If you’ve got a dodgy tummy, diarrhoea and have been vomiting, it’s easy to blame a “tummy bug” or “off food”.

But which is it? Gastro or food poisoning?

What’s the difference anyway?

What’s gastroenteritis?

Gastroenteritis, or gastro for short, is a gut infection caused by a virus, bacterium or other microbe.

The gut is teeming with cells including healthy microbes and the cells lining the gut. But when viruses, bacteria and other microbes start to invade your gut, they colonise, build up in large numbers and eventually cause the cells lining the gut to inflame. The “-itis” at the end of gastroenteritis means inflammation.

Gastroenteritis is extremely common. In Australia there are an estimated 17.2 million cases a year.

So where do these gastro-causing microbes come from? Eating contaminated food is often the source.

However you can acquire these microbes in other ways. For example, if you touch a surface where someone sick from viral gastroenteritis had vomited on, that virus could transfer to your hands. And if your hands touched your mouth, you in turn could contract viral gastroenteritis.

What’s food poisoning?

Food poisoning refers to getting sick from eating food contaminated with chemicals, microbes or toxins.

For example if you ate food contaminated with insecticides or methyl alcohol (methanol) that would count as food poisoning. If you ate puffer fish or poisonous mushrooms that would count too. But food poisoning doesn’t include the effects of eating a food you’re allergic to.

The vast majority of food poisonings are as a result of food contaminated by microbes and their toxins. When you eat or drink them it’s like a missile strike. The toxins in particular can rapidly cause inflammation and damage the lining of the gut.

To add to the confusion, food poisoning is often referred to as foodborne gastroenteritis.

Food poisoning (or foodborne gastroenteritis) is also common in Australia. It accounts for about one-third of all cases of gastroenteritis or an estimated 5.4 million cases every year.

How can we tell the two apart?

Both gastroenteritis and food poisoning have symptoms such as diarrhoea, vomiting, nausea, abdominal cramps, fever and headaches. But these symptoms can come on in different ways.

Viral gastroenteritis, such as with norovirus, usually causes symptoms 24–48 hours after exposure, which can last for one to two days.

But food poisoning after eating microbial toxins can come on very quickly. For example, toxins from the bacterium Staphylococcus aureus can cause symptoms within 30 minutes of eating contaminated food, such as undercooked meat. Fortunately, symptoms usually get better within 24 hours.

Symptoms don’t always come on so quickly in all cases of bacterial food poisoning. For example, it can take as long as 70 days between exposure to Listeria and symptoms occurring, although, on average it’s about three weeks. This long incubation period can make it difficult to work out if a particular food is responsible for someone getting sick.

As a general guide food poisoning occurs quite quickly (within hours of eating contaminated food) while gastroenteritis can take a day or more after eating to get sick. But there is no hard and fast rule.

How do I prevent them?

The same precautions when handling food apply to preventing both gastroenteritis and food poisoning. These steps not only lower your risk of being affected in the first place, they lower your risk of you infecting others.

Wash your hands thoroughly with soap and water before preparing food. Use separate cutting boards and utensils for raw and cooked foods to help avoid cross-contamination. Cook food thoroughly and store it at safe temperatures.

Gastroenteritis can involve transmission of microbes through means other than food, for instance, via poo on your hands if you don’t wash your hands after using the toilet or after changing a child’s nappy. So wash your hands afterwards.

To prevent others from becoming sick, make sure you quickly disinfect contaminated surfaces thoroughly after someone vomits or has diarrhoea. First, put on gloves and wash surfaces with hot water and a detergent. Then disinfect using household bleach containing 0.1% hypochlorite.

How can I get better?

Treating both gastroenteritis and food poisoning focuses on preventing dehydration and relieving symptoms.

To avoid dehydration, drink plenty of fluids. For moderate or severe cases, you can buy commercial oral rehydration solution from a pharmacy.

You can also make your own oral rehydration solution by adding 6 teaspoons of sugar, ½ teaspoon of salt and ½ teaspoon of sodium bicarbonate to a litre of water. You can splash in some cordial for taste.

If symptoms are severe or persist you should see your GP or go to the emergency department.

Vincent Ho, Associate Professor and Clinical Academic Gastroenterologist, Western Sydney University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Opioids are commonly prescribed when you’re discharged from hospital after surgery to help manage pain at home.

These strong painkillers may have unwanted side effects or harms, such as constipation, drowsiness or the risk of dependence.

However, there are steps you can take to minimise those harms and use opioids more safely as you recover from surgery.

Which types of opioids are most common?

The most commonly prescribed opioids after surgery in Australia are oxycodone (brand names include Endone, OxyNorm) and tapentadol (Palexia).

In fact, about half of new oxycodone prescriptions in Australia occur after a recent hospital visit.

