How many of us have taken hawkers food and ended up puking and rushing to the toilet to pass out watery stools. Then there are the abdominal cramps which strike every now and then causing the victims to double up in pain and clutching their stomachs. Food poisoning or gastroenteritis is very real and very common.
Gastroenteritis is one of the most common medical condition seen in a family practice other than colds and coughs.
It occurs at all ages from babies to elderly adults.
The most important danger is the dehydration and loss of nutrients and salts that it can cause resulting in fatalities.
Gastroenteritis is usually due to food poisoning from eating unhygienic food.
A common cause is from non-home hawker or even restaurant food and overnight food.
Most of the germs are viral in nature but there may be rarely bacterial infection such as salmonella infection.
A survey of the food causing gastroenteritis at one stage found that 50 per cent of the illness is brought about by eating chicken or duck rice in Singapore probably because the chicken or duck are left hanging on the stall exposed to germs, flies, spittle,dust etc.
The Environment ministry have now insisted that all stalls should have 3 quarters of the stall covered by glass or plastic shelves.
1.Since then the incidence of food poisoning due to chicken or duck rice has been reduced to 25 percent.
2.Another 25 per cent was contributed by seafood especially those bought from contaminated waters such as oil spills or waste discharge.
3.Another 25 per cent was from fruits and fruit juice vendors who handle the cut fruits with unhygienic hands and dirty utensils.
4.The last 25 per cent was from all the other food sold.
The safest food was those that are boiled at 100 degree centigrade such as soups.
Gastroenteritis may present with symptoms of vomiting and diarrhea.
The worst is when there is vomiting involved because of the inability to swallow medicines without vomiting it out.
In the case of babies dehydration can quickly set in.
They should always be sent to hospital for intravenous nutrition.
Most cases of diarrhea in children comes from dirt on the ground or from other children in child care facilities.
It is difficult for a child not to explore the floor or the toys with their hands which is then put into the mouth.
Sometimes the toy itself is put into the mouth.
All toys which the children may come into contact should cleaned properly .
The importance of an hygienic environment must also be emphasized.
The hands of the children must be cleansed with a clean cloth once in a while.
Some illness such as hand mouth and foot disease can be caused by certain rotavirus which can spread to the air and cause gastroenteritis.
I usually treat most gastroenteritis with lomotil or imodium with good results.
Sometime a stool hardener such as kaolin will also help to stop the diarrhea faster.
An anticholinergic may be given to stop pain.
Rarely antibiotic are given if bacterial infection is suspected.
Diarrhea itself may not be due to food poisoning.
In babies lactose intolerance to cow's milk may be a cause of diarrhea and the cow's milk must be substituted with soya bean milk.
Some diarrhea in adults are due to Irritable Bowel Syndrome and can be controlled with anticholinergic or tranquillisers.
A unique case of chronic diarrhea was seen in a baby of one and half years who had diarrhea or watery stools since the age of 6 months. He probably had a mild case of food poisoning and was treated by his pediatrician who told him to stop his milk and change to soya bean milk and gave him some kaolin.
The diarrhea did not stop so he was brought to another pediatrician who again change his milk.
Again the diarrhea did not stop .
So he was brought to many other doctors before coming to see me.
Each doctor asked the parents to change to another type of milk or soya bean milk and gave medicines.
By the time the child saw me he was slightly dehydrated but otherwise quite healthy. He already had X-rays of the abdomen, blood and stools tested by the pediatricians without obvious abnormally.
I had suspected that it was the frequent change of milk that caused the problem in the child. I asked the parents what milk the child was taking before the diarrhea and advised them to return to that milk but given at half strength. I also gave the child some mild anti diarrhea medicine. The parents were to increase the strength of the milk once the diarrhea improved.
After 1 week the child made a complete recovery.
It was the constant change of milk that caused the child's intestine irritable. Just by returning to the old milk and diluting the milk the child was able to handle the digestion of his milk.
It was a case of the proverb "If it ain't broken don't change it."
In fact for all children with diarrhea, I do not ask them to change milk just dilute it to half strength and take the medicines that I gave.
No comments:
Post a Comment