What is the treatment for headache and vomiting after eating contaminated food?

Treatment for Headache and Vomiting Following Contaminated Food

For headache and vomiting after consuming contaminated food, oral rehydration therapy should be the primary treatment, with antiemetics such as ondansetron considered for persistent vomiting to facilitate oral fluid intake. 1

Initial Assessment and Management

• Evaluate hydration status by checking for signs such as decreased skin turgor, dry mucous membranes, sunken eyes, altered mental status, tachycardia, and decreased urine output 1, 2
• Begin oral rehydration therapy immediately using reduced osmolarity oral rehydration solution (ORS) at a dosage of 50-100 mL/kg over 3-4 hours for children and 2-4 L for adults 1, 2
• For severe dehydration with inability to tolerate oral fluids, consider intravenous fluids (lactated Ringer's or normal saline) 1

Antiemetic Therapy

• Ondansetron (5-HT3 receptor antagonist) may be given to facilitate oral rehydration in adults and children >4 years with vomiting 1, 3
  • Adult dosage: 8 mg orally every 8 hours as needed 3
  • This helps reduce vomiting episodes and improves tolerance of oral rehydration 4, 5
• Metoclopramide (dopamine receptor antagonist) can be considered as an alternative antiemetic 1
  • Helps treat nausea while also improving gastric motility 1

Pain Management for Headache

• For headache relief, use NSAIDs (acetylsalicylic acid, ibuprofen, or diclofenac potassium) as first-line treatment 1
• Avoid opioids and barbiturates for pain management as their efficacy is questionable and they carry risk of dependency 1

Dietary Recommendations

• Early refeeding is recommended rather than fasting, as it decreases intestinal permeability caused by infections and reduces illness duration 1
• The traditional BRAT (bananas, rice, applesauce, and toast) diet has limited supporting data but may be considered 1
• Avoid instructing patients to refrain from eating solid food for 24 hours as this does not appear to be useful 1

Antimotility Agents

• Loperamide may be given to immunocompetent adults with acute watery diarrhea, but should not be given to children <18 years of age 1
• Avoid antimotility drugs in cases of suspected or proven inflammatory diarrhea or diarrhea with fever 1

Special Considerations

• For patients with persistent symptoms beyond 48-72 hours, consider further evaluation for other causes 1
• Avoid antimicrobial therapy unless there is evidence of specific bacterial infection with systemic symptoms 1, 2
• Patients should be advised to practice proper hand hygiene to prevent spread to others 1, 2

Prevention of Future Episodes

• When traveling to developing countries, avoid foods and beverages that might be contaminated, including raw fruits and vegetables, raw or undercooked seafood or meat, tap water, and unpasteurized milk products 1
• Safe options include steaming-hot foods, fruits that are peeled by the traveler, bottled (especially carbonated) beverages, hot coffee and tea, beer, wine, and water brought to a rolling boil for 1 minute 1

Remember that most cases of foodborne illness are self-limiting, but proper hydration and symptom management can significantly improve comfort and prevent complications while the body clears the infection.