Health & Science

For Greater Houston families dealing with persistent diarrhea, vomiting or other intestinal illness symptoms this summer, knowing what to do after the worst discomfort begins to pass can be almost as important as knowing when to call a doctor.

Houston Methodist is offering a gradual recovery guide focused on preventing dehydration, reducing digestive irritation and helping patients safely return to their normal diets. The guidance comes as federal health officials investigate a sharp increase in cyclosporiasis, an intestinal illness caused by the microscopic parasite Cyclospora.

The Centers for Disease Control and Prevention issued a national health advisory July 14 after receiving reports of 1,645 laboratory-confirmed, domestically acquired cases since May 1 — compared with 249 cases reported by roughly the same point in 2025. At the time of the advisory, 141 patients had been hospitalized and no deaths had been reported.

National surveillance numbers have continued to change as health departments review thousands of additional reports. As of July 21, the CDC listed 4,173 confirmed domestically acquired cases and at least 7,400 additional cases requiring further investigation or laboratory confirmation.

Those figures represent nationwide surveillance and do not mean that every case is connected to the same food source or outbreak. Federal and state agencies are investigating multiple clusters, including a five-state outbreak linked to recalled iceberg lettuce. The CDC has also said it is investigating other Cyclospora illnesses that are unrelated to that particular outbreak.

Why hydration comes first after vomiting or diarrhea

Intestinal illnesses can quickly drain the body of water and electrolytes, particularly when symptoms include frequent watery diarrhea or repeated vomiting. That loss can leave patients feeling weak, dizzy and exhausted even after nausea begins to improve.

“The priority is preventing dehydration and allowing the digestive system time to recover,” said Dr. Saurabh Chandan, an interventional gastroenterologist at Houston Methodist West Hospital. “Replacing lost fluids and electrolytes, while easing back into solid foods can help support recovery and prevent symptoms from worsening. Most people can return to their normal diet within about a week. Additionally, good hand hygiene and avoidance of food preparation while symptomatic is strongly advised.”

Recovery timelines vary, and the following steps are intended as general guidance rather than a substitute for individualized medical care.

The first six hours: Start slowly with ice chips

Once vomiting has stopped, Houston Methodist recommends beginning with small amounts of frozen fluids rather than immediately drinking a full glass of water.

During approximately the first six hours, patients can try:

• Ice chips
• Popsicles

Taking in too much fluid too quickly may trigger additional nausea or vomiting. Small amounts give the stomach time to settle while beginning the rehydration process.

After six hours: Introduce clear liquids

When ice chips or popsicles stay down, patients can begin taking small sips of clear liquids every 15 to 30 minutes, gradually increasing the amount as they feel better.

Options may include:

• Water
• Apple juice
• Grape juice
• Clear broth

Houston Methodist recommends temporarily avoiding carbonated beverages and opaque drinks, including soda and dairy products, during this early stage of recovery.

People recovering from diarrhea should continue replacing fluids even after their appetite returns. The CDC also advises patients with frequent or severe diarrhea to remain well hydrated.

After 24 hours: Ease back into bland foods

Once fluids are tolerated and symptoms are improving, patients may begin eating small portions of bland, easy-to-digest food.

The commonly known BRAT diet includes:

• Bananas
• Rice
• Applesauce
• Toast

Other gentle options include crackers, plain oatmeal and plain grits.

These foods are not intended to become a long-term diet. They serve as a temporary bridge while the digestive system settles. According to Houston Methodist, many patients can gradually return to their regular diet within about a week, depending on the cause and severity of the illness.

Foods and drinks that may worsen symptoms

During the early stages of recovery, patients should temporarily avoid foods and beverages that can place additional stress on the digestive system.

Those include fried foods, fatty meals, spicy foods, alcohol and caffeine. People who regularly consume caffeine may need to balance stomach irritation against the possibility of a withdrawal headache.

