The New York Times published a piece this morning by health reporter Alice Callahan that says something we have been saying for a long time: for a meaningful share of people, a foodborne infection does not end when the diarrhea does. The Times reports that research puts the figure at roughly 10 to 20 percent of people who get a gut infection from bacteria, viruses or parasites and then go on to months or years of abdominal pain, urgency and diarrhea. The condition has a name, post-infection irritable bowel syndrome, and the gastroenterologists Callahan interviewed expect to see a great deal more of it after a summer that produced the largest Cyclospora outbreak this country has recorded, along with outbreaks tied to jalapeños, sprouts and frozen blueberries.

A tip of the pen to Callahan and to the Times for covering it. It is an important topic that almost never gets covered, and the people who most need to read it are the ones who got sick in June or July, got better, and are now wondering why they are sick again.

The Times told readers what most outbreak coverage leaves out

Most reporting on an outbreak ends with the case count. The count measures the acute illness, the week or two of misery that gets someone to a doctor and a stool test, and then everyone moves on. Callahan’s piece starts where the count stops. She opens with a 55-year-old Michigan woman two months past her Cyclosporainfection who still has sharp abdominal pain and no warning before she needs a bathroom, and who is afraid her gut will never be the same. She talks to a man in Britain eight years out from a bad sandwich who still plans his days around the nearest restroom, and to a woman in British Columbia who spent six years after a spinach E. coli infection at age 14 having as many as twenty bowel movements a day, underweight and isolated through her first years of college. Those are not unusual stories. They are the stories our office hears every year.

The piece also gives readers numbers. A 2024 meta-analysis in the journal Gut that the Times cites found post-infection IBS in 11 percent of people after viral gut infections, 18 percent after bacterial infections like Campylobacter and Salmonella, and 30 percent after parasitic infections. For Cyclospora specifically, the honest answer is that no one knows, because it has barely been studied; physicians at the Medical College of Wisconsin reported what they believed was the first documented case only in 2023. And because the diagnosis requires symptoms that have lasted at least six months, the size of this outbreak’s long tail will not be visible until well into next year.

We have been writing about post-infection IBS for more than fifteen years

In October 2010 I posted the content we had built for our irritable bowel syndrome site, and it still holds up. It walked through the Rome criteria, the brain-gut connection, the enteric nervous system that some researchers call the second brain, and the mast-cell and microbiome theories. The part that mattered most to our clients was the evidence, going back to the 1950s, that gastrointestinal infection precipitates IBS. Studies at the time put the range at 7 to 31 percent of people after an episode of infectious gastroenteritis, and a meta-analysis of eight studies found post-infection IBS in 9.8 percent of infected people against 1.2 percent of controls, a sevenfold increase in the odds. The risk factors named then, female sex, a severe or prolonged acute illness, bloody stools, are the same ones the Times’ experts name now. The pathogens named then were enterotoxigenic and Shiga toxin-producing E. coli including O157:H7, Campylobacter, Shigella and Salmonella. Cyclospora was not on the list because nobody had looked.

The mechanism the Times describes, in which a toxin made by Campylobacter, Salmonella and E. coliprovokes antibodies that then attack the nerves controlling gut contractions, is the cytolethal distending toxin story our IBS page has carried for years, and our post-infectious IBS and what is IBS pages cover the rest, including the related conditions, functional dyspepsia and gastroparesis, that can follow the same infections.

Those pages exist because the question kept arriving, usually months after an outbreak had left the news. I was sick in the outbreak, I got better, and now I am sick again. Is that connected? For a lot of people, the answer is yes.

The long tail is one more reason to count the sick

I have spent this summer arguing that the 2026 Cyclospora outbreak is far larger than the confirmed federal count, and the Times piece adds a reason that has nothing to do with lawsuits. If 10 to 20 percent of the acutely ill develop lasting symptoms, then every uncounted case is a person who may never be told that their years of cramping and urgency have a cause, a date and a name. It is also a cost nobody is tallying. The economic damage of an outbreak does not stop at the plowed-under lettuce and the lost restaurant sales. It continues in gastroenterology waiting rooms, in missed work and in prescriptions, for years.

If you were sick this summer, here is what to do

Keep your records. Save the lab report that confirmed the infection, the dates you were sick and the names of the doctors you saw. If you have abdominal pain, urgency or diarrhea that is still with you six months after the infection, see a gastroenterologist. The Times’ experts say the first job is to rule out an infection that never cleared, since Cyclospora is difficult to get rid of, and to rule out other conditions like inflammatory bowel disease and the lactose intolerance that a gut infection can leave behind. There is no cure for post-infection IBS, but there are treatments: loperamide and peppermint oil over the counter, and by prescription the antibiotic rifaximin, low-dose tricyclic antidepressants that quiet the gut’s nerves, and drugs that slow the bowel. Diet changes, including a Mediterranean pattern or a supervised low-FODMAP trial, help some people. And the research suggests that about half of post-infection cases resolve within one to four years. As Dr. Baha Moshiree of Wake Forest told the Times, “You don’t have to suffer.”

Questions readers are asking

Can food poisoning cause long-term digestive problems?

Yes. Roughly 10 to 20 percent of people who get a gastrointestinal infection from bacteria, viruses or parasites develop post-infection irritable bowel syndrome, with abdominal pain, urgency and diarrhea that can last months or years after the original infection has cleared.

What is post-infection IBS?

It is a subtype of irritable bowel syndrome that begins after an acute gut infection. Symptoms include recurring abdominal pain or discomfort, bloating and gas, and diarrhea, constipation or both, with diarrhea the most common. Many people describe it as never having fully recovered from the original illness.

Which foodborne pathogens cause post-infection IBS?

It has been documented after Campylobacter, Salmonella, Shigella, Shiga toxin-producing E. coli including O157:H7, norovirus and other gut viruses, and parasites including Giardia. Studies suggest the risk is highest after parasitic infections and lowest after viral ones.

Can Cyclospora cause post-infection IBS?

Probably, but it has barely been studied. The first documented case was reported in 2023, in a Wisconsin woman with loose stools, urgency and cramping more than eight months after a Cyclospora infection. Because diagnosis requires six months of symptoms, the number of people from the 2026 outbreak who develop it will not be known until 2027.

How long does post-infection IBS last?

It varies. Unlike ordinary IBS, which is often lifelong, post-infection IBS resolves in about half of cases within one to four years. Some people have symptoms for much longer.

When should I see a doctor after food poisoning?

See a gastroenterologist if abdominal pain, urgency or diarrhea persist six months after the infection. Your doctor will want to rule out an infection that has not cleared, inflammatory bowel disease and lactose intolerance before diagnosing post-infection IBS.

Do long-term symptoms count in a food poisoning claim?

Yes. If your illness was linked to an outbreak, lasting symptoms are part of the harm a claim can account for, which is why keeping the lab confirmation, your medical records and a symptom diary matters long after the acute illness is over.tor will want to rule out an infection that has not cleared, inflammatory bowel disease and lactose intolerance before diagnosing post-infection IBS.

Do long-term symptoms count in a food poisoning claim?

Yes. If your illness was linked to an outbreak, lasting symptoms are part of the harm a claim can account for, which is why keeping the lab confirmation, your medical records and a symptom diary matters long after the acute illness is over.