Ask the doctor

I always get sick when I go home for ChristmasI am a 25 year old student living in Rwanda but my family lives in Uganda. I usually go home over the holidays but this year, I am reluctant. You see, the last two years, I always come back with a case of food poisoning. At least that is what I think. My friends insist I probably just ate too much but that is not the case. Last year and the year before, I came back really sick. I’m beginning to think my stomach is too used to food here. Is there such a thing. My symptoms were diarrhea, vomiting and even a fever. Isn’t that food poisoning? Yet when I call home, they all seem fine. It’s worrying. Now I’m making up excuses to go this year. What do you think?Adrianna, KimironkoDear Adrianna,Technically speaking, food poisoning is any illness resulting from the consumption of contaminated food, pathogenic bacteria, viruses, or parasites that contaminate food, as well as chemical or natural toxins such as poisonous mushrooms. Symptoms usually develop from few to 72 hours after consumption of the contaminated substance. In case of some infections like shigellosis, salmonellosis, e.t.c symptoms subside by themselves after some time as bacteria and toxins are removed from the body by the lose motions. One may have one or more of the following symptoms, diarrhea, abdominal pain, vomiting, nausea, fever and muscle cramps.It is more likely to be a coincidence if you have food poisoning every time you visit home or there may be some other problem. There are other medical problems which manifest with the same symptoms as food poisoning, the most common being functional dyspepsia, indigestion. This could happen if you tend to overeat something you like. Similar symptoms can also be produced if the bowels are not cleared regularly. Chronic constipation tends to produce symptoms like food poisoning and also feeling of lethargy and body ache which can be mistaken for fever. Infections like malaria and typhoid can cause fever as well as diarrhea and or nausea and vomiting. But the problem will either not resolve or will recur in one or two days without specific treatment in this case.Do not be afraid of going home, after all your family is waiting for you. The best way to avoid food poisoning is to take freshly cooked homemade food where one is sure of the hygiene levels. If at all you are tempted to eat in a restaurant, take freshly cooked food or fried food, as the heat tends to destroy germs. Avoid raw salads, boiled eggs, refrigerated meat and milk products as these can be potentially contaminated. Ensure that drinking water is safe.Eat in small quantities on a regular basis and include more of fresh green vegetables and fruits, particularly papaya in your diet. Drink a lot of water. This prevents constipation and also dyspepsia. Take sweet desserts like cakes and pastry in moderation only as sugar rich substances tend to produce and aggravate dyspepsia.If at all the symptoms occur again, get a stool sample tested for any parasitic or protozoal infection. If fever recurs, measure it objectively whether really it is fever or you are just not feeling well, which can mimic fever. It is also good to get a blood smear tested for malaria. All these conditions are treatable.Thus there is nothing for you to worry about, go home and enjoy the stay. Just be careful as to what to eat and drink.Dr. Rachna Pande is a Specialist in Internal Medicine at Ruhengeri Hospital