If
you’ve ever suffered from food poisoning (sometimes known as
“traveller’s diarrhea”) you probably know that absolutely horrible
feeling when you’d do almost anything to stop the stomach cramps,
diarrhea and vomiting.
Food borne illness is caused when parasites, bacteria, viruses or
toxins contaminate food through unhygienic food handling techniques,
insufficient cooking, inadequate refrigeration or excessive age. Typical
cases clear up within 24 – 48 hours, but in very serious cases the food
poisoning can lead to organ failure, paralysis, neurological
impairment, blindness, stillbirths and even death.
Even firm believers who avoid antibiotics whenever possible like me
are usually more than happy to take them in the hopes of feeling better
when hit with a bad case of food poisoning. Although antibiotics can
clear up many bacterial infections, they can also have side-effects,
including nausea and longer-term diarrhea! This is generally not what
you want when you are trying to get rid of a case of food poisoning.
The good news is that many incidences of food poisoning can typically
be treated at home without the need for antibiotics. Probiotics and a
healthy gut micro biome have been shown to prevent many cases of
traveler’s diarrhea, taking probiotics can also treat food poisoning and
help sufferers feel better quickly.
Note: When to Seek Immediate Medical Treatment
If you think your sickness has been caused by either eating a
mushroom or some bad shellfish, seek medical assistance promptly and do
no attempt to treat it on your own. The toxins that may be associated
with either of these foods can be dangerous and
require a doctor’s evaluation and treatment.
Additionally, if you feel dangerously ill, develop a high fever, or
feel extremely dehydrated or depleted, seek a doctor’s attention right
away as this can be an indication of serious sickness requiring medical
intervention and a strong antibiotic.
How Probiotics Assist the Immune System
Probiotics are the friendly or health-promoting microbes (including
both bacteria and yeasts) that typically live in healthy person’s
digestive tract. These health-promoting organisms assist in maintaining a
strong intestinal lining. This lining in turn helps to prevent harmful
substances from crossing from the digestive tract and into the blood
stream, where they can cause greater harm.
The large majority of the body’s immune cells are located in the
digestive tract and are assisted by the probiotic microorganism that
live there. Certain types of probiotic microorganisms can recognize the
presence of harmful pathogens and communicate with the immune system,
alerting it to the attack. They can provoke or stimulate the body to
initiate an immune response to fight off threats.
Furthermore, some probiotics support our immune system by directly
harming the disease-causing pathogens with the anti-microbial substances
known as
bacteriocins they produce, thereby working directly to eliminate them from the body.
Probiotics also help us to eliminate harmful or pathogenic bacteria
and viruses by outcompeting the harmful microbes for food and other
resources. They take up space within the digestive tract, making it
harder for the bad microbes to take hold and cause harm.
Research on Probiotics to Treat or Prevent Food Poisoning
There have been a few medical studies that have shown that probiotics
can help reduce the incidence of food poisoning as well as reducing the
duration of the illness and the severity of the symptoms.
Salmonella enterica, a pathogenic bacteria, is a very common
cause of food poisoning. Animal studies have shown that administering
probiotics has great potential to both reduce risk of
Salmonella infection and its severity. In 2007, researchers
reported on a study they undertook whereby they gave healthy pigs a mix of five common probiotic bacteria (two strains of
Lactobacillus murinus and one strain each of
Lactobacillus salivarius subsp.
salivarius,
Lactobacillus pentosus, and
Pediococcus pentosaceous) for
six days.
They then infected the pigs with Salmonella enterica and
monitored the exposed animals for the next 23 days. Those pigs that
treated with the probiotic cocktail showed reduced incidence, severity,
and duration of diarrhea as well as a reduced number of
Salmonella
cells in their feces, as compared to the control group that were not
given probiotics. The study appears to show that giving probiotics
prophylactically (to pigs at least) seems to reduce the risk of getting
Salmonella,
a potentially food-borne disease, as well as reducing the severity of
the disease for those that did get it. We look forward to human studies
looking at this issue.
Probiotics to Prevent Traveler’s Diarrhea
A significant percentage of people who travel internationally get
persistent diarrhea, which is caused by contaminated food or water and is commonly referred to as Traveler’s Diarrhea. From
5 to 50% of overseas travelers will develop this food poisoning, depending on the destination of their trip.
