You know the feeling. It comes on suddenly and if you don’t make it to the bathroom very soon, well, let’s not even go there.

No one wants to talk about diarrhea, let alone vomiting. But when you’ve been afflicted, there’s not much else to discuss. According to the Cleveland Clinic, adults experience 99 million cases of acute diarrhea gastroenteritis every year. And that doesn’t count the cases that never get mentioned to a doctor. 

Of those cases, most are caused by infection — meaning you picked up a virus or bacteria somehow. The CDC says that one in six Americans will get a foodborne illness this year, meaning that the source of their illness is their food.

Was it something I ate?

It’s not always easy to tell the difference between a garden-variety stomach virus, which may be spread from person to person, and food poisoning, says Claudia Gruss, M.D., gastroenterologist at the Arbor Medical Group in Norwalk, Connecticut.

“There is definitely an overlap,” she says. “A virus can give you an acute infection of the gastrointestinal tract involving the stomach or intestines. Food poisoning is when you get an infection due to eating contaminated food.”

Food poisoning can come from bacteria, viruses or parasites. And, depending on the type of food poisoning, the bacteria may be sending toxins into your gut. The best way to know if it’s food poisoning: Someone who ate the same thing as you got sick, too. Otherwise, you may never know the cause.

Symptoms

The symptoms for both an infection and food poisoning are largely the same:

  • Nausea
  • Vomiting
  • Watery diarrhea
  • Headache
  • Fever
  • Abdominal cramping

Food poisoning tends to come on within a few hours of eating (or even right after), while a virus can gradually come on over time (Your stomach may begin to hurt, or you might feel queasy). However, notes Gruss,  some food-based infections, like Hepatitis A, can take a month or more to show up.

In terms of how long symptoms last, food poisoning generally resolves within a day or two, while a virus can take several days to resolve. 

When to worry

No matter the cause of your stomach distress, if symptoms last for several days, are accompanied by a fever, or you have blood in your stool, you need to call your doctor. If you’ve been eating wild mushrooms, you should also call your doctor because wild mushroom (not the white button kind sold at the grocery, but types including morels and chanterelles) can be responsible for liver failure that will require immediate medical attention. 

All food poisoning is not the same

If you ate something that made you run to the bathroom for 24 to 48 hours, consider yourself lucky and move on with your life. There are some food-borne illnesses that can be very debilitating, and in some cases, fatal. Gruss named a few:

  • E. Coli (contracted through eating undercooked meat and unwashed vegetables) can damage the blood vessels in the kidney and lead to kidney failure.
  • Vibrio vulnificus is a bacteria that comes mainly from eating raw or undercooked oysters, though it can be contracted through shellfish. It is especially dangerous for people with compromised liver function (so those with liver disease should avoid shellfish altogether). 
  • Listeria, another bacteria, can be found in uncooked meats, raw vegetables, and even on the rind of cantaloupe. It can come from unpasteurized milk, and is particularly dangerous to pregnant women and the elderly.
  • Staphylococcus and Clostridium botulinum bacteria can make you sick by producing a toxin (or poison) as they grow on food. Botulism, which can be life-threatening, is most often contracted from eating improperly preserved foods (so avoid dented or broken canned goods.) 
  • Salmonellosis is contamination with the salmonella bacteria, which is often found in eggs, undercooked meat or poultry.  All poultry and eggs should be well cooked before eating.

Take care of your tummy

If you become sick with gastroenteritis, brought on by a bacteria or by a virus, the treatment is generally the same, Gruss says. Here are the steps to take to make yourself feel better: 

  • Stay hydrated: Gruss says this is the key to a healthy recovery. “You should drink enough that you are producing a lot of urine,” she says. “Plenty of fluids. Drink things with salt and sugar. Not diet soda. You need the salt and the calories. Many people think they should just drink water and that’s a mistake, because you can actually dilute out your blood stream.” Good choice: Gatorade (which has sugar and salt.)
  • Stick to a bland diet: Once you have stopped vomiting, eat whatever you can tolerate in small amounts. Try toast with some jam, plain chicken, or rice.
  • Avoid dairy: Many people have trouble digesting the milk sugar in dairy, Gruss says. “It can make your diarrhea worse”.
  • Avoid anti-diarrhea medications: Diarrhea is clearing the toxins and infections from your body, Gruss says. Anti-diarrhea medications actually paralyze the GI tract, which can make matters worse. These medications can be prescribed in some circumstances, she says, but should never be used if there is bloody diarrhea.
  • Consider probiotics: After a bout of a gastrointestinal illness, probiotics can help your system restore good bacteria to your bowel. But Gruss says you needn’t take them regularly. 

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