Treatment for Food Poisoning
The initial and most important treatment for food poisoning is aggressive rehydration, with oral rehydration solution (ORS) for mild to moderate cases and intravenous fluids for severe dehydration or those unable to tolerate oral intake. 1
Assessment and Management Algorithm
1. Assess Severity of Dehydration
- Look for:
- Dry mucous membranes
- Decreased skin turgor
- Sunken eyes
- Lethargy or altered mental status
- Tachycardia
- Hypotension (in severe cases) 1
2. Rehydration Therapy
For Mild to Moderate Dehydration:
- Administer oral rehydration solution (ORS) in the following amounts:
- Children <2 years: 50-100 mL after each stool
- Older children: 100-200 mL after each stool
- Adults: As much as desired 1
- Encourage increased intake of other fluids (water, cereal-based gruels, soup, rice water)
For Severe Dehydration:
- Immediate intravenous fluid resuscitation is necessary 1
- Consider peripheral IV access before oral challenge in high-risk patients
3. Nutrition Management
- Do not restrict food intake - there is no justification for "resting the bowel"
- Resume feeding as soon as appetite returns
- Provide energy-rich, easily digestible foods for children >4-6 months and adults
- For infants:
- Continue breastfeeding
- If formula-fed, dilute formula with equal volume of clean water until diarrhea stops 1
4. Supportive Care
- For oral intoxication (such as with caustic substances), supportive care includes:
- Replacement of fluids and electrolytes intravenously to maintain electrolyte balance
- Prevention of dehydration from vomiting and diarrhea
- Monitoring of liver and renal functions 2
- Oral activated charcoal can be considered in some poisonings to reduce gastrointestinal absorption, although its efficacy in food poisoning specifically is not well established 2
Important Considerations
Contraindicated Treatments
- Anti-diarrheal agents
- Stimulants
- Steroids
- Purgatives
- Ipecac syrup 2
These treatments can worsen the condition or cause harm. Specifically, ipecac syrup should not be used by the public as a first aid treatment for acute poisoning 2.
When to Seek Emergency Care
- Immediately contact poison control and activate emergency medical services for life-threatening symptoms
- Do not administer anything by mouth unless specifically advised by poison control in cases of suspected toxic ingestion 1
Antimicrobial Therapy
- Antimicrobial therapy is not indicated for routine treatment of uncomplicated, watery diarrhea
- Specific indications for antimicrobials include cholera, shigella dysentery, amoebic dysentery, and acute giardiasis 1
Special Considerations
For Specific Types of Food Poisoning
- Bacillus cereus emetic food poisoning (commonly from fried rice, macaroni and cheese) typically resolves within 48 hours with supportive care 3
Effectiveness of Different Rehydration Solutions
- Studies show that both glucose-based ORS (like Pedialyte) and rice syrup solids-based ORS (like Infalyte) are effective for rehydration 4
- In adults, sports drinks like Gatorade may be as effective as medical rehydration solutions for mild cases, though they may not correct electrolyte imbalances as effectively 5
Remember that food poisoning symptoms typically resolve within a few hours to several days with proper hydration and supportive care 6. The cornerstone of treatment remains aggressive rehydration to prevent complications from dehydration.