A 2007 meta-review of research that had been done on this burdensome
condition and that can really ruin a nice vacation, concluded that
taking probiotics prophylactically appeared to be effective at reducing
the likelihood of travelers developing diarrhea in the first place.
The
authors noted that no adverse effects from taking the probiotics was
observed in any of the studies they reviewed. In particular, the
probiotics
Saccharomyces boulardii and a mixture of
Lactobacillus acidophilus and
Bifidobacterium bifidum have been shown to be very effective.
With relatively little downside (other than cost) and the potential
to increase the enjoyment from a journey, it seems worthwhile to give
strong consideration to taking probiotics before and during travel,
particularly if the itinerary includes destinations such as India or
Mexico, which are known hot-beds of Traveler’s Diarrhea!
Self-care: Probiotics for Food Poisoning
Probiotics have been shown to be useful in preventing and improving
cases of food poisoning and they are typically quite safe, except for
people with compromised immune systems, who should avoid them.
Friendly microbes will assist your immune system to fight off the
illness. Additionally, the beneficial bacteria and yeasts in the
probiotics will help your digestive tract return to normal faster after a
bout of food poisoning. In some cases, an unexpected side effect of
food poisoning is that the sufferer
develops lactose intolerance ( a problem digesting milk and foods made with milk). Probiotic
Lactobacillus bacteria can help the body to digest milk and milk products while the digestive tract recovers.
If you have taken antibiotics for a bout of food poisoning, taking a
probiotic supplement along with, or even after, the prescription
medication can help return the healthy microbes to your digestive tract
that may have been inadvertently harmed by the antibiotics. One
downside of antibiotics is that they kill beneficial as well as harmful
microbes. Probiotics can help with antibiotic-induced diarrhea and
improve digestion.
Although it may be difficult to consume food or liquids when suffering from food poisoning, eating
probiotic rich foods, such a live-culture yoghurt,
kefir
or preservative-free fermented foods like miso and sauerkraut is one of
the most effective ways to get a high dose of good quality probiotics.
Be sure to eat and drink lots of these prior to travel to destinations
known for a high incidences of food poisoning.
Anecdotally, we have heard people having very quick improvement from food poisoning symptoms after drinking kefir.
If you prefer to take probiotics for preventing or treating food poisoning in pill form,
choose a good quality probiotic that contains some or most of these beneficial organisms that have been shown to helpful:
Saccharomyces boulardii, Lactobacillus acidophilus, Bifidobacterium bifidum, Lactobacillus murinus,
Lactobacillus salivarius,
Lactobacillus pentosus, and/or
Pediococcus pentosaceous.
Don’t forget to seek medical treatment if your bout lasts longer than
a few days, you develop a high fever or you notice blood in your stool.
Signs and Symptoms
The
typical signs of food poisoning are nausea, vomiting, abdominal
cramping, diarrhea, head or muscle aches, and fever. Specific bacteria
may cause these signs and symptoms:
- Clostridium botulinum (C. botulinum, or
botulism): weakness, blurred vision, sensitivity to light, double
vision, paralyzed eye nerves, difficulty speaking and swallowing,
paralysis that spreads downward, respiratory failure, and death
- Salmonella spp., Shigella spp., and Campylobacter jejuni (C. jejuni): fever, chills, and bloody diarrhea
- Escherichia coli (E. coli): hemorrhagic colitis
(diarrhea with very little stool and large amounts of blood), occurring
up to 3 days after eating contaminated food
- Mushroom poisoning: stomach upset, delirium
(confusion), vision difficulties, heart muscle problems, kidney failure,
death of liver tissue, and death if left untreated
Fish
poisoning causes nausea, vomiting, diarrhea, abdominal pain, dizziness,
and headache. Specific types of fish poisoning can cause other signs and
symptoms, such as:
- Ciguatera (caused by toxins in some fish, including grouper,
snapper, mackerel, and barracuda): numbness or tingling around the
mouth, feeling of loose teeth, impaired touch sensation of hot as cold
and cold as hot, itching, muscle and joint pain, slow heart rate, low
blood pressure
- Numbness or tingling around the mouth, trouble coordinating
movement, difficulty swallowing, excess saliva, twitching, loss of
ability to talk, convulsions, paralysis that spreads upward, respiratory
failure, and death (Pufferfish poisoning).
