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If the holiday buffet has your stomach in knots, you're not alone. "From Thanksgiving to New Year's, doctors are flooded with calls from holiday revelers who are fighting intestinal problems, including diarrhea, vomiting, and lactose intolerance," says Harry Clearfield, M.D., a gastroenterologist at Hahnemann University Hospital, in Philadelphia.
Even during the rest of the year, summer picnics and anytime buffets or cookouts can leave you feeling less than happy about what you ate. Here's how to find relief:1) Stop stomach poisoning
"The risk for food-borne illness is high over the holidays because people eat foods that are left out way too long at parties and buffets," says Susan Conley, director of food-safety education for the USDA's Food Safety Inspection Service.
More than two dozen types of bacteria and viruses can set up camp in your food and cause vomiting, diarrhea, and mild fever four to 24 hours after you've cleaned your plate. The Centers for Disease Control and Prevention (CDC), in Atlanta, estimates that 76 million people in the U.S. suffer from food-borne illnesses annually. Though most recover on their own, as many as 325,000 people require hospitalization.
A recent study by the CDC found that raw or undercooked eggs, a hot-bed of salmonella, were the most commonly determined cause of food-borne illnesses. Holiday favorites, including cookie dough, hollandaise sauce, and homemade eggnog are potential culprits. Other dangers may be hidden in your main course: turkey. In a study published in 1998, the USDA tested more than a thousand turkeys from across the country and found that 19 percent harbored salmonella, and 90 percent contained campylobacter, one of the most common bacteria implicated in food poisoning.
Prevention pointers: Only 12 percent of Americans regularly use a food thermometer while cooking, but it's the best way to make sure foods reach bacteria-killing temperatures. Cook poultry to 180 degrees F., pork to 160 degrees F., and roasts to 145 degrees F. Take your reading in the thickest area, away from bone, fat, and gristle. And don't forget to check the stuffing, which should reach 165 degrees F.
Fruits and veggies can also carry dangerous bacteria. Wash them thoroughly under running water, and avoid cross-contamination by using separate cutting boards for meats and vegetables. Leave leftovers unrefrigerated for no longer than two hours, and if you've cooked a large batch of food (say a pot of soup), divide it into shallow containers before storing. "Otherwise, the center of the dish may not cool down within two hours, and bacteria could have a field day," says Jackie Newgent, R.D., a New York City-based spokesperson for the American Dietetic Association. If you must make a recipe with raw eggs, use the pasteurized variety.
If you're the guest at a holiday meal, pass on poultry that looks pink -- it's probably undercooked. Dining buffet style? Make your plate early, especially if cold food isn't on ice or hot food isn't on a burner, suggests Newgent. Pregnant women and people with weakened immune systems should take special precautions, avoiding hot dogs, soft cheeses (such as goat cheese), and deli meats because these can harbor listeria, a bacteria that can cause miscarriages, birth defects, and stillbirths.
Rx for relief: Get plenty of rest and stay hydrated. If you're vomiting, take small sips of water every 15 minutes. If you have diarrhea, eat salted crackers and drink about one half cup of white grape or apple juice diluted with one half cup of water every two to three hours. "This will replace the sugar and salt your body has lost," says Maria T. Abreu, M.D., assistant director, research, at the Inflammatory Bowel Disease Center at Cedars-Sinai Medical Center, in Los Angeles. See your doctor immediately if you notice blood in your stool, a tip-off that the infection could be serious.
A few warnings: Don't take an antidiarrheal medication unless you have the green light from your doctor. "Diarrhea is your body's way of getting rid of the organisms that are making you sick," says Abreu. And avoid antibiotics. A recent study found that they may increase the risk of serious complications from food-borne illnesses, including liver failure.2) Fight the flu
Gastroenteritis, the medical term for the stomach flu, can be triggered by food poisoning, but a virus is usually responsible. The result? Twenty-four to 48 hours of nausea, vomiting, diarrhea, abdominal discomfort, headache, fever, and muscle aches. "It's difficult to distinguish between viral gastroenteritis and food-borne illnesses without lab tests," says Abreu. Of course, if several party-goers get sick at the same time, you can point the finger at food.
Seasonal sources: You catch the stomach flu the same way you do a cold -- by touching the hands of infected people and then touching your eyes, nose, or mouth. Since we socialize more over the holidays, it's easier for the virus to be passed around.
Prevention pointers: Wash your hands frequently, especially before and after eating finger foods. Scrub with soap and warm water for at least 15 seconds. Dry your hands completely with a clean or disposable towel. Be careful not to share food or utensils, which may also transmit a virus.
Rx for relief: Follow the same treatment as for food poisoning, getting plenty of rest and fluids. Also avoid antidiarrheal medications, which can prolong the illness.3) Put an end to extra pit stops
Don't be surprised if your Christmas bonanza has you bound for the bathroom again and again. "It's common for people's bowel movements to double from one or two to three or four daily at this time of year," says Abreu. "People call that diarrhea, but it's not." Diarrhea -- defined as frequent loose, watery stools -- almost always has an underlying cause, such as food poisoning.