Dairy products may also be difficult to tolerate immediately following some intestinal illnesses. Foods should be reintroduced gradually, with patients paying attention to whether cramping, nausea or diarrhea returns.

What is Cyclospora, and what symptoms should residents watch for?

Cyclospora is a microscopic parasite that causes cyclosporiasis. People can become infected after consuming contaminated food or water. The illness is not usually transmitted directly from one person to another because the parasite must spend time outside the body before becoming infectious.

Cases typically increase during spring and summer, with the CDC identifying May 1 through Aug. 31 as the annual cyclosporiasis season. Previous outbreaks have often been associated with contaminated fresh produce.

Symptoms may begin two to 14 days after exposure, although they commonly appear about a week later. The most recognizable symptom is frequent, watery diarrhea.

Other possible symptoms include:

• Loss of appetite
• Weight loss
• Abdominal bloating or cramping
• Nausea
• Fatigue
• Increased gas
• Low-grade fever
• Vomiting

Without treatment, symptoms may improve and then return, sometimes continuing for a month or longer. Although cyclosporiasis is not usually life-threatening, prolonged diarrhea can lead to dehydration and other complications.

Persistent diarrhea may require specific testing

Residents should contact a health care provider when watery diarrhea lasts more than a few days, repeatedly improves and returns, or is accompanied by signs of dehydration.

Routine stool examinations do not always reliably detect Cyclospora. The CDC is advising clinicians to specifically request Cyclospora testing when the infection is suspected, including molecular testing where available.

Confirmed cyclosporiasis is commonly treated with the prescription antibiotic combination trimethoprim-sulfamethoxazole, also known as TMP-SMX. Patients should not attempt to diagnose or treat the infection on their own and should consult a qualified medical professional.

Who faces the greatest dehydration risk?

Infants and toddlers, older adults, people with kidney disease and those with poorly controlled diabetes can be especially vulnerable to dehydration. These patients may need medical attention sooner than otherwise healthy adults.

Houston Methodist advises seeking medical guidance when:

• Symptoms continue to worsen or are not improving
• The patient cannot keep water or other fluids down
• Signs of dehydration develop
• Severe fatigue, confusion, dizziness or intense thirst occurs

Additional warning signs can include very little urination, a dry mouth, rapid heartbeat, fainting or unusual sleepiness. Severe symptoms may require urgent or emergency care.

How families can reduce the risk of Cyclospora infection

The CDC recommends washing fresh fruits and vegetables thoroughly under clean running water before eating, cutting or cooking them. Produce should be washed even when packaging says it is pre-washed.

Chemical produce washes and sanitizing products may not fully eliminate Cyclospora. Safe food handling remains important, but no washing method can guarantee that contaminated produce will be completely free of the parasite.

Anyone experiencing vomiting or diarrhea should avoid preparing food for other people while symptomatic. Handwashing with soap and water is especially important after using the restroom, changing diapers and before handling food.

Residents should also check current CDC and U.S. Food and Drug Administration recall information before consuming a product that may have been connected to an active investigation. The current lettuce-linked outbreak has involved recalled iceberg lettuce and illnesses reported in five states, while other Cyclospora clusters remain under investigation.

What Greater Houston residents should know next

Federal health officials continue to analyze reports and investigate potential food sources, meaning national case totals and outbreak details may change as additional illnesses are confirmed.

For local families, the practical message is straightforward: take prolonged watery diarrhea seriously, restore fluids gradually, avoid rushing back into heavy meals and contact a medical provider when symptoms persist or dehydration develops.

Residents can stay tuned to My Neighborhood News for continuing updates on public health advisories, food recalls and other information affecting Greater Houston families.

By Tiffany Krenek, My Neighborhood News 

Tiffany Krenek has been on the My Neighborhood News team since August 2021. She is passionate about curating and sharing content that enriches the lives of our readers in a personal, meaningful way. A loving mother and wife, Tiffany and her family live in the West Houston/Cypress region.