Uh - if I were given the choice, I might have opted for “continuous pasty dribbles of shit” if it meant I could fly or breathe underwater! Wait a minute - what does this imply about Patrick Duffy?!
Well, it’s not like they grow on trees!
Actually…
For Gabriela,
I’m basically back to normal, but I do take the odd hyoscine-N-butylbromide pill if symptoms threaten to return. I’m surprised to hear you say (read that you write?) that I had the flu. It was a very slight fluey feeling, only in the late evenings, but now that I think about it, well, I guess it makes sense. But then that means I didn’t get it from something I ate or drank, something I’d not questioned, only whether I’d got it from the rat cafe, or the bird bistro, or the submerged spoon restaurant. I think an infected leg can lead to a fever, which feels like flu, so it seemed logical that an infected gut could do the same.
“Only the worst diarrheas are caused by bad germs in the contents of the guts - the ones I called the equivalent of terrorists releasing sarin gas. E coli 0157:H7 works by a toxin. Cholera works both by a toxin and by clamping onto your mucosal cells and doing direct damage to them.”
How do people get traveller’s tummy then if not from food?
You have made me realize how little I really know about what goes on in my guts. I always assumed I could say, I always get the shits the morning after going to the rat cafe, so I won’t go there again. Was I imagining that I could see patterns like that? Is there any point in trying to match diarrhea to restaurant. Obviously,?, you can’t match flu to a restaurant, can you?
As for thinking that white cells and antibodies don’t work in the shit, well, I guess I’d just never heard of them working outside of tissue. They didn’t tell me a damn thing thing about shit at all the schools I went to. The fearless spirit of the Straight Dope was absent. I guess I thought the white cells would pile up and you’d get pus all over your shit (sorry if anyone’s eating while reading this 
which I’ve never heard of. I also thought that the white cells wouldn’t be able to survive the alien environment, ie wrong nutrients, acidity, or whatever. I mean if they knew that white cells could clean up shit, they really should have told me at school, or via some other medium - it’s amazing. Ultimate heroism, I mean there’s no getting back into to blood after that. Surely a white cell can’t pass through another cell, so there’d need to be an actual hole in a blood vessel to allow the white cell to get from the blood to the shit, or have I got it wrong?
Another problem would be the quantity of antibodies and/or white cells. I mean there’s a huge mass of bacteria, many of them bad and they are measured in grams (correct me if I’m wrong). And again, nothing gets out of the shit alive, the ultimate sacrifice, any leftover antibodies getting lost forever.
“I would venture without literature to back me that the big problem with secreting stuff into the gut is the ratio between freedom fighters and bugs. It’s a kamikaze raid out there.” is what you said, so I’m paraphrasing you again. But how could it be?
For Dr Paprika: I’m not eating tissue paper. Get some sleep.
For brossa: your opinions would be welcome.
So glad to hear you’re feeling better.
Look, the human body isn’t set up to know accurately what it got sick from. It’s just set up to respond when it gets sick as if the last important thing eaten made it sick - a good poisonous-plant-avoiding system for life in the wild. This is a common and well described occurrence: a person gets sick from the flu or other unrelated cause the day after eating some food or at some restaurant; they feel nausea and must avoid that food or restaurant forever after, even if (here’s the kicker) they know it was the flu.
What I’m saying here is “post hoc, ergo propter hoc?” - the Latin name of a fallacy in deductive reasoning that our bodies make so often. It means, “I did this and then that happened, so this caused that, right?” Such as, I ate at the rat cafe or the bird bistro and then I got sick, so the food at the rat cafe or the bird bistro caused the sickness, right?
