Best barf practices for food poisoning.
May 13, 2013 7:50 AM   Subscribe

I'm going to put most of this behind the cut because, ew, but basically my question is: what should you do when you feel the first symptoms of food poisoning?

I ate some bad supermarket sushi on Friday at lunchtime (or so I hypothesize), and an hour later I was feeling pretty terrible and nauseous and gastrointestinally upset, but decided if (as proved to be the case) I was going to hurl, I'd much rather hurl at home in my own toilet, so rather than spending some quality time in the restroom at work, I got in my car and drove home.

So here's my question: would I have been better off vomiting as soon as I felt the urge? Was the extra 40 minutes the food spent in my stomach in any way important to the progress of my illness or is food poisoning generally a case of "what's done is done" as soon as (or even before) you first start to feel bad?

For what it's worth, in this particular case the GI symptoms were done within a few hours, and although I had a feverish night I was basically fine within 24 hours. The one other time I had anything like this (not sure if it was food poisoning or something like norovirus) I was in misery for days.
posted by mskyle to Health & Fitness (8 answers total) 1 user marked this as a favorite
I've had that kind of food poisoning twice, and I have a feeling that it's the kind of thing where if the food being in your system an extra 40 minutes were going to be that severe a problem, your body would just simply have taken over (meaning - the fact that you didn't have to pull over and puke by the side of the road is probably a sign that you were okay driving home without having puked yet).

Feel better.
posted by EmpressCallipygos at 7:59 AM on May 13, 2013 [1 favorite]

Purely from a practical standpoint, I would have taken the opportunity to hurl at work, rather than risking losing control of and thoroughly soiling the car.

I can't speak to the toxin absorption except as a layman, and I would want to get rid of the toxin-bearing food as fast as I could. If your body is telling you to puke, do it as soon as you can.

Last time I had the 24-hours-of-sweats-and-puking it was discount sushi, too. My sympathies.

Your workplace culture might make a difference, of course. I would personally think a person more heroic if they went on bended knee before the porcelain god at in the office bathroom, then left with their flushed and pale head held high, rather than skulking off in mystery and anguish.
posted by Kakkerlak at 8:00 AM on May 13, 2013 [2 favorites]

If the symptoms come on that quickly, you are almost certainly dealing with staphylococcus aureus. Sadly, there isn't much you can do once it is coming, as the illness is more of a result of a toxin the bacteria produces instead of the bacteria itself.
posted by procrastination at 8:16 AM on May 13, 2013 [1 favorite]

the fact that you didn't have to pull over and puke by the side of the road is probably a sign that you were okay driving home without having puked yet

That's certainly been my experience. The human body can be incredibly efficient at getting rid of stuff it doesn't want.
posted by The Underpants Monster at 8:22 AM on May 13, 2013

Response by poster: Oh, at the risk of TMI, I will add: I did indeed need to pull over. One block from home. Not one of my finer moments, but fortunately I was able to return the sushi to the grocery bag from whence it came with no damage to the car.

So, just based on that experience, I will definitely be predisposed towards barfing first and driving home later.
posted by mskyle at 8:30 AM on May 13, 2013

"If the symptoms come on that quickly, you are almost certainly dealing with staphylococcus aureus."

On a related note, usually symptoms don't come on that quickly. Like, ninety-five percent infectious gastroenteritis is caused by bugs that typically strike 16-36 hours after ingestion.

So waiting a few minutes before you boot is probably only marginally increasing the time the bug has spent in your gut. The damage done in that fraction of time is probably not as great a concern as the danger of ralphing on your steering wheel, the having to sit on the high-way while feeling terrible.
posted by midmarch snowman at 8:37 AM on May 13, 2013 [2 favorites]

I don't know the science - and would be very interested in it - but it seems to me that my body gets rid of things when it needs to. Over the past year, I have eaten moldy tortillas and had a sip of spoiled milk (oops) and both time, I threw up within 10 minutes. My body just rejected the food immediately; waiting was not an option.
posted by insectosaurus at 1:04 PM on May 13, 2013

If you're getting sick within 1-6 hours of exposure, it's probably a toxin-mediated event, usually from toxins produced by Staph aureus (grows in mayo) or Bacillus cereus (grows on rice). Neither of these bacteria are able to survive in your gut, but staph enterotoxin A and cereulide, the toxin produced by B. cereus, withstand harsh environments and act by stimulating serotonin receptors on vagal nerve endings in your stomach which activate your gag reflex and medullary vomiting center, causing you to undertake a review of your lunch.

Inasmuch as you have agency to suppress this vomiting reflex (I doubt any of us really do), the additional few minutes that the toxin spends in your gut is probably inconsequential. For the most part, your body knows what to do.

Another possibility, however, (assuming there was fish in your sushi) is Scombroid food poisoning, though this would usually also present with flushing/sweating and headache. This poisoning occurs when fishy muscle fibers spoil and get digested by bacteria. One of their component amino acids, l-histidine, gets broken down to histamine and other similar compounds. The exact vomiting mechanism in this case is unknown, but suffice it to say that your vomiting center does have histamine receptors.

Harrison's mentions that "affected fish typically have a sharply metallic or peppery taste" (SPICY TUNA ANYONE?), and that this type of poisoning can also cause several other nasty sympoms including "headache, thirst, pharyngitis, palpitations, tachycardia, dizziness, and hypotension," such that Scombroid food poisoning is often mistaken for an allergic reaction.

The entry continues, "protracted nausea and vomiting, which may empty the stomach of toxin, may be controlled with a specific antiemetic," which implies a couple things about therapy relevant to your question: if the vomiting is causing you more distress than the other symptoms, then keeping the toxin onboard by suppressing vomiting is a prudent clinical decision (best decided by you + doctor). If, on the other hand, you want to get it all over with sooner, it may be more prudent to just get it all out of your system by letting the toxin do its thing. More often than not, toxin-mediated food poisoning is self-limited and clears up on its own within 8-12 hours.
posted by The White Hat at 2:40 PM on May 13, 2013 [9 favorites]

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