-layer mucus barrier of the colon. The small intestine is, by design, more permeable to facilitate absorption of nutrients such as vitamins, minerals, amino acids, fatty acids, etc. But when fecal microbes invade the small intestine, whether via food poisoning or the ascent of fecal microbes in SIBO, unpleasantness ensues.

Something else to ponder: My friend, Donna Schwenk, with a 22-year history of fermenting foods, has witnessed this phenomenon numerous times in herself, her family, and the many people who follow her website and recipes: They experience food poisoning with the usual symptoms. They drink something fermented, e.g., the brine in fermented vegetables or pickles, and symptoms subside within 20 minutes. Presumptively, the microbes in the fermented food block the attachment of food poisoning species to the intestinal wall and cause them to be expelled. Why wouldn’t this work in eradicating SIBO? I speculate that the numbers of microbes involved with SIBO, as well as the 24-foot length of microbial over-population, are far greater than the small contamination consumed orally causing food poisoning.