Digestive Health

Updated 06 August 2014

Treating the trots

You're more in the loo than at your desk. Is it something you ate or do you have 24-hour gastric flu? Either way, you need to stop the trots - and fast.

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You're more in the loo than at your desk, and you still can can't figure out whether it's something you ate or whether you've got 24-hour gastric flu. Either way, you need to stop the trots - and fast.

Getting to the root of the problem
Diarrhoea can be caused by a wide variety of factors and agents. Spoilt food that has either started to ferment or gone sour, or is infected with microorganisms (both bacteria and viruses) is a common cause of diarrhoea.

During the summer, when parties and functions abound and it's hot and humid (not to mention the effect of power cuts!), food contaminated with microorganisms is an ideal medium for the proliferation of these infective agents.

Ironically, many favourite party dishes such as chicken pies and custards are perfect for promoting the growth of pathogens, especially if they're kept warm for long periods of time. In fact, party buffets or bain maries are startlingly similar to the water baths in bacteria are cultivated in laboratories!

When we eat contaminated food, we develop tummy upsets that can make us ill. These upsets usually last for 24 to 48 hours. The most common organisms responsible for bouts of post-party diarrhoea are Salmonella and Listeria, as well as many different viruses.

Unhygienic practices such as neglecting to wash one's hands when working with food, cross-contamination of foods in the same kitchen, inadequate cold-storage facilities, and repeated reheating of foods all contribute to microbiological growth.

There are, of course, a host of other more virulent microorganisms such as Shigella and amoebas that can cause serious, long-lasting diarrhoea. However, the focus of this article is on the less dangerous types of gastrointestinal infections that plague us at this time of year.

Prevention
Good hygiene practices can virtually eliminate food contamination. The following tips may be useful:

a) When visiting a restaurant:

  • Select a good-quality restaurant where you can preferably see the chefs working in the kitchen. Check them out to see if everything is spotless.
  • Wash your hands thoroughly when you're at a restaurant and dry them with hot air or disposable paper towels – don't use soggy material towels that may be contaminated by other patrons.
  • Select fresh foods and avoid 'bug breeders' such as chicken pies, chicken stews, custards, boiled salad dressings and desserts made with milk.
  • Avoid all limp foods that may have been reheated a couple of times.

b) In your home:

  • Inspect your fridge regularly and discard all suspect foods. Do the 'sniff test' - if the food smells sour, throw it away.
  • Store all foods at the proper temperature. If you keep on having to throw away food, your fridge may not be maintaining an adequate temperature and should be checked by a refrigeration engineer.
  • Let food cool down rapidly after cooking, before storing in the fridge. You can hasten the process by immersing the container in water to which you have added ice cubes.
  • Once the food is cool, either freeze it in the bottom of your freezer for quick results, or place in the coldest part of the fridge and use it as soon as possible.
  • Wash your hands thoroughly before working with food, particularly when handling raw meat or fish, and wash your hands repeatedly between food-processing tasks.
  • Make sure that all your utensils are clean and that you don't use the same knife and board for cutting meat and vegetables.
  • Scrub boards thoroughly with Jik or a strong detergent, and soak kitchen wipes and cloths in Jik water to ensure decontamination.
  • Allow frozen food to defrost in the fridge – it may take slightly longer, but is much safer.
  • If you have to reheat foods, make sure that they have been heated through for at least 5 to 10 minutes to avoid the growth of organisms.

Post-diarrhoea diet
If you're battling diarrhoea, try the following remedies to make life a bit more bearable:

  • If you have a 24-hour viral gastric flu, the best treatment is to allow the bugs to be flushed out of your system and not to take medications such as loperamide, unless the symptoms persist for longer than 24 hours.
  • While the symptoms persist, you should avoid eating anything. However, make sure that you have an adequate liquid intake (see next point).
  • Diarrhoea and/or vomiting depletes the body of large quantities of water and important electrolytes (sodium and potassium), which is why patients feel so limp and washed-out after a bout of gastric flu. It is essential to replace the liquid and these electrolytes. You can buy special electrolyte solutions at the chemist, or use the following easy home remedy that was featured in Time Magazine as the simplest remedy for diarrhoea:
    Mix a fistful of sugar and a pinch of table salt in 1 litre of clean, boiled and cooled water. Sip this mixture in small quantities all day until the diarrhoea abates. Continue to drink the rehydration mixture until you feel better.
  • Make sure that you take things easy and that you rest while rehydrating yourself.
  • When your appetite returns, start out by eating bland, low-fat foods such as dry toast with black tea, peeled, grated apple and boiled potato with boiled squash.
  • There is no harm in avoiding other foods for a day or so.
  • Once the diarrhoea has fully abated and you feel better with a return in appetite, you can start eating your normal diet again, but go easy on rich, fatty foods and alcohol.
  • To recolonise the 'good' microorganisms in your gut, which will have been scoured out by the diarrhoea, eat 1-2 cups of plain, fat-free yoghurt which contains live cultures for about a week. Also use a good probiotic supplement for at least a month. You can buy these supplements at health shops and chemists.

A word of warning
If your diarrhoea persists for longer than 48 hours, you need to see a doctor as you may need antibiotics to eradicate the microorganism that's causing your illness.

If babies and young children develop diarrhoea, you should immediately start giving them the rehydration mixture (see above) and take them to your doctor, nearest hospital or clinic. Diarrhoea can be fatal in young children and should be attended to without delay.

- (Dr Ingrid van Heerden, DietDoc, updated February 2008)

References:
(Bronstein, P (2006). A Simple Solution. Time. Oct 16, 2006, pp:36-43)

Read more:
General food safety
A-Z of Dehydration

 

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Digestive Health Expert

Dr. Estelle Wilken is a Senior Specialist in Internal Medicine and Gastroenterology at Tygerberg Hospital. She obtained her MBChB in 1976, her MMed (Int) in 1991 and her gastroenterology registration in 1995.

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