Food Poisoning
Definition
Western
Food poisoning is an acute illness that develops after the ingestion of food which is contaminated by bacterial, viral or parasitic pathogens of both biological and/or chemical origins [1-2]. Typically characterised by vomiting and diarrhoea, accompanied by other gastrointestinal symptoms like nausea, excruciating abdominal pain and fever may occur. Contaminations can also happen if food is not handled with good hygiene, under cooked, or inappropriately stored [3]. The effects of food poisoning depend on the type of contaminants, the degree of contaminations, incubation period, as well as one’s immunity.
Traditional Chinese Medicine (TCM)
Food poisoning is a result of exogenous pathogens (substances harmful to the body) invading the digestive system, which, if not physiologically strong enough to defend itself against them, would become dysfunctional, whereby food cannot be properly transported down the gastrointestinal tract and digested into simpler substances for absorption into the bloodstream. This results in gastrointestinal disorders such as nausea, vomiting, gastric pain, abdominal pain and diarrhoea.
Classifications or Symptoms Displayed in TCM Context
Acute Onset
When the gastrointestinal tract suffers from bacterial / viral / fungal infections or harmful effects of toxins, the initial symptoms presented by the body are usually the results of the victim’s immediate immune responses and self-protective mechanisms. Common symptoms include vomiting, gastric pain, unbearable abdominal pain, diarrhoea, fever, headaches, body aches or malaise.
Post-acute Onset
If one’s digestive system is relatively weak, the physiological functions of the digestive system are more easily disrupted as a result of the infections. Hence the symptoms presented by the body at this stage are usually due to the body’s inability to digest food, absorb nutrients, and pass bowels effectively. Common symptoms include diarrhoea, abdominal pains that diminish after clearing bowels, bloated stomach, nausea, loss of appetite or fatigue.
Causes
Frequenting road-side stalls which practise poor hygiene and cooking habits, consuming food that was not handled or stored properly, or food that is past expiry, accidental contamination i.e. leaching of chemicals from containers or utensils, or food that has been treated with pesticides or fertilised with polluted water/animal waste products but are not thoroughly washed before cooking, or seafood especially shellfish which is contaminated with toxins [4] or heavy metals.
Risk Factors
Lifestyle
People who frequently consume cold drinks, alcohol, spicy and oily foods, or have irregular diet patterns. Such people usually have mild appetite, complaint of feeling bloated shortly after a meal, pass watery stools or have irregular bowel habits.
Treatments
Herbs commonly used in prescriptions are:
1. Huo Xiang -藿香
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English/ Common name
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Patchouli
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Latin species
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Pogostemon cablin
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Park of plant used
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Whole plant, except roots
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Action/s
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Has anti-spasmodic effects on gastrointestinal tract and helps to promote gastric secretions. Also has anti-bacterial [15], pain-relieving and anti-inflammatory effects [5].
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Precaution/s
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No significant side effects
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2. Zi Su -紫苏
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English/ Common name
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Shiso
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Latin species
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Perilla frutescens
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Park of plant used
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Whole plant, except roots
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Action/s
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Helps to promote the secretion of digestive juices and increase peristalsis of the gastrointestinal tract [15]. Also has anti-microbial activities [6].
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Precaution/s
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No significant side effects.
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3. Cang Zhu - 苍术
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English/ Common name
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Atractylodes
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Latin species
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Atractylodes Iancea (Thunb.) DC.
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Park of plant used
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Rhizomes
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Action/s
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Has anti-spasmodic effects on intestinal smooth muscles and promotes peristaltic movements of the gastrointestinal tract [15]. Also helps to promote gastric functions of the stomach [7] by regulating gastric secretions and inducing regular muscle contractions.
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Precaution/s
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Individuals who worked long hours or those who experience profuse sweating should not use.
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4. Sheng Jiang - 生姜
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English/ Common name
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Ginger
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Latin species
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Zingiber officinale Rosc.
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Park of plant used
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Rhizomes
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Action/s
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Helps in protecting the mucosa of gastric wall and relieves nausea [15]. Also has anti-bacterial [8] and anti-inflammatory effects [9-10].
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Precaution/s
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No significant side effects.
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5. Yi Yi Ren - 薏苡仁
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English/ Common name
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Chinese Barley, Coix seeds
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Latin species
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Coix lacryma
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Park of plant used
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Seeds
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Action/s
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Found to have pain-relieving [15] and anti-microbial effects [11]. Also effective against viral diseases through enhancement of cytotoxic activities [14].