- Numbness or tingling around the mouth or in the arms and legs,
trouble swallowing, difficulty speaking (Shellfish poisoning, caused by
toxins in algae that are eaten by shellfish).
What Causes It?
Usually bacteria and algae cause food poisoning, but poisonous plants and animals are other potential causes.
Common bacterial causes include:
- E. coli in undercooked hamburger, unpasteurized
apple juice or cider, raw milk, contaminated water (or ice), vegetables
fertilized by cow manure, or spread from person to person
- Listeria monocytogenes (L. monocytogenes) in cole slaw, dairy products (mostly soft cheeses from outside the United States), and cold, processed meats
- Salmonella spp. in poultry, beef, eggs, or dairy products
- Shigella spp. from raw vegetables or cool, moist foods (such as potato and egg salads) that are handled after cooking
- Staphylococcus aureus (S. aureus) in salad dressing, ham, eggs, custard-filled pastries, mayonnaise, and potato salad (usually from the hands of food handlers)
- C. jejuni in raw milk and chicken
- C. botulinum in improperly home canned foods (in children under 1 year of age, mostly from honey but also from corn syrup)
- Clostridium perfringens(C. perfringens) in
meat and poultry dishes and gravies, mostly foods that were cooked more
than 24 hours before eating and were not reheated well
- V. cholerae in bivalve (two shelled) shellfish (such
as mussels, clams, oysters, and scallops), raw shellfish, and
crustaceans (such as lobsters, shrimp, and crabs)
Common types of fish poisoning include:
- Scombroid poisoning from bacteria in dark meat fish (tuna, bonito, skipjack, mahi-mahi, mackerel) that are not refrigerated well
- Ciguatera poisoning in tropical fish (grouper, surgeonfish, snapper, barracuda, moray eel, shark) that have eaten toxic plankton
- Puffer fish poisoning from the organs and flesh of puffer fish
- Poisoning from shellfish that feed on certain algae
Mushroom poisoning occurs from eating poisonous wild mushrooms, especially Amanita phalloides.
Who's Most At Risk?
Infants and the elderly are at greater risk for food poisoning. Other risk factors include:
- A pre-existing medical condition, such as chronic kidney failure, liver disease, or diabetes
- Taking antibiotic, antihistamine, or steroid medicines
- Sickle cell anemia and other problems with red blood cells
- A weakened immune system, pregnant women and people over age 65 are most at risk
- Traveling in an area where contamination is more likely
Listeriosis
is most common in pregnant women, fetuses, and people with immune
problems. When a fetus is infected with listeria, it may be born
prematurely or die.
What to Expect at Your Provider's Office
Your
health care provider will examine you for signs and symptoms of food
poisoning, such as stomach problems, and dehydration. Your health care
provider may also ask about foods you have eaten recently, where you may
have traveled, and if you have had contact with people showing similar
symptoms. Tests of your vomit, blood, and stool can identify the cause.
In the case of botulism, your health care provider may request
electromyography (a test to measure electric impulses in the muscles) to
confirm the diagnosis. A lumbar puncture (spinal tap) may be done to
check for signs and symptoms related to central nervous system
disorders.
Prevention
These steps can help prevent food poisoning:
- Wash your hands and clean any dishes or utensils when you are making or serving food.
- Keep juices from meat, poultry, and seafood away from ready-to-eat foods.
- Cook foods to proper temperatures.
- Refrigerate any food you will not be eating right away.
- If you take care of young children, wash your hands often and
dispose of diapers carefully so that bacteria can't spread to other
surfaces or people.
- If you make canned food at home, make sure to follow proper canning techniques to prevent botulism.
- Do not feed honey to children under 1 year of age.
- Do not eat wild mushrooms.
- When traveling where contamination is more likely, eat only
hot, freshly cooked food. Boil water before drinking. Do not eat raw
vegetables or unpeeled fruit.
- Always refrigerate fish.
- Don't eat tropical fish caught during blooms of poison plankton.
- Eat pufferfish only in specially licensed restaurants with chefs trained to cook it.
