From the Guidelines
Food poisoning treatment should prioritize fluid and electrolyte replacement, with ancillary treatments like antimotility, antinausea, or antiemetic agents considered only after adequate hydration is achieved 1. The primary goal is to manage symptoms while the body fights the infection.
- Rest and stay hydrated by drinking small sips of water, clear broths, or oral rehydration solutions like Pedialyte to replace lost fluids and electrolytes.
- Avoid solid foods initially, then gradually reintroduce bland, easy-to-digest foods such as toast, bananas, rice, and applesauce (BRAT diet) once vomiting subsides. For symptom relief, consider the following:
- Antimotility drugs like loperamide may be given to immunocompetent adults with acute watery diarrhea, but should be avoided in cases of suspected or proven toxic megacolon, inflammatory diarrhea, or diarrhea with fever 1.
- Antinausea and antiemetic agents like ondansetron may be given to facilitate tolerance of oral rehydration in children >4 years of age and in adolescents with acute gastroenteritis associated with vomiting 1. It is essential to seek medical attention immediately if severe symptoms occur, such as:
- Persistent vomiting
- Bloody diarrhea
- High fever above 101.5°F (38.6°C)
- Severe abdominal pain
- Signs of dehydration (extreme thirst, dry mouth, little or no urination, severe weakness)
- Symptoms lasting longer than three days Proper hydration is crucial to prevent complications from dehydration, and most food poisoning cases resolve within a few days as the immune system clears the infection.
From the FDA Drug Label
Acute Diarrhea Adults and Pediatric Patients 13 Years and Older: The recommended initial dose is 4 mg (two capsules) followed by 2 mg (one capsule) after each unformed stool. The treatment for food poisoning (acute diarrhea) in adults and pediatric patients 13 years and older is loperamide (PO) with a recommended initial dose of 4 mg followed by 2 mg after each unformed stool, with a maximum daily dose of 16 mg 2.
- The dosage for pediatric patients 2 to 12 years of age varies by weight and age.
- Loperamide may be used to treat diarrhea, but the FDA label does not explicitly state it is for food poisoning.
- Bismuth subsalicylate (PO) label does not provide information on the treatment of food poisoning 3.
From the Research
Food Poisoning Treatment Options
- Bismuth subsalicylate has been evaluated for its efficacy in relieving common gastrointestinal symptoms, including diarrhea and vomiting due to acute gastroenteritis 4
- Short-term medication with bismuth subsalicylate has been shown to be effective against infectious gastroenteritis, such as travelers' diarrhea 4
- The bacteriostatic/bactericidal effects of bismuth subsalicylate against a variety of pathogenic gastrointestinal bacteria have been documented 4
Efficacy of Bismuth Subsalicylate
- A systematic review and meta-analysis of 14 clinical studies found that subjects treated with bismuth subsalicylate had 3.5 times greater odds of preventing travelers' diarrhea compared with placebo 4
- The same review found that subjects with infectious diarrhea treated with bismuth subsalicylate had 3.7 times greater odds of diarrhea relief compared to those receiving placebo 4
- Bismuth subsalicylate may decrease the risk of inappropriate antibiotic utilization in individuals at risk or affected by food and waterborne diarrheal disease 4