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Precaution/s
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No significant side effects.
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6. Chen Pi - 陈皮
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English/ Common name
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Tangerine peel
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Latin species
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Citrus reticulata Blanco
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Park of plant used
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Skin of the fruit
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Action/s
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Found to have anti-fungal and anti-bacterial effects [12]. Also found to induce apoptosis in human gastric cancer cells [13].
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Precaution/s
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Individuals with chronic diarrhoea should use with caution.
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Tests & Diagnosis
Laboratory Tests
Test stool samples, vomitus and/or leftovers of ingested food to analyse the types of pathogens causing the food poisoning. Test blood serum to identify the nature of infections i.e. bacterial or viral. Clinical symptoms can help to support the diagnosis of food poisoning as well as identify the likely chemicals / microorganisms responsible for the cause.
Lifestyle & Home Remedies
Avoid frequent intakes of alcohol and cold drinks. Maintain regular diets and avoid overeating. Avoid eating foods that are raw, oily or spicy. When diagnosed with food-poisoning, drink lots of water to replenish lost body fluids. Maintain simple diets of plain rice porridge for at least the next 3 days after attack.
Huo Xiang + Zi Su + Cang Zhu + Yi Yi Ren + Chen Pi + Sheng Jiang
a) Soak barley in water overnight
b) Place cangzhu, yiyiren, chenpi and shengjiangin a cooking pot and add water till the pot is half filled.
c) Bring to boil for 20 minutes.
d) Add Huoxiang + zisu, simmer for a further 10 minutes
e) Remove herbs. Add brown sugar to taste. Serve warm
References
2. SM Matsui Food Poisoning. Encyclopedia of Gastroenterology 2003: pp59-62
3. D Roberts Food Poisoning Classification. Encyclopedia of Food Sciences and Nutrition (Second Edition) 2003 pp:2654-2658
4. EC Jong Food Poisoning: Toxic Syndromes. The Travel and Tropical Medicine Manual (Fourth Edition) 2008 (29): pp467-473
6. H Yamamoto, T Ogawa Antimicrobial activity of perilla seed polyphenols against oral pathogenic bacteria. Bioscience Biotechnology and Biochemistry 2002 66 (4): pp. 921–924
7. J Kitajima, A Kamoshita, T Ishikawa, A Takano, T Fukuda, S Isoda, Y Ida Glycosides of Atractylodes lancea. Chem Pharm Bull 2003(52): pp673-678
8. Yin MC, Cheng WS Inhibition of Aspergillus niger and Aspergillus flavus by some herbs and spices. J Food Protect. 1998 (61): pp123-125
9. JA Ojewole Analgesic, anti-inflammatory and hypoglycaemic effects of ethanol extract of Zingiber officinale (Roscoe) rhizomes (Zingiberaceae) in mice and rats. Phytother. Res. 2006 (20): pp764-772
10. RC Lantz, GJ Chen, M Sarihan, AM Solyom, SD Jolad, BN Timu The effect of extracts from ginger rhizome on inflammatory mediator production. Phytomedicine Feb 2007 14(2-3): pp123-128
11. Y Ishiguro, K Okamoto, F Ojima and Y Sonoda A novel antimicrobial substance in etiolated seedlings of adlay. Chem. Lett. 1993 (7): pp1139–1140
12. M Chutia, PD Bhuyan, MG Pathak, TC Sarma, P Boruah Antifungal activity and chemical composition of Citrus reticulata Blanco essential oil against phytopathogens from North East India. LWT-Food Science and Technology Apr 2009 42(3): pp777-780
13. Kim MJ, Park HJ, Hong MS, Park HJ, Kim MS, Leem KH, Kim JB, Kim YJ, Kim HK Citrus Reticlata blanco induces apoptosis in human gastric cancer cells SNU-668. Nutr Cancer 2005; 51(1):78-82
14. Soh CT, Kim SH, Kim KY, Park H, Chung HT, Kim TU, Jeon SM, Iian YB Biostatic activity of Coix Lacryma seed extract on Toxoplasma gondii in macrophages The Korean Journal of Parasitology 1996 34(3): pp197-206
15. Gao XM. Zhong Yao Xue. 2002.