Well first, stomach acid can kill many germs but not all of them. Second, in some cases of food-borne illness, it’s not the germs themselves that make you sick but toxins created by the germs, and stomach acid doesn’t do anything to those toxins. This is why can’t eat spoiled food even if it’s cooked. Yes, cooking may kill the germs, but it still leaves the toxins that make you sick.
One thing I haven’t seen mentioned is that most food based illness in the developed world isn’t due to bacteria, but norovirus. Norovirus will quite happily move through your stomach to your small intestine where it sets up replicating and irritating your gi tract. Then when it’s done enough damage it exits (in both directions) and gets spread onto every surface in your bathroom when you flush the toilet. Anyone who touches those surfaces can then infect themselves by putting their fingers or something they touch in their mouth, or infect others by failing to wash their hands (with bleach; norovirus largely ignores soap) and then serving/cooking their food.
The same way we claim a dogs mouth is cleaner than a humans. The bacteria in a dog’s mouth isn’t as harmful to us as some of the bacteria that grows in our own…especially the ones that rot our teeth and inflame our gums. As food is consumed by bacteria in the fridge or counter, it’s releasing toxins that affect us when we eat them. Those bacterial growths and their toxins are what make us sick, not the food itself.
A lot to unpack here but here it goes:
First, there are two main ways that bacteria cause foodborne illness: intoxications and infections
1. Intoxications: Bacteria grow in the food and make toxins, and then you eat the food with the toxin and get sick. The toxins are acid resistant enough that the stomach acid doesn’t do anything to them.
2. Infection: Stomach acid can and will kill some of the germs, but enough survive to get into your intestines and cause an infection.
Edit: spelling, grammar
People have touched on almost everything, but it effectively boils down to a few factors;
– the bacteria type
– does the bacteria produce a toxin that *isn’t* broken down by stomach acid?
– how *much* bacteria are you getting in the bolus of food? One of the things I hadn’t seen addressed here is that you can get sick if the number of colony forming units (CFUs) outnumber the amount of acid that gets them. If you wanted to raid a castle that had a moat around it, and you had an unlimited number of soldiers, and you were a psychopath…well, just continue throwing soldiers at the castle until the moat fills up with dead people, and then climb over it. Sure, lots of bacteria will die in that acid bath…but some might make it through the gates on the dissolving bodies of their comrades and make a nice home in your guts.
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