Is It Really Food Poisoning?

It could be intolerance to a certain food, or just stomach irritation.

From the WebMD Archives

You enjoyed every bite of the pasta alfredo, flame-grilled burger, or creme brulee but hours later you're sprinting, nonstop, to the bathroom.

After vomiting or having diarrhea, you may not be thinking kindly of the restaurant or your BBQ host, figuring you have food poisoning.

But is it really? Your upset stomach could be caused by a food intolerance or irritation -- your GI tract and creme brulee simply don't get along.

In the U.S., about 76 million people get sick each year from food-borne illnesses, and more than 300,000 are hospitalized, according to the Centers for Disease Control and Prevention. Although food-related illness is often short and mild, it can sometimes be life-threatening. About 5,000 people in the U.S. die each year from food-borne illnesses.

Figuring out if food-related problems are indeed food poisoning isn't always easy, not even for doctors. Here’s how to tell, and how to determine if you need medical help.

What Is Food Poisoning?

''Food poisoning is a non-medical term," says Jay Solnick, MD, professor of medicine and an infectious disease specialist at the University of California Davis School of Medicine. But it typically means bacteria in the food made you sick.

A range of organisms and toxins that can cause food poisoning, including Campylobacter, Salmonella,Shigella, E. coli 0157: H7, Listeria, and botulism.

Certain foods are considered "high risk" for food poisoning, says David Burkhart, MD, staff physician at the Indiana University Health Center in Bloomington, who has published a scientific article on the topic.

High-risk foods include: dairy products, raw seafood, raw eggs, lunch meat, undercooked meat, and poultry. "Those are some of the major foods that oftentimes will be contaminated," Burkhart says.

Symptoms of food poisoning vary, but typically include vomiting, diarrhea, and abdominal pain. Fever can occur, too. The severity of symptoms, as well as the symptoms themselves, varies.

Some people have fever, others don't, Solnick says. Abdominal pain can be mild or severe.

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What Else Can Cause Nausea and Vomiting?

Sometimes, bacteria are blamed unfairly, Solnick and other experts say. "You can be intolerant of something," Solnick says. For instance, those with lactose intolerance have trouble digesting the lactose sugar found in milk. Those who are gluten sensitive have intolerance to wheat.

You could also have a stomach virus or gastroenteritis, a condition that leads to irritation and inflammation of the stomach and intestines triggered by infection, says Jason Dees, DO, a family physician in New Albany, Miss., and a member of the board of directors of the American Academy of Family Physicians.

"With food poisoning and gastroenteritis, the symptoms can look like each other," Dees says. "Differentiating the two can be really difficult."

How Do You Know if It's Food Poisoning?

"A lot of times it is not possible to confirm one way or the other if it's food poisoning," Burkhart says.

But doctors will try, taking a careful history, which can yield clues. For instance, Burkhart says if symptoms start before you’ve even finished the meal -- your stomach starts to feel queasy -- it's a good guess you've been infected with an organism that causes food-borne illness.

If everyone who has eaten at the same picnic or restaurant is suddenly sick, that, too, points to food poisoning.

Food Poisoning: What Can You Do to Self-Treat?

If the food-borne illness is mild, you can treat yourself and wait for symptoms to pass, experts say. You can lower a slight fever with acetaminophen. (Call a doctor for high fevers.)

Keep yourself (or your child) hydrated by drinking plenty of fluids. "Make sure you take frequent sips of water, or drink clear soups, clear sodas, or juice mixed with water," Dees says.

You can also buy oral rehydration solutions, such as CeraLyte, Oralyte, and Pedialyte. "That has the right mix of all the salt, sugar, and other nutrients you lose when you have diarrhea or vomiting," Dees says.

Dee says many sports drinks don’t have the ideal balance of electrolytes, and should be avoided.

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When Should You Call the Doctor?

"If the abdominal pain is severe, it's worth seeing the doctor," Solnick says. "If you have intractable vomiting, it's worth seeing the doctor."

Anyone at serious risk from dehydration should call the doctor, including young children, the elderly, and people with underlying medical conditions, such as those with chronic heart problems.

Burkhart offers this advice: "If you are vomiting so badly and having so much diarrhea you are getting lightheaded when you stand up and can't keep fluid down," it's time to see a doctor.

Other reasons to call the doctor:

  • Neurologic signs, such as numbness.
  • A fever over 100 degrees, especially if you can't control it with acetaminophen.
  • Blood in the mucous or stool.
  • Vomiting that persists more than a couple of days.
  • Diarrhea that is substantial and persists more than three days or so.

True Food Poisoning Is a Public Health Concern

If a group of you has gotten sick after a trip to a restaurant or attending a barbecue, tell the doctor, Solnick says. "That's important for public health [departments] to know," he says, so they can investigate the restaurant or food supplier.

Your doctor may try to culture the stool to figure out which organism may be to blame, Dees says. If a bacteria is found – and your case is severe – the doctor may prescribe antibiotics. But often the doctor won’t prescribe antibiotics because you’ll probably recover in several days without treatment.

For severe vomiting, your doctor may prescribe a drug called an antiemetic, which may help ease vomiting.

Is there any good news?

"Most kinds of food-borne illnesses are self-limited," Burkhart says. You can expect to recover within a few days.

WebMD Feature Reviewed by Brunilda Nazario, MD on 8/, 009

Sources

SOURCES:

Jay Solnick, MD, professor of medicine and infectious disease specialist, University of California Davis School of Medicine.

Jason Dees, DO, family physician, New Albany, Miss., and board of directors member, American

Academy of Family Physicians.

David Burkhart, MD, staff physician, Indiana University Health Center, Bloomington, Ind.

WebMD: "Food Poisoning Health Center."

WebMD: "Gastroenteritis."

Centers for Disease Control and Prevention: "Food-Related Diseases."

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