- Don't eat shellfish exposed to red tides.
If
others may have eaten a food that made you sick, let them know. If you
think the food was contaminated when you bought it from a store or
restaurant, tell the staff and your local health department.
Treatment Plan
Treatment
for most cases of food poisoning involve replacing fluids and
electrolytes (such as sodium, potassium, magnesium, and chloride). While
experiencing vomiting and diarrhea, the person should avoid solid food
but increase clear liquids. In more severe cases, a person may need help
either breathing or stopping vomiting. Health care providers usually
don't prescribe antibiotics because they may prolong diarrhea. If you
have eaten certain toxins (such as from mushrooms or shellfish), your
health care provider may take steps to clean out your stomach (a process
called lavage, or pumping the stomach) and administer activated
charcoal, which can help absorb the remaining toxin.
Drug Therapies
Depending on the symptoms, cause, and severity of food poisoning, a health care provider may prescribe drugs, including:
- Oral rehydration therapy
- Antibiotics
- Antitoxin to neutralize toxins from C. botulinum (only given within the first 72 hours)
- Amitriptyline to control the numbness and tingling from ciguatera poisoning
- Apomorphine or ipecac syrup to cause vomiting and help rid the body of toxins
- Atropine for mushroom poisoning
- Diphenhydramine and cimetidine for fish poisoning
- Mannitol for nerve-related symptoms of ciguatera poisoning
Complementary and Alternative Therapies
If
you are suffering from severe food poisoning, seek conventional medical
treatment. Complementary and alternative therapies are best used to
strengthen the body and aid in the prevention of food poisoning. Animal
studies have shown that certain vitamins and nutrients may protect
against some food toxins while others may actually worsen the effects of
toxins. Milk thistle is an herb commonly used in Europe as a primary
treatment for mushroom poisoning. Homeopathy may help treat diarrhea in
children (which is sometimes caused by food poisoning) in developing
countries.
Nutrition
The following general nutritional guidelines may be helpful in the case of food poisoning:
- Drink plenty of fluids (to prevent dehydration).
- Drink barley or rice water (to soothe inflamed stomach or intestine).
- Take probiotics, such as Lactobacillus acidophilus and Lactobacillus bulgaricus,
can help restore the balance of good bacteria in the intestine. If you
are traveling to an area where the food and water may be contaminated,
in addition to taking the precautions above, taking probiotics both
before and during your trip may help maintain intestinal health. People
with weakened immune systems should speak with their doctors before
taking probiotics.
- Apple cider vinegar is a traditional remedy that, although it
has not been studied scientifically, may have some antimicrobial
properties. Mix 2 tsp. in one cup warm water and drink several times a
day.
- Several studies suggest that a number of cooking herbs,
including thyme, rosemary, basil, coriander, sage, spearmint, and fennel
have strong antimicrobial effects against food borne pathogens, and may
add an additional layer of protection when used in cooking.
For specific types of food poisoning:
- Alpha-lipoic acid -- Several reports indicate that
alpha-lipoic acid, an antioxidant commonly found in broccoli, spinach,
and beef, may help treat Amanita (mushroom) poisoning, especially when combined with milk thistle (Silybum marianum). Seek medical treatment if you suspect mushroom poisoning. Do not self-treat.
- Vitamin A -- Studies on rats show that vitamin A offers some protection against salmonella. Rats infected with Salmonella
appeared to eliminate the bacteria from their bodies faster when
pretreated with vitamin A rather than with placebo, according to one
study. They also gained more weight and had a greater immune response
than rats that didn't receive the vitamin.
- Calcium phosphate -- One animal study suggests that rats receiving calcium phosphate supplements may be protected from Salmonella poisoning. Researchers think calcium phosphate helps boost Lactobacillus, the good bacteria found in the intestine, which helps fight off Salmonella.
Supplements to avoid:
- Fish oil -- In a study of mice infected with the bacteria Listeria,
animals that regularly consumed diets rich in fish oil had
significantly more bacteria in their spleens than animals that consumed
diets rich in lard or soybean oil. Until researchers can determine what
these results mean to humans, people with Listeria infection should avoid foods containing fish oil.
Herbs
Various
herbs have been used traditionally to treat different types of food
poisoning. More research is needed. The following herbs should not be
used in place of conventional medical care and are listed only for the
purposes of discussion.
