Food Safety and Post-Infectious IBS

Potlucks, picnics, dinner parties, and other social gatherings are lots of fun and opportunities to taste new recipes. Unfortunately, if you're vegan and have IBS, they're typically a challenge to negotiate in terms of finding anything to eat that won't trigger or exacerbate symptoms. Even more important, they can be a perfect breeding ground for foodborne pathogens.

This is especially problematic for people with IBS because a bout of food poisoning can set off symptoms that may then become very difficult to manage. On top of that, a gastrointestinal infection caused by foodborne pathogens can cause post-infectious IBS, also known as IBS-PI. A blood test can confirm whether a person developed IBS symptoms from a foodborne pathogen, but it's not yet possible to identify the specific invader. Also, confirming the source of the IBS doesn't help with determining the appropriate therapies. It's estimated that up to one-third of people affected by acute bacterial gastroenteritis will develop post-infectious IBS and could account for a large portion of IBS in the United States. Symptoms may resolve in a year or two or may linger for several years after the initial infection. 

Soups, casseroles, spreads, dips, pasta, potato salads, and many other foods typically sit on buffet tables at room temperature for hours on end. Because the host at most potlucks and picnic meals doesn't have control over what dishes guests bring, there is little control over how foods are prepared, handled, stored, or served. This is true of vegan, vegetarian, and omnivore gatherings alike.

Food sensitivities are rampant today. As a result, potluck, picnic, and party meals can be particularly frustrating and even dangerous for people with special dietary needs. Not only are foods rarely labeled with a complete list of ingredients, but there also is the additional hazard of cross-contamination of both food allergens and foodborne pathogens caused by improper handling or the use of a single serving utensil for multiple dishes. Although IBS isn't directly related to food allergies or celiac disease, it's possible to have IBS on top of these conditions, and cross-contamination could aggravate or compound symptoms. 

Most gatherings don't provide ways to keep hot foods hot and cold foods cold, so the pathogens that can cause illness frequently abound. Contrary to popular belief, vegan and vegetarian foods (low-FODMAP or not) are just as capable of causing debilitating food poisoning as animal products. Often people don't associate a headache, gastrointestinal upset, or vomiting with the foods they ate at a potluck, picnic, or party, because food-poisoning symptoms can take many hours and sometimes even days to appear. Consequently, safety measures should be taken with every group meal, whether or not meat is being served.

Remember that food spoilage in progress is virtually impossible to detect. It takes only one hour for bacteria to grow to dangerous proportions in warm, moist conditions. Dangerous pathogens don't alter the taste, odor, or appearance of most foods at the time the foods are being served. Take extra precautions with high-protein and moist, high-carbohydrate foods, as these are especially susceptible to foodborne bacteria.

If you are the host of a potluck, picnic, or similar gathering, here are some recommendations to keep you, your children, and your guests safe from foodborne illness. If you are not the host but are attending a potluck event, pass on these suggestions to the appropriate person in charge.

• Food display and service should be well planned in advance so potentially hazardous foods are handled, stored, and served properly and at the correct temperatures.
• Hot foods must maintain an internal temperature of 140°F or higher (preferably between 140°F and 160°F).
• Reheated foods must reach 165°F or higher and then be reduced to 140°F or higher for holding or serving.
• Soups should be heated to boiling; they then can be transferred to a covered electric slow cooker for serving.
• Casseroles must be reheated to an internal temperature of 165°F and can be kept hot (140°F or higher) on the buffet table with warming trays, chafing dishes, or slow cookers.
• Cold foods must be maintained at 40°F or colder during service or storage. Keep foods cold by nesting dishes in bowls of ice.
• Use a clean stab thermometer for checking the internal temperature of food (such as casseroles and loaves or chilled dishes), and wash it thoroughly before checking another dish.
• Use disposable gloves to cover cut or scraped hands or long or painted fingernails.
• Maintain a list of the names, addresses, and phone numbers of all the people who brought an item to the event, including what they prepared.
• Foods should be transported to the event in a clean vehicle with proper temperature control.
• Make sure that every dish served is accompanied by a card that lists the ingredients in full. Be sure that guests understand the importance of listing every ingredient, as some foods can be extremely hazardous for people with food sensitivities. Of course, this is also a good way for vegans with IBS to find out which dishes are acceptable for them while alleviating the pressure and awkwardness of asking questions.
• Food handlers should not be ill, have an asymptomatic illness, or open cuts or wounds.
• Food handlers should not be permitted to use tobacco or eat or drink while handling foods.
• Proper hand washing should be strictly enforced after restroom use, smoking, drinking, eating, or handling garbage or dirty dishes.
• Have only one person designated to serve. Do not permit self-serve for adults or children.
• Do not allow children to handle or serve food.

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