Stephen J. Schueler, M.D.

Overview Incidence Symptoms Evaluation Treatment questions for doctor Home Care diarrhea in adults diarrhea in children itching vomiting in adults vomiting in children warning signs Prevention Outlook Complications Underlying Cause

Fish Poisoning Home Care

Home care for ciguatera includes:

  • Oral rehydration therapy for older children and adults:
    • Drink clear liquids only, such as water, sports drinks (best), fruit juice and dilute tea.
    • Drink small quantities of fluids frequently, such as 2 tablespoons of fluid every 5 minutes.
    • The absence of food allows the intestines to rest.
    • May be able to advance to full liquid diet once symptoms improve
    • Effective to treat mild to moderate dehydration
  • For two weeks after the ciguatera poisoning
    • Do not drink alcohol.
    • Avoid eating reef fish.
    • Avoid eating shellfish.
    • Avoid eating nuts.
  • Take nonprescription antihistamines for itching
  • Take cool baths for itching.
    • Add Aveeno to the bath water.
  • Take prescribed medications as directed:
    • Don't skip doses of your medication. This makes them less effective.
    • Be aware of the common side effects that may be caused by your medication.

Fish Poisoning Diarrhea in Adults

Home treatment of diarrhea in someone with ciguatera includes hydration and dietary therapy.

Hydration
Those who are able to drink liquids can restore lost water and salt with oral rehydration therapy (ORT).

ORT fluids are usually used in children, but are also effective for adults. These include:

  • Infalyte
  • Lytren
  • Naturalyte
  • Pedialyte
  • Rehydralyte
  • ReVital
  • Generic drugstore brands

Additional ORT fluids include:
  • Soft drinks without caffeine
  • Sports drinks (Gatorade)
  • Tea
  • Water

Dietary Therapy
ORT is most important if you have vomiting with the diarrhea. Once vomiting and nausea resolves, eat bland foods first. If you tolerate bland food, then you can resume a normal diet.

Foods that may help diarrhea:
  • Applesauce
  • Bananas
  • Bread
  • Cereal
  • Crackers
  • Mashed potatoes
  • Noodles
  • Oatmeal
  • Potatoes
  • Rice
  • Strained carrots
  • Wheat
  • Yogurt

Items that may worsen diarrhea include:
  • Alcohol
  • Caffeine
  • Concentrated fruit juices
  • High-sugar foods (junk food)
  • Cow's milk
  • Spicy foods
  • Sugar substitutes

Fish Poisoning Diarrhea in Children

Home treatment of diarrhea in children with ciguatera includes hydration and dietary therapy.

Hydration
Those who are able to drink liquids can restore lost water and salt with oral rehydration therapy (ORT).

ORT fluids used in children include:

  • Infalyte
  • Lytren
  • Naturalyte
  • Pedialyte
  • Rehydralyte
  • ReVital
  • Generic drugstore brands

Additional ORT fluids for older children include:
  • Soft drinks without caffeine
  • Sports drinks (Gatorade)
  • Tea
  • Water

Strategies for breast-fed infants under 6 months include:
  • Continue breast feeding as much as your baby desires.
  • Provide additional ORT fluids to supplement breast milk.
  • If vomiting occurs, provide small amounts of ORT fluids every 30-60 minutes.
  • Prevent diaper rash by changing diapers frequently and apply Vaseline to the skin.
  • Watch for symptoms of dehydration.

Strategies for bottle-fed infants under 6 months:
  • Give your child normal amounts of formula.
  • Provide as much ORT fluids as your baby desires.
  • If vomiting occurs, provide small amounts of ORT fluids every 30-60 minutes.
  • If vomiting occurs, try a lactose-free formula.
  • Prevent diaper rash by changing diapers frequently and apply Vaseline to the skin.
  • Watch for symptoms of dehydration.

Strategies for children over 6 months:

Dietary Therapy
ORT is most important if you have vomiting with the diarrhea. Once vomiting and nausea resolves, provide bland foods first. If bland foods are tolerated, then you resume a normal diet.

