Stomach upsets, typhoid and food safety at home

Diarrhoea and vomiting are common and usually short-lived. The priority at home is fluid, not medicine, and knowing which symptoms mean you need to be seen.

Caring for a stomach upset at home

• Drink small amounts often. Oral rehydration salts are better than water alone when losses are heavy.
• Eat when you feel able. Plain foods such as rice, porridge, bananas or bread are usually tolerated.
• Avoid very fatty or very sugary foods and alcohol until you recover.
• Wash hands thoroughly after using the toilet and before handling food, to protect the rest of the household.

Anti-diarrhoeal medicines are not suitable for everyone and should be avoided in children and when there is blood in the stool or a high fever. Ask a pharmacist or clinician first.

Signs of dehydration

Thirst, dry mouth, passing little urine or dark urine, dizziness on standing, and in children sunken eyes, no tears when crying, or unusual sleepiness. Dehydration in babies and older adults can develop fast and needs prompt care.

How typhoid differs

Typhoid fever is a bacterial infection spread through contaminated food and water. Rather than sudden diarrhoea, it often begins with a fever that climbs over several days, headache, abdominal pain, weakness and poor appetite. Some people have constipation rather than diarrhoea. It is diagnosed with a blood test and treated with antibiotics chosen by a clinician.

A single widely used rapid test can be unreliable on its own, so treatment decisions should be based on a proper assessment rather than one quick result.

When to seek care

• Blood in stool or vomit
• A fever that lasts more than three days, or a very high fever
• Severe abdominal pain
• Signs of dehydration, or inability to keep fluids down
• Diarrhoea lasting more than a few days, or any diarrhoea in a young baby
• Recent travel to an area with a cholera outbreak, with sudden heavy watery stools

Prevention: water and food

• Drink treated, boiled or bottled water where supply quality is uncertain, and use the same water for brushing teeth and washing produce.
• Wash fruits and vegetables with clean water, peeling where practical.
• Cook meat and fish thoroughly, and keep raw and cooked foods separate.
• Refrigerate leftovers promptly and reheat until steaming hot.
• Wash hands with soap before cooking and eating, and after the toilet.
• Choose busy food vendors where food is cooked fresh and served hot.

Typhoid vaccination is available and may be worth discussing with a clinician, particularly before travel to higher-risk areas.