Why Your Stomach Problems Never Seem To End

Photographed by Megan Madden.
There's nothing quite like the feeling of triumph that accompanies eating your first full meal after recovering from a stomach bug. Unfortunately, there are those among us who have returned to their normal eating habits only to endure cramps, bloating, and, of course, diarrhea all over again. For some, this isn't another case of the stomach flu but an altogether different condition known as post-infectious inflammatory bowel disease, or, for short, post-infectious IBS.
While general IBS can be caused by a wide range of triggers, from certain foods to stress, post-infectious IBS arrives in the wake of a particularly severe case of bacterial, parasitic, or viral gastroenteritis, one that lasts several days, involves vomiting or diarrhea and usually a prolonged fever. David M. Poppers, MD, PhD, clinical associate professor of gastroenterology at NYU Langone Health, tells Refinery29 that any type of infection can lead to post-infectious IBS, but research has linked it more closely to infections involving the bacterial strains Campylobacter and Escherichia coli.
In other words, it isn't a given that you'll end up with post-infectious IBS just because you have a 24-hour bug. But, if you've just gotten over the stomach flu and are still dealing with pain or discomfort (and making many more trips to the bathroom than usual), you may want to get in touch with your doctor or gastroenterologist.
Ideally, Dr. Poppers says, your doctor will already be somewhat familiar with your medical history, and you'll already be pretty aware of what "normal" means for your poop. Being aware of your gut's baseline and making sure your doc knows, t0o, will help you recognize when something's off. (For the record, beyond simply feeling not yourself, there are a few "alarm signs" that Dr. Poppers says always warrant an appointment, including sudden weight loss, lack of appetite, rectal bleeding, black stool, or blood in your stool.)
Dr. Poppers explains that conditions like IBS are usually diagnosed through exclusion, or by ruling out other illnesses first. So, after running through your medical history, your doctor will probably ask to do a physical examination, and, in most cases, take a stool sample. Only by taking these steps (and, Dr. Poppers stresses, maintaining a relationship with your doctor) will you be able to determine whether you're dealing with post-infectious IBS or something else.
Once your doctor has concluded that you're dealing with post-infectious IBS, they may suggest that you avoid certain foods like gluten or dairy, or make larger overall dietary changes for a period of time to see if your symptoms abate. In addition to identifying (and, if necessary, eliminating) foods that trigger your IBS, your doctor may also recommend such medications as loperamide (aka imodium), rifaximin, or eluxadoline, to help treat symptoms like diarrhea.
This may sound like a lot of trial and error, but, as anyone who suffers from regular IBS knows, that's kind of how matters of the gut tend to be. What's important, Dr. Poppers says, is to maintain an open line of communication with your doctor throughout the process, even after starting treatment: "Medications are very, very helpful, but having a close, ongoing relationship with one's physician has the best outcomes in terms of symptom relief."

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