Milk thistle (Silybum marianum) is often used for liver disorders and is widely used in Europe to treat Amanita mushroom poisoning. Studies show that patients with Amanita
poisoning can be effectively treated with pharmaceutical silibinin (the
primary active component of milk thistle) up to 48 hours after eating
the deadly mushrooms.
Animal studies of Chinese and Japanese combination herbal remedies used for Listeria suggest they may be effective for food poisoning. Active ingredients include:
- Asian ginseng (Panax ginseng)
- Astragalus root (Astragalus membranaceus)
- Chinese cinnamon bark (Cinnamomum aromaticum)
- Ginger root (Zingiber officinale)
- Licorice ( Glycyrrhiza glabra)
- Peony root (Paeonia officinalis)
- Skullcap (Scutellaria lateriflora)
Seek
the advice of a trained and licensed herbalist or practitioner of
Traditional Chinese Medicine who will guide your individual treatment.
Do not self-treat with herbs. Some herbs should not be taken if you have
heart disease or high blood pressure, or if you take blood-thinning
medication. In addition, some herbs interact with other herbs,
supplements, and prescription medications, so it is important to make
sure all your health care providers know what you are taking.
Laboratory (test tube) studies suggest that the following herbs
have antibacterial or antimicrobial properties, although there is no
evidence they are effective for treating food poisoning in humans. Do
not use these herbs without speaking to a physician or knowledgeable
herbal practitioner. Some side effects can be dangerous:
- Bittervine (Mikania micrantha)
- Goldenseal (Hydrastis canadensis)
- Oregon grape (Mahonia aquifolium)
- Chamomile (Matricaria recutita)
Barberry (Berberis vulgaris) has also been used traditionally to treat diarrhea from infectious causes such as E. coli and V. cholera.
Berberine, the active ingredient in barberry, can cause brain damage in
newborns. Speak to a physician before using berberine-containing herbs
with children of any age.
Homeopathy
Studies examining the
effectiveness of homeopathic remedies for food poisoning are lacking.
Before prescribing a remedy, homeopaths take into account a person's
constitutional type -- your physical, emotional, and intellectual
makeup. An experienced homeopath assesses all of these factors when
determining the most appropriate remedy for a particular individual.
Below are some more common remedies for food poisoning or diarrhea:
- Arsenicum album -- for foul-smelling diarrhea from
food poisoning or traveler's diarrhea with burning sensation in the
abdomen and around the anus. This remedy is most appropriate for
individuals who feel exhausted yet restless and whose symptoms tend to
worsen in the cold and improve with warmth. Vomiting may also occur.
Practitioners may also recommend Arsenicum to prevent diarrhea when traveling.
- Chamomilla -- for greenish, frothy stool that smells
like rotten eggs. Used primarily for children, especially those who are
irritable, argumentative, and difficult to console.
- Calcarea carbonica -- for children who fear being in the dark or alone, and who perspire heavily while sleeping. Stools have a sour odor.
- Podophyllum -- for explosive, gushing, painless
diarrhea that becomes worse after eating or drinking. Exhaustion often
follows bowel movements, and the individual for whom this remedy is
appropriate may experience painful cramps in lower extremities.
- Sulphur -- for irritable and weepy children. May have a red ring around the anus and diarrhea with the odor of rotten eggs.
Prognosis/Possible Complications
Most
cases of food poisoning are mild and clear up on their own within 4 - 7
days. However, with mushroom poisoning, up to half of people may die.
With botulism, less than 10% die, and some people may need help
breathing for months afterward. More than half of poisonings from
pufferfish are fatal. Death is rare in other fish poisonings, but
nerve-related symptoms can continue for months.
The following are some possible after effects of food poisoning:
- After shigellosis, white blood cell problems and kidney problems
- After E. coli infection, kidney problems and bleeding problems
- After botulism, long hospital stays (1 - 10 months) with
fatigue and difficulty breathing for 1- 2 years, or muscle weakness
followed by respiratory failure
- After salmonellosis, Reiter syndrome (an arthritis-like disease) and inflammation of the heart lining
- After campylobacteriosis, Guillain-Barré syndrome (a nerve disease)
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