Brief Answer:
Food poisoning

Detailed Answer:
Hello Ms. XXXXXXX
Thank you for your query.

I'm Dr. Shuba Hariprasad and will be answering your query today.
I have read through your query and understood your concerns.

I would like to first address your conerns:
- your twin seems to have had food poisoning (common with shell fish & red meat). This usually recovers by itself in 48hrs unless a severe infection occurs.
In this case, she may have a fever, prolonged diarrhea which is green with mucus & possibly blood. This needs to be treated with antibiotics & supportive therapy. I will not go into details with this as she seems to be already recovering.

- if the vomiting is too severe (not able to eat/drink or throws up right after eating), she needs an anti-emetic like Domperidone, ondasetron, taken atleast 40 minutes before she tries to eat again.
The water & electrolyte loss also needs to be replaced with oral rehydration solutions (maybe available as an OTC). About 200 ml slowly, after a vomiting or loose stool episode. This is in addition to water & regular diet.
Refrigerate it and ask her to take it in small sips.

-milk is a natural antidote for ulcers & relieves symptoms of acidity. However, it may worsen the diarrhea. If her diarrhea still persists, I suggest she withholds milk till she is diarrhea free for more than 24 hrs & has passed a normal stool. Restarting milk may cause diarrhea again. In this case start with smaller amount and gradually work it up.

-I understand your concern of a coffee ground vomitus (blood). However, if it was just the once and now it is clear (yellowish or with food she ate) and her stool are also brown (not black),it's fine.
If not and it continues to be coffee - ground colour- take her to the ER right away. This is gastrointestinal bleeding & needs immediate medical attention.

-headache may be due to dehydration and the pressure caused by throwing up. Monitor her urine output. It should be light yellow. Her tongue should not be dry or coated.

Some things I would like to caution you about :

- aleve is a non steroidal anti-inflammatory drug (NSAID) & is not advised in a person with duodenal ulcer. This can worsen ulcer and cause it to bleed.

-I would suggest ulcer therapy with more potent Proton pump inhibitors like nexium or pantoprazole for a brief period till her symptoms heal and till the ulcer has healed.

-shell fish exacerbates acidity and can worsen the ulcer.

Recommendations ;
-Hydration, bland & easily digestible meals (soups, for instance), smaller & more frequent meals is advised for now. This will help the stomach recover and also give her enough nutrition.

-avoid caffeine on an empty stomach. Black tea with honey may help with reducing the diarrhea.

-avoid sweets, sugars. This worsens diarrhea.

Hope this helps. I hope she feels better.

Please let me know if there is anything else I can help you with or if you need further clarification.

If not, please close this discussion & rate my answer.
Wish you both good health.

Regards,
Dr. Shuba Hariprasad

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Brief Answer:
Different people react differently

Detailed Answer:
Hello,
Thank you for the follow up.

I see your point.
However,
1) I believe that the shell fish or the pork meatballs did not suit your sister or that that she was unfortunate to get a contaminated one .It could also be something else she ate.
2) that said, even if the whole batch was contaminated, each one responds to a the same contamination in different ways depending on what suits/irritates our body or the level of immunity we have at that point of time. It may (hope not) affect you a little later. (Sorry, am just trying to explain how each individual is different, even twins)
3) certain food combinations (if she has something else alone with that even a drink), it could have lead to intolerance. you mentioned a chocolate, that tips the balance in favour for food poisoning. Even microorganisms have a sweet tooth. Sugars alter the pH and good bacteria levels in your body.

An ulcer does not predispose you to food poisoning directly. It could make you prone to certain other infections (due to the treatment taken for an ulcer) or alter the way you digest food due to the acid levels & inflamed mucosa.

It is possible that may have also been affected but your body has the ability to deal with it or the contamination was not encouraged by other food stuff.

I hope this makes sense. I hope I've addressed your queries adequately.

Please let me know if there is anything else I can help you with.
If not, please close this discussion & rate my answer.

Wish you good health

Regards,
Dr.Shuba Hariprasad

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