Most commonly, people will be given immediate-release opioids for their pain. These are quick-acting and are used to manage short-term pain.

Because they work quickly, their dose can be easily adjusted to manage current pain levels. Your doctor will provide instructions on how to adjust the dosage based on your pain levels.

Then there are slow-release opioids, which are specially formulated to slowly release the dose over about half to a full day. These may have “sustained-release”, “controlled-release” or “extended-release” on the box.

Slow-release formulations are primarily used for chronic or long-term pain. The slow-release form means the medicine does not have to be taken as often. However, it takes longer to have an effect compared with immediate-release, so it is not commonly used after surgery.

Controlling your pain after surgery is important. This allows you get up and start moving sooner, and recover faster. Moving around sooner after surgery prevents muscle wasting and harms associated with immobility, such as bed sores and blood clots.

Everyone’s pain levels and needs for pain medicines are different. Pain levels also decrease as your surgical wound heals, so you may need to take less of your medicine as you recover.

But there are also risks

As mentioned above, side effects of opioids include constipation and feeling drowsy or nauseous. The drowsiness can also make you more likely to fall over.

Opioids prescribed to manage pain at home after surgery are usually prescribed for short-term use.

But up to one in ten Australians still take them up to four months after surgery. One study found people didn’t know how to safely stop taking opioids.

Such long-term opioid use may lead to dependence and overdose. It can also reduce the medicine’s effectiveness. That’s because your body becomes used to the opioid and needs more of it to have the same effect.

Dependency and side effects are also more common with slow-release opioids than immediate-release opioids. This is because people are usually on slow-release opioids for longer.

Then there are concerns about “leftover” opioids. One study found 40% of participants were prescribed more than twice the amount they needed.

This results in unused opioids at home, which can be dangerous to the person and their family. Storing leftover opioids at home increases the risk of taking too much, sharing with others inappropriately, and using without doctor supervision.

How to mimimise the risks

Before using opioids, speak to your doctor or pharmacist about using over-the-counter pain medicines such as paracetamol or anti-inflammatories such as ibuprofen (for example, Nurofen, Brufen) or diclofenac (for example, Voltaren, Fenac).

These can be quite effective at controlling pain and will lessen your need for opioids. They can often be used instead of opioids, but in some cases a combination of both is needed.

Other techniques to manage pain include physiotherapy, exercise, heat packs or ice packs. Speak to your doctor or pharmacist to discuss which techniques would benefit you the most.

However, if you do need opioids, there are some ways to make sure you use them safely and effectively:

• ask for immediate-release rather than slow-release opioids to lower your risk of side effects
• do not drink alcohol or take sleeping tablets while on opioids. This can increase any drowsiness, and lead to reduced alertness and slower breathing
• as you may be at higher risk of falls, remove trip hazards from your home and make sure you can safely get up off the sofa or bed and to the bathroom or kitchen
• before starting opioids, have a plan in place with your doctor or pharmacist about how and when to stop taking them. Opioids after surgery are ideally taken at the lowest possible dose for the shortest length of time.

If you’re concerned about side effects

If you are concerned about side effects while taking opioids, speak to your pharmacist or doctor. Side effects include:

• constipation – your pharmacist will be able to give you lifestyle advice and recommend laxatives
• drowsiness – do not drive or operate heavy machinery. If you’re trying to stay awake during the day, but keep falling asleep, your dose may be too high and you should contact your doctor
• weakness and slowed breathing – this may be a sign of a more serious side effect such as respiratory depression which requires medical attention. Contact your doctor immediately.

If you’re having trouble stopping opioids

Talk to your doctor or pharmacist if you’re having trouble stopping opioids. They can give you alternatives to manage the pain and provide advice on gradually lowering your dose.

You may experience withdrawal effects, such as agitation, anxiety and insomnia, but your doctor and pharmacist can help you manage these.

How about leftover opioids?

After you have finished using opioids, take any leftovers to your local pharmacy to dispose of them safely, free of charge.

Do not share opioids with others and keep them away from others in the house who do not need them, as opioids can cause unintended harms if not used under the supervision of a medical professional. This could include accidental ingestion by children.

For more information, speak to your pharmacist or doctor. Choosing Wisely Australia also has free online information about managing pain and opioid medicines.

Katelyn Jauregui, PhD Candidate and Clinical Pharmacist, School of Pharmacy, Faculty of Medicine and Health, University of Sydney; Asad Patanwala, Professor, Sydney School of Pharmacy, University of Sydney; Jonathan Penm, Senior lecturer, School of Pharmacy, University of Sydney, and Shania Liu, Postdoctoral Research Fellow, Faculty of Medicine and Dentistry, University of Alberta

This article is republished from The Conversation under a Creative Commons license. Read the original article.