After a miserable day or two spent hugging the toilet, most of us wonder if it was something we ate (hello, sushi dinner!) or a typical tummy bug, aka the stomach flu. Of course, there’s no such thing as true stomach flu; the term is simply a colloquialism for a bout of gastroenteritis or a viral or bacterial infection, which is an inflammation of the digestive tract and intestines.

It’s tough to tell which you have since the symptoms can often be identical, but there are a few subtle differences to help you decipher between the two.

“They are both an explosion of your gastrointestinal tract so to speak,” says Dr. Patricia Raymond, fellow of the American College of Gastroenterology and associate professor of clinical internal medicine at Eastern Virginia Medical School in Norfolk, Va.

One way many people try to figure out if it was food poisoning or a tummy bug is to look back and remember if they ate something six to 12 hours before that was a likely culprit, such as cream-based foods, mayonnaise-based salads, meat items that weren’t cooked thoroughly, or sprouts or vegetables from a salad bar. If other family members are sick but did not eat the same foods, however, you’re likely looking at a bout of gastroenteritis.

According to the Centers for Disease Control and Prevention (CDC), about 76 million Americans get food poisoning every year, while viral gastroenteritis is a leading cause of severe diarrhea in both adults and children.

Many types of viruses can be the culprit, including norovirus (popularized by cruise ship outbreaks) and rotavirus, most common in children and elderly adults living in nursing homes.

How to tell which tummy trouble you have:

Need to know
Gastroenteritis
(stomach flu)
Food poisoning
Symptoms
Feeling low energy, muscle aches, stomach cramps, vomiting, diarrhea, fever
Weak, dizzy, nausea, vomiting, bloody diarrhea
Lag time
About 12 hours after coming in contact with the virus
4-6 hours after eating tainted food. Serious strains like E. coli can crop up 24 hours later, though.
Duration of symptoms
1-5 days
6-24 hours
Treatment
Drink clear liquids—Pedialyte, Gatorade or fruit juice with a pinch of salt to help replace lost electrolytes and prevent dehydration. Try an anti-nausea/ anti-diarrhea medication like Imodium.
 
After 24-48 hours start the BRAT diet (bananas, rice, applesauce, toast), which can help bind you up.
Drink plenty of fluids to help flush out your system and expel the toxins. Skip anti-diarrhea medication unless you have to leave the house, and then take the lowest possible dose. “You want the body to expel the toxins, not stop them up,” says Raymond.
Natural remedies
Arsenicum alb is a popular homeopathic remedy to reduce symptoms in both cases.
 
Colocynth, known as bitter apple helps with cramps, nausea and accompanying symptoms, and wind flower can be used to relieve vomiting associated with gastroenteritis.
Drink ginger tea as ginger is loaded with anti-inflammatory compounds that quell nausea.
 
Try 300-500 mg. of Andrographics twice a day, a Chinese herb that can eliminate symptoms. Or try a few drops of the South American herb Dragon’s Blood to help restore intestinal balance.
When to see the doctor or head to the ER
After 3 days with no improvement, or if you have a high fever over 102 F, if you’re dehydrated, are passing blood or having seizures.
If you’re still sick after 48 hours or passing blood, you should see the doctor right away.
The most important thing with both is to stay hydrated. The instinct is to not bother drinking because things are coming up both ends, but you must force down fluids regardless, stresses Raymond. Most people come to the ER totally dehydrated and at that point you’ll need IV fluids.

“For both of them you should also practice stringent hand washing,” Raymond says. You can spread germs whether your illness is bacterial or viral. Plus, if you suspect food poisoning and you think the trigger food was eaten at a restaurant, you should notify your physician because it may affect other patrons.

Of course, if you're taking prescription medicines or have a chronic health condition, check with your doctor before self-treating with over-the-counter or natural remedies.

And it doesn’t hurt to use a good probiotic once you’ve recovered, such as Lactobacillus acidophilus, which can help restore your digestive tract to normal more quickly after a bout of either of these tummy troubles.

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