Ask any patient with irritable bowel syndrome (IBS) when their condition began and most will struggle to answer but the occasional patient will cite a specific date, saying “ I was fine until….” Such patients, who have a sudden onset of their IBS after an episode of infectious gastroenteritis, seem to be rather different from the others, or are they? As the current review1 shows, this area of research been very active, and the implications are both clinical, mechanistic, and therapeutic.