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“I’m fine,” you muttered. Kelly knocks again. “You’ve been in there a long time, Jen. You sure you don’t need any help?”
“I’m fine!,” you yell back from the bathroom stall. This is the fourth time you have had diarrhea today, and this cramping in your abdomen is not going away! You also are sweating, and having a mild headache, chills and fatigue. “I’ve never had a hangover this bad,” you mutter to yourself. You only had 3 margaritas last night. But then you recall that you had those amazing “al pastor” tacos from the food truck last night as well!
Gastroenteritis (food poisoning) is a major cause of illness in the United States. Approximately 179 million episodes of gastroenteritis occur per year, and the disease results in ~600,000 hospitalizations. Here Haute MD expert Dr. Akash Mehta explains the details surrounding treating food poisoning.
Causes
A specific cause is only found in ~20% of cases, but viruses are recognized as being the most common cause. This is because of the lack of diagnostic tests available in regular medical settings. There are a large variety of viruses, bacteria, and parasites that can cause gastroenteritis; thus, the less common tests for these organisms are usually found only in research and public health laboratories.
Symptoms
The main symptoms of food poisoning include nausea, vomiting, and diarrhea. They can also include abdominal cramping and fever. The fever itself can cause more systemic symptoms that are common almost any time you have a fever—muscle aches, chills, headache, fatigue. Sometimes, the illness can lead to bloody stools. This may indicate a bacterial infection that may or may not require prescription antibiotics. If you experience bloody stools, I recommend seeking out immediate medical attention with your primary care doctor, and if not able, to go to the nearest Emergency Department (ED) for further evaluation and treatment.
Treatment Options
Hospital Care
Most cases of gastroenteritis are self-limiting. The affected individuals will usually get better on their own, and most cases of viral gastroenteritis last less than 7 days. However, know there are over half a million hospitalizations and more than 5,000 deaths from gastroenteritis per year in the United States. How can this happen? Well, first, fluid loss from vomiting and diarrhea can lead to severe dehydration. Additionally, if the illness is caused by bacteria or parasites, the illness can be more severe in intensity and duration. Thus, dehydration can be more intense and may require prescription antibiotics or anti-parasitic medication.
The mainstay for treatment is hydration, which is best done with fluids with electrolytes. This is because the vomiting and diarrhea contain water and electrolytes, and can lead to dangerous electrolyte imbalances in your body. Commercially available oral electrolyte solutions can be found at nearly any drugstore; Pedialyte® is a common brand name. Sports electrolyte drinks are often more widely available and less expensive, such as Gatorade® and Powerade®. However, the original versions of these can often contain a large amount of sugar, which can make symptoms worse. I would recommend diluting these with water, with about a half-half mix, if you want to use these.
Over-the-counter (OTC) treatment
Treatment outside of a hospital can also include treating the symptoms. Over-the-counter (OTC) medicines such as acetaminophen and ibuprofen can be used to treat fevers and pain; loperamide is also available over the counter to treat diarrhea. (Most medicines to help vommitting in the United States require a prescription.). And of course, prescription antibiotics and anti-parasitic medicines may be needed in certain cases. However, do not start taking any OTC/prescription medicines or supplements without consulting with a medical professional. Even OTC products have numerous dangerous interactions with other medicines and supplements and have numerous side effects that can be dangerous for different pre-existing conditions (such as kidney or liver disease, stomach ulcers, etc.)
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Can Gastroenteritis spread?
The micro-organisms that cause gastroenteritis can be contracted in various ways, and viral causes are extremely contagious. They can be spread by simply a handshake or touching a countertop. The organism can be on a person’s hand or a countertop from improperly cooked food, or residual vomit/feces. Then you may accidentally put your hand after contact in your mouth and ingest the organism. Sharing food/drinks is also a common vector. As far as spread by food, usually, it’s food that’s been improperly cooked, left out of proper storage for an extensive period of time, or reheated.
Prevention of spreading and contracting the disease mostly centers around disinfection and avoidance of certain situations (something that most of you should be knowledgeable about after the recent COVID-19 pandemic). Please isolate yourself until about 48 hours after the symptoms have resolved. Wash your hands thoroughly after using the bathroom, and before and after handling food/drink. Keep cold food cold (below 5°C) and hot food hot (above 60°C) to discourage the growth of bacteria. When traveling overseas to countries where sanitation is suspected, only drink bottled water. Don’t forget to brush your teeth in bottled water too. Avoid food buffets, uncooked foods or peeled fruits and vegetables, and ice in drinks.
When should you visit an Emergency Department (ED)?
Bloody diarrhea or symptoms for more than 6 days can indicate a bacterial/parasitic infection, so please try to visit a medical professional immediately. Urgent care or ED would be recommended if you cannot do so.
Moderate to severe dehydration and severe electrolyte imbalances can require hospitalized care. These can include consistently very high fevers (above 39.5°C), lack of sweating, very dark or very low output of urine, dizziness, near-fainting, fainting, confusion, drowsiness, palpitations, seizures, vision changes, numbness/tingling, severe muscle cramps, and others. If you develop these symptoms, please call your local Emergency Medical Services (EMS) immediately (which are called by dialing 9-1-1 in the United States.)
Gastroenteritis can also initially mimic other more dangerous illnesses, such as appendicitis, severe colon infections, colon obstruction, ischemic colon (like a “heart attack” of the colon), diabetic emergencies, severe allergic reactions and others. Worsening and severe abdominal pain can be indicative of very dangerous intra-abdominal disease. Metabolic diseases such as diabetic emergencies usually come with moderate and severe dehydration quickly, and of course, patients with pre-existing conditions such as cardiac disease and diabetes are more inclined to have dangerous bowel conditions and diabetic emergencies. Severe allergic reactions often include itching and a rash. Please contact EMS immediately if your gastroenteritis symptoms are accompanied by such red flags.
All in all, gastroenteritis is a very common illness, and most cases are self-limiting. Prevention of contraction and spread centers around sanitary practices, and properly cooking and storing food. Nausea, vomiting, and diarrhea are the main symptoms that define this illness. Symptoms that may require immediate medical attention include but are not limited to bloody stools, fevers for more than 6 days, symptoms of moderate to severe dehydration, severe abdominal pain, and rash.