I see it all the time in the deaths of middle-aged men who do not suspect they are having heart attacks, who think their nausea and vomiting is due to stomach troubles. We have taken to calling it “the tragedy of the fatal Tums overdose”. They take Tums or Tagamet or Alka Seltzer for the stomach trouble. They take it once, and the nausea does not go away. They take it twice, and the nausea does not go away. They wait half an hour and take it a third time, and the nausea slowly goes away. They attribute the decrease in the nausea to the third dose of Tums, when all the time, they are slowly infarcting the subendocardium of their left ventricle in the distribution of an obtuse marginal off the circumflex. Post hoc, ergo propter hoc? The nausea went away after the third dose of antacid, therefore the third dose of antacid caused the nausea to go away, right? Wrong. Then, when they die the next week from a cardiac arrhythmia, and I find the week-old MI and scars from previous small MI’s in their hearts, their wives are possessed by a fury which can never be let out on those husbands. If only I had made him go to the doctor! Touche.
Not that I think you have heart disease. I think you had the flu.
The germs come in on the food, make their way to the edge of the shit stream, and attack the mucosa which lines the tube.
If a lot of people have diarrhea from the same restaurant, the Public Health service is very good at matching diarrhea to the restaurant. But they work with all sorts of tools such as analysis of the diarrheal germs that you don’t have.
If you always get the shits the morning after the rat cafe, then perhaps you do have a problem with the rat cafe’s food. It is the repeatability of the experiment which is convincing. But the problem may not be germs in the food. It may be that you are allergic to some spice they use (as some people are to dill or MSG). It may be that they use irritants in their food (most capsaicins are irritants) that make your gut overreact. You can pair the cafe with the shits without knowing that you have been fed an infection.
Flu takes days to come on, and when epidemiologists trace an outbreak back, they can’t just check on where you were last night. You breathed it from someone else’s outbreath. Or you may have touched an infected doorknob and put your hand in your mouth or eye without knowing it.
Really serious diarrheas and other gut illnesses are sometimes diagnosed by pus all over the shit. Pus is incredible numbers of white cells. Beyond millions. Your diarrhea certainly contained some white cells, but a lot fewer, which could easily have been seen in a shit sample under the microscope, but not massed enough to be detected by the naked eye. Also guessing you didn’t look at your shit that hard.
White cells that want to get out into the shit stream squeeze their way between the mucosal cells standing lined up facing out into the shit, like special tactics forces in head to toe black, bent double, squeezing their way out between the knees of lined up blue-uniformed police. Even blood vessels will open up gaps between their lining cells to let white cells squeeze by. They reclose the gap after the white cell gets out.
Also, if there is a hole in a very small blood vessel (capillary bleeding), yes, sometimes the white cells will mass at the hole and bleed their way into the bowel. I hope you weren’t that sick.
Body cells are surprisingly willing to make the ultimate sacrifice. There are circuits in cells for something called apoptosis. They work like the Do Not Push This Button button in enemy ships in bad scifi movies. Push the button, the cell obligingly autodestructs for the good of its fellow cells. The whole shaping of the fetus depends on autodestruction of willing cells. Compared to that, flinging your white cell or your antibody out into the shit is mere kamikaze fulfillment - at least it gets to achieve the point of its little life while it dies.
One thing that probably helps with the cell-to-bacteria ratio is that the white cell is a focused killer. It will ignore great clouds of E coli and B fragilis to go after the salmonella for which it has been designated. Antibodies are even more specific than that; they can only go for one tiny molecular knob sticking out of one particular bacterial surface. On the other hand, you probably lose a lot of them that never hit their targets. A trade-off the body is willing to make.
Brossa? Dr Paprika? Colleagues? Where are you?
I once farted and shat myself 
in Benidorm, Spain.
Luckily I was in the sea at the time 
As a slight aside, I’ve been to many foreign countries and as soon as the airplane hits foreign airspace I get the poos.
Except when going to the USA
Ah, the TUMS overdose. They don’t call it “heartburn” for nothing. Many people I see seem remarkably bad at diagnosing “acid reflux” (This is/isn’t reflux, I know what that feels like) and constipation (sorry, the X-ray doesn’t lie). The exception to this is single men over the age of 60 who can describe every bowel movement from the last two weeks.
I’ve already talked about diarrhea and the World Dryer Corporation. I’m sorry, but us emergency doctors only get involved when the … shit hits the fan… ducks and runs :smack: