Food poisoning

Symptoms Of Food poisoning 

The symptoms of food poisoning range from mild to severe. The symptoms can start appearing from a few hours to several weeks later after having contaminated food. In most cases, symptoms resolve on their own or with the right home care within a few days of contracting the infection. 

Early signs 

These symptoms are the first to appear and are common to most types of food poisoning. These include:

• Nausea

• Vomiting

• Diarrhea

• Dull stomach ache, cramps, or a sharp pain

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The other symptoms might include:

• Headache

• Dizziness

• Intense thirst

• Diarrhea which may contain blood or mucus

• Dehydration

• Decreased urination

• Cold and clammy skin

• Slow pulse

• Fever

• Chills

• Muscle ache

• Lack of energy

• Loss of appetite

Individuals can also experience several long-term severe symptoms in some cases which include:

• Reactive arthritis (sometimes known as Reiter's Syndrome)

• Severe vomiting

• Profuse watery diarrhea

• Severe dehydration

• Confusion

• Seizures

• Muscle weakness

• Double vision

• Slurred speech
  
  

Did you know?

Stomach flu/viral gastroenteritis and food poisoning often share similar symptoms. The difference lies in the transmission. Stomach flu is mostly caused by viruses and is transmitted from person to person while food poisoning is caused by the ingestion of contaminated food and water. 

Causes Of Food poisoning 

Food poisoning is caused by the contamination of food by either microbes or any other toxins. 

A. Microbial contamination

1. Bacteria: It is the most common cause of food poisoning. The symptoms and severity of the infection depend upon the type of bacteria that has contaminated the food. Some of the bacteria that cause food poisoning are:

• Campylobacter: These bacteria usually contaminate raw/undercooked meat, raw milk, and contaminated water. The incubation period (time between exposure of bacteria to the onset of symptoms) is 2-5 days. The symptoms of this infection generally last for a week.

• Salmonella: The contaminated raw/undercooked meat, raw eggs, milk, and other dairy products are the main sources of these bacteria. The symptoms start appearing between 12 to 72 hours. 

• Listeria: These bacteria are found in “ready-to-eat” foods such as pre-packed sandwiches, hot dogs, cooked sliced meats, and soft cheeses. The symptoms can appear from a few days to several days. The food poisoning usually resolves within 3 days.

Note of caution: Pregnant women are 10 times more likely than other people to get Listeria infection. It can cause complications such as miscarriage, stillbirth, or premature birth.

• Escherichia coli (E. coli): These bacteria normally inhabit the intestines of several animals and humans. Most of their types are harmless but some of them can cause food poisoning. The bacteria contaminate food such as undercooked beef and unpasteurized milk. Symptoms usually start appearing within 1 to 8 days of contracting the bacteria and last for a few days. 

• Shigella: Any food such as fruits and vegetables washed in contaminated water can be exposed to shigella. Symptoms typically develop within seven days of eating contaminated food and last for up to a week.

• Bacillus cereus: This microorganism mainly develops in improperly stored food. The infection with Bacillus is characterized by diarrhea and vomiting. 

• Staphylococcus: It is most commonly found in undercooked meats, eggs, and dairy products. 

•  Vibrio: This type of bacteria are commonly found in coastal water and can contaminate oysters, fish, and shellfish. Symptoms can start appearing 1 day after infection and usually resolves in 3 days. 

• Clostridium: This bacteria contaminates food that is cooked in large batches. The common food items that may contain this bacteria include poultry and meat. 

1. Parasites: Parasites are the organisms that drive their nutritional requirements from other living organisms. The symptoms of food poisoning caused by parasites develop within 10 days of exposure to the parasite. The common examples of parasites that cause food poisoning are:

• Giardia intestinalis

• Cryptosporidium

• Entamoeba histolytica

2. Viruses: The viruses that can cause food poisoning spread through contaminated water. It can also spread via a person infected with the virus while preparing or handling food. The common viruses that cause food poisoning include: 

• Rotavirus

• Adenovirus

• Parvovirus

3. Fungi: There are several fungi that may cause food poisoning. Some fungi produce harmful chemicals that contaminate foods. The common examples of fungi that can cause food poisoning are:

• Alternaria

• Aspergillus

• Candida

• Fusarium

B. Non-microbial

In some cases, harmful chemicals are already present in the food which can cause food poisoning. Fish and shellfish may contain toxins produced by algae or bacteria present in water. 