Foods that may help diarrhea:
  • Applesauce
  • Bananas
  • Bread
  • Cereal
  • Crackers
  • Mashed potatoes
  • Noodles
  • Oatmeal
  • Potatoes
  • Rice
  • Strained carrots
  • Wheat
  • Yogurt

Items that may worsen diarrhea include:
  • Alcohol
  • Caffeine
  • Concentrated fruit juices
  • High-sugar foods junk food
  • Cow's milk
  • Spicy foods
  • Sugar substitutes

Fish Poisoning Itching

Medications for itching in someone with ciguatera include:


Oral antihistamines can be sedating. Use with caution and do not mix with alcohol or other sedatives. Follow directions on product packaging

Fish Poisoning Vomiting in Adults

Home care for vomiting in adults with ciguatera:

  • Drink clear liquids only, such as water, sports drinks, fruit juice and dilute tea. Sports drinks are best. The absence of food allows the intestines to rest.
  • Drink small quantities of fluids frequently. In general, two tablespoons of fluid every 5 minutes is an effective strategy.
  • Avoid milk and dairy products for 3 days.
  • Avoid liquids that irritate the stomach, such as citrus juice, alcohol and coffee.
  • If nausea or vomiting continues despite the above, consider one of the nonprescription medicines listed below.
  • Once vomiting and nausea resolves, start bland foods first. If you tolerate bland food, then you can resume a normal diet.

Nonprescription medications for vomiting include:

Fish Poisoning Vomiting in Children

Home treatment of vomiting in children with ciguatera includes hydration and dietary therapy. Those who are able to drink liquids can restore lost water and salt with oral rehydration therapy (ORT).

ORT fluids used in infants include:

  • Infalyte
  • Lytren
  • Naturalyte
  • Pedialyte
  • Rehydralyte

ORT fluids used in older children include:
  • Sports drinks (Gatorade)
  • Broth
  • Dilute fruit juices
  • Flat soda
  • Weak tea with sugar

Strategies for breast-fed infants younger than 6 months:
  • If the infant tolerates breast milk, continue breast-feeding in small amounts very frequently.
  • Provide additional ORT fluids to supplement breast milk.
  • Feed very small amounts every 30-60 minutes, or try giving small amounts more frequently, such as:
    • Children up to 5 kg (11 lb): give 5 ml (1 teaspoon) every 5 minutes
    • Children 5-10 kg (11-22 lb): give 10 ml (2 teaspoons) every 5 minutes
  • Watch for dehydration: dry mouth, decreased urination, dark yellow urine and lack of tears.

Strategies for formula-fed infants younger than 6 months:
  • If the infant tolerates formula, continue to provide small amounts very frequently.
  • Provide additional ORT fluids to supplement formula.
  • Try giving small amounts more frequently, such as:
    • Children up to 5 kg (11 lb): give 5 ml (1 teaspoon) every 5 minutes
    • Children 5-10 kg (11-22 lb): give 10 ml (2 teaspoons) every 5 minutes
  • Watch for dehydration: dry mouth, decreased urination, dark yellow urine and lack of tears.

Strategies for children over 6 months:
  • Provide as much ORT fluids as your child desires.
  • If vomiting occurs, provide small amounts of ORT fluids more frequently:
    • Children 10-20 kg (22-44 lb): 15 ml (1 tablespoon) every 5 minutes
    • Children 20-40 kg (44-88 lb): 22 ml (1 and 1/2 tablespoons) every 5 minutes
    • Children 40 kg (88 lb) and over: 30 ml (2 tablespoons) every 5 minutes
  • Watch for dehydration: dry mouth, decreased urination, dark yellow urine and lack of tears.

Dietary Therapy
Most children with vomiting improve in a few hours and symptoms usually resolve in one day. Once vomiting and nausea resolves, provide bland foods first. If bland foods are tolerated, then you resume a normal diet.

Foods that are easiest to tolerate include:
  • Crackers
  • Oatmeal
  • Jell-O
  • Soft foods
  • Yogurt

Foods to avoid include:
  • Concentrated fruit juices
  • Junk foods
  • Milk products
  • Recently introduced foods
  • Spicy foods

Nonprescription medicines for vomiting should only be used under the direction of your doctor.

Fish Poisoning Warning Signs

Continue to Fish Poisoning Prevention

Last Updated: Feb 14, 2011 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Fish Poisoning References
  1. Farstad DJ, Chow T. A brief case report and review of ciguatera poisoning. Wilderness Environ Med. 2001 Winter;12(4):263-9. [11769923]
  2. Isbister GK, Kiernan MC. Neurotoxic marine poisoning. Lancet Neurol. 2005 Apr;4(4):219-28. [1577810]
  3. Lewis RJ. The changing face of ciguatera. Toxicon. 2001 Jan;39(1):97-106. [10936626]
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