What caused the stomach ache?

Life with young chidren seems to make stomach upsets unavoidable. Thankfully, they’re usually over pretty quickly. I often see posts about it on social media, so I’ve made a little infographic, and had a think about some of the questions that are sometimes asked. Like everything, there are exceptions to the rule. Like always, I’m not offering medical advice – if you’re worried go to the GP! Here’s the NHS page on gastroenteritis and how to look after yourself or your child and when to seek help.

Is it food poisoning?

Hard to say. Generally the viral stomach bugs, like norovirus and rotavirus, are transmitted from one person to another, or from the environment. But they can cause “food poisoning”. A food handler who is ill with norovirus could easily contaminate food (so they definitely should not be working!) and some foods can harbour norovirus too (raw oysters are a risk, for example).

Likewise, the things we traditionally think of as being linked to food poisoning, might not be. E. coli can be transmitted from person to person quite readily (especially in nurseries), or could be picked up on farms. Salmonella is often found in reptiles, we’ve had outbreaks linked to the mice that you feed snakes, other pet food, and people feeding hedgehogs in the gardens.

So is it food poisoning? Who knows!

What food did I get it from?

Even if you suspect food poisoning, narrowing down what caused it can be close to impossible. Even in large outbreaks, with many people ill it can be hard to find the food that caused it.

For common causes of food poisoning, such as Campylobacter or Salmonella, it usually takes couple of days from eating something contaminated with the bacteria to getting ill. That means, when your stomach starts churning, it is more likely to be the salad you ate two or three days ago, than the chicken kebab late last night. Many an innocent kebab shop, pizza restaurant or deli has been blamed for a dicky tummy, I fear.

Even if it was a restaurant, was it really their fault? If their lettuce had Salmonella in, did it get there from poor hygiene in the restaurant, or has it been there since the lettuce left the field? Could they have done anything to prevent it?

Obviously, if a large group of you all became ill a few days after eating the same meal, you stand a better chance of working out what the cause is, but even then, the individual ingredient to blame can be hard to pinpoint. Almost any food can cause food poisoning, from watercress to watermelon, from leeks and potatoes to oysters (sorry, I only included the oysters because the thought of serving them in a nursing home tickled me!).

In an outbreak of E. coli in Germany, it was hard to track down the cause because people didn’t recall or report eating the sprouted fenugreek seeds atop their salads. Likewise, Salmonella has been found in spices, which, unless you know the exactly ingredients of your take-away, would be impossible for you to guess.

Is it viral or bacterial (or parasitic, or something else)?

This is generally what people mean when they ask “is it food poisoning?” – is it a short, sharp bout of norovirus, or am I going to be ill for the next week? Well, take a look at my little graphic, and see what you think. It’s based on the most likely scenarios – there are always exceptions to the rule.

Bugs

And here’s some more detail:

The viruses

Generally, viruses are more common in the winter and come on suddenly. Norovirus is characterised by lots of vomit…everywhere! Rotavirus is often diarrhoea and vomiting! Norovirus tends to be short and sharp: just as you think this might be the end of you, suddenly the fog clears and you fancy that bacon butty after all. Rotavirus is similar in older children and adults as you will have built up immunity over time (almost all children over five have some immunity to it). In younger children it can be more severe, can cause severe dehydration, and is the most common cause of gastroenteritis in this age group…Luckily there’s now a great rotavirus vaccine available – Boybug has had his, and has been bug-free so far!

The bacteria

Campylobacter, Salmonella, E. coli to name a few. In comparison to the viruses, a bacterial infection might leave you feeling a little off for a few days before really getting to work. First it’s one end, then the other, and after day three you know you’re in for the long haul. You might feel like you have flu at the same time, or may notice blood. It’s really not nice! Sometimes you may need to go to the Dr (definitely do if you notice blood), sometimes they may give you antibiotics, other times they may decide the infection should clear up on its own. As well as wanting to avoid overuse of antibiotics, antibiotics can be really dangerous in cases of E. coli, especially in children. It’s unlikely that the GP will give a child antibiotics without first knowing what is causing the stomach upset!

Bacterial toxins

This is a mixed group of bacteria, which produce toxins, such as Bacillus cereus, Clostridium perfringens and Staphylococcus aureus. Often these toxins are not sensitive to heat, so once they get in food they aren’t destroyed by cooking. Onset is usually sudden, and only a few hours after ingesting the toxins. Diarrhoea is a common feature, but thankfully it doesn’t tend to last more than 24 to 48 hours.

Other things

The list is endless. Other causes can include parasites such as Cryptosporidium and Giardia, chemical contaminants in foods, side effects from prescription drugs, and underlying illness. If you’re worried – see the GP.

So, what did cause my illness?

In truth, I have no idea. Hopefully this shows that it’s really hard to work out which bug caused your illness without some lab tests, and it’s also very hard to say whether it’s food poisoning, and if so what food. Worth a though before blaming that poor kebab shop!

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