Unwashed produce may also cause food poisoning due to the presence of pesticides used during crop production.

The contaminants can be of: 

1. Vegetable origin (Mushrooms)
2. Animal origin (Shellfish)
3. Chemicals (Flavouring agent, coloring agent, and preservatives)

How does the food get contaminated?

Food is not only contaminated in the kitchen. It can be exposed to contamination during its production, harvesting, processing, storing, shipping and preparation. 

Microbes can cause food poisoning if they are not washed off or killed before consuming. The following things can keep the microbes alive to cause food poisoning:

• Consuming partially cooked food

• Keeping cooked food unrefrigerated for a long period

• Storing packaged food at the wrong temperature 

• Promptly refrigerating hot food

• Keeping raw foods such as beef, poultry, and eggs together with ready-to-eat foods
  
  

The microbes of food poisoning can also spread through an infected person via:

• Eating food that is touched by the infected person

• Cross-contamination (where harmful bacteria are spread between food, surfaces and equipment)

• Sometimes, food poisoning can also occur through having ready-made contaminated food

• Touching contaminated surfaces and objects such as handrails, elevator buttons, utensils, and doors while eating or handling food

• Sharing food and beverages with the infected person

Risk Factors For Food poisoning 

Any individual can suffer from food poisoning but there are some groups of people that are more prone to it. These people include:

1. Children younger than 5 years of age

Children have an underdeveloped immune system so the chances of getting any infection is higher in them. Food poisoning can cause severe diarrhea and dehydration in children. It is also seen that children are 3 times more prone to be hospitalized if they get Salmonella infection.

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2. Pregnant women 

Pregnant women are more prone to food poisoning. Studies suggest that pregnant women are 10 times more likely to get a Listeria infection. 

3. Older people above 65 years of age

The immune system of older people is compromised due to which the chances of infections in these groups of people are high. 

4. People with weakened immune system

Some individuals have a weakened immune system which can be a cause of recurrent food poisoning. The disorders that can contribute to the weakened immune system include:

• Diabetes

• Liver disease

• Kidney disease

• Cancer

• HIV infection

5. Consuming certain food 

There are some food items that are more prone to microbial contamination and thus food poisoning. Such items include raw meat, unpasteurized milk, fish, shellfish, eggs, poultry, cheese, raw fruits, vegetables, nuts, spices, beef, salad, seafood, sprouts, and raw flour. The frequent consumption of such foods increases the risk of food poisoning. 

6. Other factors

• Purchasing food from unauthorized sources

• Cooking the food at the wrong temperature

• Storing the food without refrigeration

• Practicing poor personal hygiene such as not washing hands before eating or serving food

• Using contaminated food and utensils.

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Diagnosis Of Food poisoning 

There are no specific tests to diagnose food poisoning. In most of the cases, symptoms are mild and last for a few hours. In case of severe poisoning, the following steps can help your doctor determine cause of your food poisoning:

1. History taking

It is the first step to establishing food poisoning. Your doctors will ask for a set of questionnaires to identify the agent of food poisoning. The questions can be asked regarding:

• Recent meal that you have taken

• Recent place of travel, if any

• Other people you know having similar symptoms

• Medicines you are taking

Your doctor also asks about the symptoms you are experiencing. This information helps in establishing the cause and type of food poisoning.

2. Physical examination

It is done to see the changes in the body as per the symptoms experienced. During a physical exam, your doctor may: 

• Examine the blood pressure to check the signs of dehydration

• Check the temperature to confirm fever

• Assess the abdomen using a stethoscope

• Inspect any tenderness or pain in the abdomen through tapping.

3. Laboratory tests

The type of contaminant is diagnosed through several tests. The microbial contaminant is assessed using samples of blood, urine, vomit or stool. It also reveals the severity of poisoning. It usually include following tests: 

• Stool tests: The stool is examined for the presence of bacteria, parasites or blood.

• Blood test: Blood tests are performed to look for any sign of complications such as dehydration and kidney abnormalities. It includes assessing the level of electrolytes and other markers of kidney function. 

• Urine test: It is also done to look for bacterial infection. 

4. Imaging tests 

• Abdominal ultrasound: This imaging test look at organs in the abdomen, including the intestine, liver, gallbladder, spleen, pancreas, and kidneys. It is an extremely useful imaging modality for evaluating the patient with acute abdominal symptoms.

