Can food poisoning cause vomiting and diarrhea?

From the Guidelines

Yes, vomiting and diarrhea are common symptoms of food poisoning, and it is crucial to prioritize staying hydrated and managing these symptoms to prevent complications such as dehydration, which can significantly impact morbidity, mortality, and quality of life. When you consume food contaminated with bacteria, viruses, parasites, or their toxins, your body often responds by trying to expel the harmful substances through both vomiting and diarrhea. These symptoms typically begin within hours to days after consuming contaminated food and can last from a few hours to several days depending on the cause.

Key Considerations for Management

• Treatment primarily involves staying hydrated with water, clear broths, or oral rehydration solutions like Pedialyte, as recommended by the 2017 IDSA guidelines for the diagnosis and management of infectious diarrhea 1.
• Take small, frequent sips if you're having trouble keeping fluids down.
• Over-the-counter medications like loperamide (Imodium) can help with diarrhea, while bismuth subsalicylate (Pepto-Bismol) may help with both symptoms, but these should not be used if you have a high fever or bloody stool, as cautioned in the guidelines 1.
• Rest is important, and when you begin eating again, start with bland, easy-to-digest foods such as toast, bananas, rice, or applesauce.
• Seek medical attention if symptoms are severe, persist beyond three days, or if you experience signs of dehydration like extreme thirst, dry mouth, little or no urination, severe weakness, dizziness, or lightheadedness, emphasizing the need for prompt medical evaluation in such cases 1.

Preventing Dehydration

• Oral rehydration solutions (ORS) are recommended as the first-line therapy for mild to moderate dehydration in infants, children, and adults with acute diarrhea from any cause, as per the 2017 IDSA guidelines 1.
• Nasogastric administration of ORS may be considered in infants, children, and adults with moderate dehydration who cannot tolerate oral intake.
• Isotonic intravenous fluids such as lactated Ringer’s and normal saline solution should be administered when there is severe dehydration, shock, or altered mental status and failure of ORS therapy, highlighting the importance of appropriate fluid management in severe cases 1.

From the FDA Drug Label

Adverse experiences recorded during clinical studies with loperamide hydrochloride were generally of a minor and self-limiting nature They were more commonly observed during the treatment of chronic diarrhea. The adverse events reported are summarized irrespective of the causality assessment of the investigators. The adverse events with an incidence of 1. 0% or greater, which were reported at least as often in patients on loperamide hydrochloride as on placebo, are presented in the table below. Gastrointestinal AE% Nausea Vomiting The adverse events with an incidence of 1. 0% or greater, which were more frequently reported in patients on placebo than on loperamide hydrochloride, were: dry mouth, flatulence, abdominal cramp and colic. A number of the adverse events reported during the clinical investigations and post-marketing experience with loperamide are frequent symptoms of the underlying diarrheal syndrome (abdominal pain/discomfort, nausea, vomiting, dry mouth, tiredness, drowsiness, dizziness, constipation, and flatulence).

Yes, you can vomit and have diarrhea with food poisoning.

• Nausea and vomiting are reported as adverse events in the clinical studies with loperamide hydrochloride, which is used to treat diarrhea.
• Diarrhea is a symptom of the underlying condition being treated by loperamide hydrochloride. 2

From the Research

Symptoms of Food Poisoning

• Vomiting and diarrhea are common symptoms of food poisoning, as they are the body's way of trying to expel the harmful substances from the system.
• According to 3, food products and water can become contaminated with microorganisms and toxins that make people ill, and the very young, the elderly, and immunocompromised individuals are especially susceptible.

Treatment of Nausea and Vomiting

• Ondansetron appears to be a very effective antiemetic drug for use in selected intoxicated patients, as shown in 4.
• Loperamide is a nonprescription opioid widely used for the treatment of diarrhea, but it can be misused and lead to life-threatening toxicity, as described in 5 and 6.

Management of Foodborne Illness

• Education of healthcare providers, food handlers, and the public is critical in reducing the incidence and spread of foodborne illness, as stated in 3.
• A comprehensive review of treatments for nausea and vomiting can be found in 7, which covers pharmacotherapy, bioelectrical neuromodulation, behavioral and surgical therapies, and complementary medicine.

Diarrhea and Vomiting in Food Poisoning

• While the provided studies do not directly address the question of vomiting and diarrhea with food poisoning, it can be inferred that these symptoms are related to foodborne illnesses, as discussed in 3.
• The use of medications such as ondansetron and loperamide may be relevant in managing these symptoms, as shown in 4, 5, and 6.