Food poisoning: what to do at home and when you need a doctor - help in Tashkent

Why does this happen and how quickly?

The causes are divided into three groups, and the time from food to the first symptoms helps to guess what exactly a person is dealing with. This is not an idle detail: a very rapid onset indicates a ready-made toxin, not microbial proliferation, and such poisonings are usually short-lived and do not require antibiotics.

• After 30 minutes - 6 hours: staphylococcal toxins that have accumulated in food in advance. Typical for cream products, salads with mayonnaise, dairy products that have been kept warm. Vomiting predominates, temperature is low
• After 6–24 hours: bacteria from the Clostridia group, often after meat dishes and pilaf, cooked in advance and cooled slowly. Abdominal cramps and diarrhea predominate
• After 12–72 hours: salmonella, campylobacter, E. coli - eggs, chicken, meat, unpasteurized milk. Characterized by high fever and severe diarrhea
• After 24–48 hours: Viral infections, primarily norovirus and rotavirus, are highly contagious and spread from person to person
• Separately: botulism, usually after 12–36 hours, home-canned food, dried and smoked fish, home-made sausage

A hot climate significantly increases risks. At air temperatures above thirty degrees, cooked food becomes dangerous after just an hour or two outside the refrigerator: bacteria double in number in a matter of minutes. Hence, the most typical scenarios for summer are salads with mayonnaise for a feast, pilaf or meat dishes that have been sitting on the table for half a day, cream pies, food bought on the street without refrigeration, as well as a cut watermelon that has been sitting warm.

What to do at home in the first hours

In the normal course of an adult without severe chronic diseases, treatment comes down to one main task - to replenish what is lost through vomiting and diarrhea. Everything else is of secondary importance. The procedure is simple and worth remembering in advance.

1. Начать пить сразу, не дожидаясь жажды, и делать это дробно: по одному-два глотка каждые 5–10 минут. Большой объём разом провоцирует новую рвоту.
2. Использовать растворы для оральной регидратации of аптеки — они содержат правильное соотношение солей и глюкозы. Простая вода восполняет объём, но не соли.
3. Ориентироваться на объём: взрослому после каждого жидкого стула нужно дополнительно примерно 200–250 мл раствора.
4. Есть по аппетиту, не голодая: подойдут рис, сухари, бананы, отварной картофель, печёное яблоко, нежирный суп. Голодная пауза дольше суток замедляет восстановление слизистой.
5. Временно исключить молоко, жирное, жареное, острое, кофе, алкоголь и сладкие газированные напитки — последние усиливают понос.
6. Отдыхать и контролировать мочеиспускание: если моча есть и она светлеет — жидкости достаточно.

A homemade solution is suitable if a pharmacy is not at hand: a liter of boiled water, six level teaspoons of sugar and half a teaspoon of salt. It is important to keep the proportions exactly - too sweet a solution increases diarrhea. In this case, it is better to give the drug to children, since an error in concentration is more dangerous for them. A good guideline for an adult: during the first day, with a moderate flow, about two to three liters of liquid are usually required, and you need to drink more actively than you feel necessary due to your well-being.

Dehydration: how to recognize

This is the most important part because it is the dehydration, not the infection itself, that determines the severity of the condition. It develops gradually, and its first signs are easy to miss, especially if the person lies down and moves little. You need to actively check for these signs, rather than wait until it becomes obvious that something is wrong.

• Decreased amount of urine, its dark, rich color; absence of urination for more than 8–12 hours is an alarming sign
• Dry mouth, sticky tongue, lack of saliva, chapped lips
• Thirst that is not quenched - in this case, in older people, the feeling of thirst is dulled, and they do not drink enough
• Dizziness and darkening of the eyes when standing up, rapid pulse
• The skin loses its elasticity: gathered into a fold on the back of the hand, straightens out slowly
• Weakness, drowsiness, confusion, unusual irritability
• In children: crying without tears, sunken eyes and fontanel, dry diapers for several hours, lethargy and refusal to drink

Children and the elderly become dehydrated much faster than adults. A child has a smaller fluid supply and more fluid loss per kilogram of weight, while an elderly person often simply does not feel thirsty and, in addition, takes diuretics that increase loss. For these two groups, the threshold for seeing a doctor should be noticeably lower: what is permissible for an adult to wait at home for a day, for a child in the first years of life requires examination much earlier.

Myths: charcoal, antibiotics and fixatives

Several persistent misconceptions have accumulated around the treatment of poisoning, and some of them are not just useless, but harmful. It is worth disassembling them separately.