Seasonal sources: Stress and fatty foods can help usher food through the digestive system, resulting in more bathroom breaks.
Prevention pointers: Indulge in one or two high-fat foods, but focus on healthier options like chicken or turkey breasts, sans the skin. Cut back on stress by scheduling time for yourself: Get a massage after you finish your holiday shopping, or hire a baby-sitter so you can have a night out with your husband.
Rx for relief: Let it ride its course, suggests Abreu. It will subside once your stress levels and eating habits return to normal.
A muscular valve at the end of your esophagus helps trap digestive juices where they belong -- in your stomach. If the valve loosens -- sometimes due to overeating -- acid travels up your esophagus, causing a burning sensation. About one in three women complain of frequent heartburn at Christmastime, according to the American College of Gastroenterology. What's causing the burn? Overeating and common holiday foods make it harder for the valve to stay tightly closed.
Seasonal sources: Everything from candy canes to champagne can make you feel the burn. "Chocolate, alcohol, anything flavored with mint, caffeine, citrus foods, tomatoes, and onions are all culprits, and high-fat foods have the potential to cause acid reflux because they relax the valve," says John W. Popp, Jr., M.D., a clinical professor of medicine at the University of South Carolina School of Medicine, in Columbia.
Prevention pointers: Don't overeat. Before attending a holiday party, have a bowl of soup (avoid the tomato-based variety, which can trigger heartburn) to help fill you up. Once you're at the party, eat small portions so you can taste an array of foods without overdoing it. Limit yourself to just one alcoholic beverage, then switch to water or a non-citrus punch. And don't hit the sack until at least two hours after your last bite. "Lying down makes it easier for acid to travel up the esophagus," says Popp.
If you're especially susceptible to heartburn, take an over-the-counter acid blocker, such as Tagamet or Zantac, about 45 minutes before your feast begins. (Check with your doctor first.)
Rx for relief: If heartburn hits, acid blockers will provide little relief. Instead, try an over-the-counter antacid, such as Tums, Mylanta, or Rolaids. If you don't have any in your medicine cabinet, drink one half teaspoon of baking soda mixed in eight ounces of water to neutralize stomach acid and soothe the esophagus, suggests Fred M. Sutton, M.D., an associate professor of medicine at Baylor College of Medicine, in Houston. Or suck on hard candy (anything but mints) to increase saliva, a natural acid-neutralizer. If heartburn persists, or occurs more than twice a week, talk to your doctor -- you may have a more serious condition called gastroesophageal reflux disease (GERD).5) Down dairy with ease
People tend to eat more dairy products during the holidays than they do the rest of the year," says Sutton. "So even if you don't normally notice a problem with lactose intolerance, you may feel it now." To digest the sugar (lactose) in milk, cheese, ice cream, and other dairy foods, your body needs an ample supply of the enzyme lactase. Unfortunately, thirty million to fifty million people in the U.S. don't have enough lactase. And although experts don't know why, people who have recently suffered from the stomach flu may also have a temporary shortage of lactase. Without enough of the enzyme, too much dairy can cause lactose to linger in the stomach, causing bacteria to accumulate, leading to bloating, gas, and sometimes diarrhea.
Seasonal sources: Cheesecake, ice cream, and eggnog are among the usual suspects, but milk and its dairy cousins are hidden in holiday fare like pumpkin pie and fudge.
Prevention pointers: If you're extremely sensitive to dairy foods, take a lactase supplement, available in pill or liquid form, before the holiday meal. (Check with your doctor first.) "It supplies your body with the lactase it needs to digest dairy products," says Abreu. If you forget to take the supplement in time, pass on milk- and cream-based foods, but you can still feast on aged cheeses like Parmesan, which have low levels of lactose, and yogurt with live cultures, which aids digestion.
Rx for relief: Unfortunately, once symptoms of lactose intolerance strike, there's little you can do. "Your best bet is to find a bathroom," says Abreu.6) Beat irritable bowel symptoms
About five million Americans, mostly women, suffer from irritable bowel syndrome (IBS), which causes abdominal pain, bloating, diarrhea, or constipation. Extra stress during the holidays can make the condition even worse.
Seasonal sources: Dairy products and high-fat foods may cause flare-ups, but the most common culprit is stress. In a 16 month study of more than 100 irritable bowel sufferers, researchers at Royal North Shore Hospital, in Sydney, Australia, found that the intensity of symptoms could be attributed to chronic stress in 97 percent of cases.
Prevention pointers: Stick to low-fat meals, and talk to your doctor about new medications, including antidepressants, to treat IBS. And pinpoint what aspect of the holidays has you in knots. Is it paying the bills? Set spending limits and be sure to stick to them. Is it cooking a holiday feast? Switch to potluck or order from your local gourmet food store.
Rx for relief: Stamp out stress: Take a walk around the neighborhood, chat with a friend, sign up for a yoga class at your local YMCA, or make an appointment for a manicure.