From the Guidelines
Acute food poisoning should be managed primarily with fluid replacement and rest, as most cases are self-resolving and do not require antibiotics. The main goal of treatment is to prevent dehydration and manage symptoms. According to the 2017 Infectious Diseases Society of America clinical practice guidelines for the diagnosis and management of infectious diarrhea 1, acute gastroenteritis is a frequent cause of outpatient visits and hospitalizations in the United States, with an estimated annual burden of 179 million outpatient visits, nearly 500,000 hospitalizations, and >5000 deaths.
To manage symptoms, patients can take over-the-counter medications like loperamide (Imodium) for diarrhea (2mg after each loose stool, maximum 8mg/day) or bismuth subsalicylate (Pepto-Bismol) following package directions, as these have been shown to be effective in reducing diarrhea prevalence and duration 1. Anti-nausea medications like dimenhydrinate (Dramamine) can help control vomiting. It is essential to drink plenty of clear fluids like water, diluted fruit juices, or oral rehydration solutions (such as Pedialyte) to prevent dehydration from vomiting and diarrhea, with adults aiming for at least 2-3 liters of fluid daily.
Some key points to consider when managing acute food poisoning include:
- Eating bland, easy-to-digest foods such as bananas, rice, applesauce, and toast (BRAT diet) once food can be tolerated
- Avoiding high-risk foods such as undercooked meat and seafood, unpasteurized milk, and soft cheese made with unpasteurized milk
- Practicing good hygiene, including hand washing and proper food preparation and storage
- Seeking medical attention if symptoms persist or worsen, such as high fever, bloody diarrhea, severe abdominal pain, or signs of dehydration
It is crucial to note that antimicrobial and antimotility agents can increase the risk of complications from diarrhea, particularly in cases caused by C. difficile and STEC infections 1. Therefore, their use should be avoided unless absolutely necessary and under the guidance of a healthcare professional. By following these guidelines and taking a cautious approach to treatment, patients can effectively manage their symptoms and reduce the risk of complications from acute food poisoning.
From the Research
Symptoms of Acute Food Poisoning
- Vomiting, diarrhea (with or without blood), fever, abdominal cramping, headache, dehydration, myalgia, and arthralgias are common symptoms of foodborne illnesses 2
Treatment of Acute Food Poisoning
- Empiric treatment should focus on symptom management, rehydration if the patient is clinically dehydrated, and antibiotic therapy 2
- Oral rehydration therapy (ORT) is recommended for mild to moderate dehydration in children with gastroenteritis 3
- Ondansetron has been shown to be an effective adjunct to ORT in children with acute gastroenteritis 4, 5, 3
Effectiveness of Ondansetron in Treating Acute Food Poisoning
- The use of ondansetron has been shown to reduce the need for intravenous hydration in children with acute gastroenteritis 4, 5
- Ondansetron has also been shown to reduce the rate of admissions in children with acute gastroenteritis 5