• Activated carbon in packs is the most common myth. It binds some of the substances in the intestinal lumen, but does not affect bacteria in the mucous membrane and does not replenish fluid, that is, it does not affect either the cause or the main danger. In addition, it turns the stool black and makes it difficult to notice intestinal bleeding in time.
• Antibiotics without a doctor's prescription are not needed for ordinary food poisoning: most cases are caused by viruses or ready-made toxins, which antibiotics have no effect on at all. With some bacterial infections, they can even worsen the course, and self-administration blurs the picture and complicates diagnosis
• Drugs that stop diarrhea are inadmissible at high temperatures and blood in the stool: diarrhea in this case removes the pathogen, and its suppression retains toxins in the intestines
• Alcohol, vodka with salt, potassium permanganate inside - they do not heal, but harm; a concentrated solution of potassium permanganate can cause a burn to the mucous membrane
• Fasting for longer than a day does not speed up recovery: the intestinal mucosa needs nutrition to recover
• Warming the abdomen with a heating pad during pain is dangerous: if the cause turns out to be appendicitis or another surgical disease, heat will sharply worsen the situation

What really has proven importance is rehydration. Simple saline solutions save more lives against intestinal infections than any medicine used for these conditions. Among the auxiliary means, the doctor may recommend drugs that reduce nausea and individual sorbents, but all this remains an addition to drinking, and not a replacement for it.

Botulism: when the clock is ticking

Botulism stands apart and deserves a separate discussion because it is easy to recognize: it is not like ordinary poisoning. Botulism toxin does not affect the intestines, but the transmission of signals from nerves to muscles, so the main symptoms are not vomiting and diarrhea, but impaired vision, swallowing and breathing. Without timely administration of serum, the disease can lead to respiratory arrest.

• Home-canned food, especially mushrooms, vegetable caviar, beans, as well as dried and smoked fish, sausage and home-cooked meat
• The first symptoms usually occur within 12–36 hours, sometimes later: dry mouth, blurred vision, fog and blurred vision, double vision
• Drooping upper eyelids, dilated pupils that are poorly responsive to light
• Difficulty swallowing, sensation of a lump in the throat, choking, nasal or slurred speech
• Increasing muscle weakness, spreading from top to bottom, with completely intact consciousness and normal temperature
• A feeling of lack of air and shallow breathing is a threatening sign
• Severe constipation and bloating instead of diarrhea

The rule of thumb is simple: if after eating home-made canned food, dried fish or home-made sausage, a person’s vision becomes worse, he has difficulty swallowing, or his speech has changed, you should immediately call an ambulance and be sure to say that botulism is suspected. It is important to preserve the remains of a suspicious product - it will be needed for research. In this case, you cannot wait until the morning or watch the development of events at home: the serum is more effective the earlier it is introduced. It is also worth remembering that normal temperature and clear consciousness with botulism are common, and they often create a false impression of well-being.

How not to get poisoned

Almost all household poisonings are associated with temperature violations and cross-contamination in the kitchen. Prevention measures are known, but in hot climates their importance increases many times over, and here the little things matter.

1. Не оставлять готовую еду при комнатной температуре дольше двух часов, а в жару — дольше одного часа.
2. Быстро охлаждать большие объёмы приготовленного: разложить в неглубокую посуду, а не оставлять кастрюлю остывать до ночи.
3. Разогревать до горячего состояния во всей толще, а не до тёплого; повторно разогревать блюдо более одного раза не следует.
4. Хранить сырое мясо, птицу и рыбу отдельно от готовой еды, использовать разные доски и ножи, мыть руки после работы с сырыми продуктами.
5. Тщательно проваривать и прожаривать курицу, мясо, яйца; не есть блюда с сырыми яйцами домашнего приготовления в жару.
6. Мыть овощи, фрукты и зелень проточной водой, а разрезанный арбуз и дыню сразу убирать в холодильник.
7. Осторожно относиться к уличной еде без холодильного оборудования, кремовым изделиям и салатам с майонезом в жаркую погоду.

There are several groups of people for whom ordinary food poisoning is more dangerous than for others, and it makes sense for them to follow these rules more strictly and consult a doctor earlier: children in the first years of life, pregnant women, the elderly, as well as people with diabetes, chronic kidney disease, cirrhosis of the liver and those with reduced immunity. In pregnant women, listeriosis associated with soft cheeses made from unpasteurized milk and ready-made deli meats is of particular importance - it is dangerous for the fetus even with mild symptoms in the mother. And one more rule that is forgotten: with a viral intestinal infection, a person remains contagious for several days after the symptoms stop, so washing your hands with soap and a separate towel makes sense even after recovery, especially if there are children in the house.