• Abdominal X-ray: In some cases of poisoning, an abdominal x-ray may check the presence and location of the ingested substances. Toxins that may be visible on x-rays include iron, lead, arsenic, and other metals. 

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Specialist To Visit 

Food poisoning often resolves on its own without seeking medical advice. The specialty of doctor that may help in diagnosing and treating food poisoning include: 

• General physician
• Gastroenterologist
• Pediatrician (for kids)

A gastroenterologist is a specialist in the disorders and diseases that affect the digestive system. A pediatrician is a doctor who deals with the diseases of children. 

When to see a doctor?

Some symptoms of food poisoning should not be ignored. Consult your doctor immediately if you have any of the following symptoms:

• Persistent vomiting or diarrhea for more than three days

• Inability to keep fluids down for a day or longer

• Watery or bloody diarrhea

• Fever higher than 102 degrees

Signs of dehydration 

Any sign of dehydration should not be ignored. The sign of dehydration include:

• Extreme thirst

• Dry mouth

• Dark urine

• Infrequent urination

• Dizziness

• Tiredness

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Prevention of Food poisoning 

Food poisoning can be prevented by practicing hygiene while storing, handling or preparing food. The following measures can reduce the chances of food poisoning:

A. Follow safe practices

1. While buying food items

• Buy foods such as meat and seafood from hygienic outlets
• Do not buy food items whose expiry has elapsed
• Do not purchase undercooked or raw meats
• Buy only pasteurized (heat treated to kill the disease-causing microbes) milk and cheese
• Do not buy cracked or leaked eggs
• Choose fresh fruits and vegetables
• Check for any damage, rusk or dent on cans while buying beverages
• Take frozen and refrigerated items from an authentic grocery store

2. While storing food

• Keep raw meat, poultry and seafood in separate bags during refrigeration to avoid cross-contamination 
• Keep the temperature of the main section below 4oC
• Store the food as per the instructions on the label
• Keep cooked leftovers quickly in the refrigerator
• Keep raw cereals and dough away from the reach of children

3. While cooking and handling food

• Do not leave cut vegetables and fruits uncovered 
• Cook the food thoroughly
• Cook the eggs until both the yolk and white are firm
• Discard the food in case of a suspicious look and smell
• Make sure that the food is steaming all the way through while reheating
• Avoid reheating food more than once

4. While traveling

• Drink only boiled or bottled water
• Avoid eating raw vegetables and salads
• Avoid buying food from unhygienic vendors

5. While dining out 

• Avoid taking dishes that contain undercooked eggs, sprouts, meat, poultry, or seafood

B. Maintain proper hygiene

• Wash your hands, counters, and cutting surfaces between preparation of different foods
• Use glass or plastic cutting boards for chopping vegetables or meat instead of wooden boards for ease of cleaning
• Wash fresh fruits and vegetables under running water
• Avoid contact with sick persons while handling or preparing food
• Ensure sanitation of the painting floors, utensils, and other articles in the kitchen
  
  

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C. Clean the refrigerator frequently

The refrigerator should be cleaned thoroughly along with removable parts. The following measures should be taken while cleaning refrigerator:

• Dispose off the contaminated food in a garbage bag
• Wash the container in which contaminated food was stored with soap and water
• Avoid leaving food out of the refrigerator for more than 2 hours

Treatment of Food poisoning 

The treatment of food poisoning is based upon the cause and symptoms. The most important goal of the therapy is to maintain hydration and electrolyte balance.

Fluid therapy

• Most cases of mild dehydration can easily be managed at home through fluid therapy.

• It is advised to drink plenty of fluids like water, coconut water to compensate for water loss and prevent dehydration. 

• Oral rehydration solutions(ORS) are preferred over other clear fluids for managing diarrhea.

• Patients having severe dehydration and persistent vomiting may require hospital admission for continuous monitoring of electrolyte levels. 

• Enteral (oral or nasogastric) and intravenous fluids (saline solution and lactate Ringer’s solutions) are given to patients facing difficulty in taking fluids due to nausea, vomiting, and to correct electrolyte levels. 

Medications

• Antibiotics: They are mostly used to treat food poisoning caused by bacteria. Some of the commonly used antibiotics are: 

  • Metronidazole

  • Ceftriaxone

  • Azithromycin

• Antiemetics: Antiemetic medications are the drugs that are used to control nausea and vomiting. The commonly used antiemetic medications are:

  • Ondansetron

  • Metoclopramide

• Antidiarrheal medications: These are drugs that relieve symptoms of diarrhea. These are used only in those patients who are not able to maintain a well-hydrated status. Medications include: 

  • Diphenoxylate

  • Loperamide

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Home Care For Food poisoning 

1. Keep a watch on fluid intake

It is advised to have plenty of fluids like fresh fruit juices, coconut water, clear soups etc. In case of severe vomiting, take small sips of fluids at regular intervals. The mothers of the infected infants should make sure that their babies are getting enough breast milk. 

