Spending formal dinner night on the cruise ship with your head slumped on the white-linen tablecloth – that’s food poisoning. Crawling to the bathroom, too weak to stand – that’s food poisoning. When you regurgitate and it tastes not just like the meat you ate, but like spoiled meat that sat in a Dumpster overnight – that’s food poisoning.
You’re most likely to hear about food poisoning as part of multistate outbreaks. These are most often caused by contaminated fish, shellfish, chicken and dairy foods, according to the Centers for Disease Control and Prevention. However, many more illnesses related to foodborne disease occur in isolation and are never reported. Here’s how to tell if you’re suffering from food poisoning, and what you can do to recover.
Mystery and Misery
Dr. Anthony Ng sees several patients with food poisoning daily at GI Health, his New York City practice. What people think of as “stomach flu” is frequently viral gastroenteritis or food poisoning, says Ng, who is also an attending physician at both Mount Sinai Beth Israel and NewYork-Presbyterian Lower Manhattan Hospital. Sometimes the culprit is a virus, like norovirus, which is notorious for causing mini-epidemics on cruise ships. Bacteria, parasites and toxins are other common causes.
“Occasionally, you’ll get cases of people who come back from travel, or something very obvious, where they had eaten at a barbecue and other people who ate with them also felt sick,” Ng says. Or patients may recall eating sushi that clearly tasted “off.” However, he says, “most of the time, it’s a mystery where that food poisoning arose from, or exactly when the infection occurred.”
“There’s generally an incubation period, especially for bacteria,” Ng says. “So that when you come into contact with an offending organism, you may not develop symptoms right away. It can actually lag for a few days – even up to a week.”
Once food poisoning erupts, it hits quickly and hard. “One day or one minute people weren’t sick, and very soon they became ill,” Ng says. Sudden symptoms include a bloated feeling, extreme abdominal pain, nausea and vomiting, cramps, watery diarrhea and fever.
When It Hits
It was an unforgettable day for Diane Taheri. It happened about two years ago. With a video conference planned for that afternoon, she put on a nice ivory suit and headed to her Dallas workplace. Around noon, she went to a restaurant in the same building, one where she’d eaten at least 50 times before. But instead of her usual menu choices, she felt like a change.
“This particular day, they had pasta that had a richer sauce than what I would normally eat,” Taheri says. It was a cheesy sauce, she says, that probably contained cream. “That, I think, might have been the culprit,” she says. “It had a slightly funny taste to it. But it still tasted good – not horrible, like it was obviously bad.”
At 2 p.m., Taheri joined her video conference. As stomach symptoms suddenly raged, she tried to sit them out but couldn’t. Fortunately, she had a colleague in the room. “I finally looked at him and said, ‘I am really feeling horrible. I need to leave.'”
While she was in the restroom throwing up, a concerned co-worker heard her. “So the office nurse shows up with what I call an entourage,” Taheri says. “It was a security person and a facilities person. And they brought a wheelchair.” The nurse also wanted to listen to her heart, to Taheri’s initial surprise.
Taheri, who is the president and founder of My Breast Choice, a nonprofit focused on educating patients on treatment options, later learned that women can experience gastric symptoms when they’re having a heart attack. In this case, however, food poisoning was the most likely suspect, and when she finally felt able to stand and leave the nurse’s station, she went home to recover.
Flush Your System
Food poisoning usually gets better on its own within a few days, Ng says. Drinking plenty of fluid, especially water, is the first line of treatment to replace lost fluid and prevent dehydration. Sports drinks can help replenish important electrolytes such as calcium and potassium. “When you have that type of electrolyte imbalance, you will have muscle weakness and sometimes muscle cramping,” Ng says.
At home, Taheri was past the nausea and vomiting, but she felt weak and shaky. She turned to a remedy from her childhood: a can of 7UP to settle the stomach. Taking tiny sips, it took an entire day for her to finish that single can. The next morning she was able to drink some water and eat some bread. The following day she felt fine, and she was back to work the same week.
Start With Bland Foods
People suffering from food poisoning make one common mistake, Ng says. “They tend to reach for medications like Pepto-Bismol and Imodium in order to cure their diarrhea,” he says. “More often than not, that makes the situation worse.” Vomiting and diarrhea are the body’s natural way of eradicating an infection, he explains.
The next rule of recovery is to stay away from certain unhelpful foods. Dairy products can exacerbate diarrhea, and greasy foods are another no-no. “We tell people to avoid foods that can make you sicker,” Ng says. “No sushi or carpaccio; no raw stuff at all.”
Salads are temporarily off limits because of the lettuce and other raw ingredients. “Anything that’s uncooked, anything that is raw or anything that is not hot or not fresh, I generally tell patients to stay away from it, at least for three to seven days,” he says.
Following the BRAT diet – bananas, rice, applesauce and toast – can keep people comfortable instead of queasy. Bananas are rich in potassium, and they also have binding properties.
See a Doctor When …
If you can’t keep food or fluid down, call the doctor. “That, to me, is a differentiating critical point for treating the patient at home versus sending them to the hospital or sometimes having them hanging out in our office to give them some I.V. fluid,” Ng says. Patients might also receive medicine to relieve nausea or cramping.
The threshold is lower for kids to see their pediatrician. “There is definitely more of a risk in children of becoming dehydrated when they fall sick and have vomiting and diarrhea,” Ng says.
Similarly, it’s safer for older adults to see a doctor. “Anybody who is frail and elderly, meaning above 75 years old, who has [coexisting] illnesses such as diabetes, heart disease or kidney disease, should definitely err on the side of caution,” Ng says.
Medication issues may need to be addressed for certain patients who can’t take pills properly because they can’t hold down water. For instance, Ng says, high blood pressureor diabetes could spiral out of control with several missed doses.
Depending on the cause of the infection, the severity and their individual health situations, a minority of patients may eventually be treated with antibiotics. Pregnant women who suspect they have food poisoning should talk to their health care providers.
Case of Cramping
Recently, Ng treated a case of food poisoning in his own family. Randy Ng, his cousin, says it felt different from any previous bouts of stomach illness: “This time, I just had the most extreme cramping,” he says. The onset was “sudden and strong. Very strong.”
He has no clue where the infection came from. “Basically, my wife ate the same thing I ate for the last three days, and she’s perfectly fine,” Randy Ng says. His cousin prescribed medication to ease the stomach spasms, says Randy, who had immediately started sipping on sports drinks.
He’s able to eat now but is staying away from raw or greasy food. “My stomach is not 100 percent,” he says. “It’s definitely much better than it was a day or two ago.”
Prevention Worth a Pound …
If the source of food poisoning is traceable, let your local health department know. And learn how to protect yourself, family and guests from when selecting, preparing, storing and serving food.
Dr. Ng says he avoids eating sushi in U.S. restaurants, where preparation is not yet as safe as in Japan. New York City, at least, is catching on, Ng says, pointing to a new regulation, reported last July by The New York Times, requiring restaurants to freeze raw fish before serving.