2. Have ice chips

If you are facing difficulty in digesting fluids, try to suck ice chips. This also helps in rehydration. The ice chips should not be given to small children. 

3. Consume BRAT diet

B.R.A.T stands for bananas, rice, applesauce, and toast. These food items should be included in the diet as it helps in making the stool smooth and helps in compensating the nutrient loss from vomiting and diarrhea.

It is also advised to consume smaller easy to digest meals at regular intervals.

4. Try herbal remedies

In most of the cases, food poisoning can be managed by simple home remedies like:

• Ginger (Adrak): It possesses anti-inflammatory, anti-viral, and anti-bacterial properties. It also eases nausea. It can be taken in raw form or can be boiled in water or tea. 

• Apple cider vinegar (ACV): It can soothe an irritated stomach and thereby reduce nausea, vomiting, and abdominal cramps. Add 1 teaspoon of apple cider vinegar to a glass of warm water and drink 30 minutes before eating a meal.

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• Yogurt (Dahi): It contains a lot of good bacteria that help in maintaining the overall good health of the gut. It also helps in reducing watery diarrhea. It should be added to every meal of the patient suffering from food poisoning. 

• Cinnamon (Dalchini): It has antibacterial and antiviral properties which can be used for combating food poisoning. It also helps in reducing stomach pain and bloating. 

• Turmeric (Haldi): Curcumin, present in turmeric, possesses anti-inflammatory properties. It can be consumed by adding a glass of warm water or milk. 
  
  

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• Basil (Tulsi): It possesses antispasmodic properties and helps in reducing spasms in food poisoning. It also has gastroprotective properties which aid in relieving symptoms of food poisoning. 

• Peppermint (Pudina): It soothes the stomach and helps in treating bloating and gas. The most effective way to use it is to consume it in the form of tea. 

• Triphala: It is known to improve digestive health and also helps in the absorption of nutrients. 

• Coriander (Dhania): It possesses healing properties and it is known to alleviate the symptoms of upset stomach and diarrhea.

• Asafoetida (Hing): It is known for years to strengthen the digestive system. It possesses antiviral and antibacterial properties. It can be added in meals or can be consumed with lukewarm water. 

• Licorice (Mulethi): It also promotes the healing of an inflamed stomach and treats indigestion. 

• Rice water: It is used especially in infants to reduce diarrhea. 

• Chamomile tea: It is used as a digestive relaxant and can help in the treatment of many gastrointestinal disturbances, like diarrhea and vomiting, which is most commonly observed in food poisoning. 

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5. Avoid certain foods

Certain food items should be avoided as they can make the stomach upset and can cause indigestion. The impaired digestion can aggravate diarrhea and vomiting. These include:

• Milk
  

• Greasy and spicy food containing chilly, black pepper, and garlic 
  

• Drinks with caffeine, such as coffee and tea, and soft drinks.
  

• Fatty junk foods such as fried foods, pizza, and fast foods.
  

• Foods and drinks containing large amounts of simple sugars, such as sweetened beverages and packaged fruit juices.

6. Take proper rest

People should take proper rest even after the completion of therapy. This will lead to complete recovery and healing of the digestive system. 

7. Try heating pad 

Some patients suffer from severe abdominal pain. Such patients can use a heating pad to relieve cramps. 

8. Say no to alcohol

Alcohol can cause inflammation in the stomach. This can increase the secretion of gastric acid. So, alcohol should be avoided as it can increase the feeling of vomiting (nausea).

Complications of Food poisoning 

Untreated food poisoning can lead to the following complications :

• Chronic diarrhea

• Inflammatory bowel disease (condition in which there is an inflammation of small intestine and large intestine) 

• Irritable bowel syndrome (condition characterized by abdominal pain)

• Arthritis

• Hemolytic uremic syndrome (a kidney condition that happens when red blood cells are destroyed and block the function of the kidney)

• Guillain-Barre syndrome (neurological disorder in which immune system attack the nervous system)

• Nervous system infections such as meningitis.