Introduction The term "food poisoning" is often referred to acute diarrhoea of any etiology. This is expected as diarrhoea is one of the main symptoms of "food poisoning" and most acute diarrhoeas are indeed caused by ingestion of contaminated food. Food poisoning is defined as an illness caused by consumption of food contaminated with bacteria, parasites, viruses or plants (mushrooms) and their toxins or chemicals. It is a common ailment in the community. It is also called traveler's diarrhoea when it afflicts travellers to foreign counties. Symptoms are caused by direct invasion of the gut wall by these bacteria or viruses, or by the irritant effects of toxins produced by these agents. Many different species of bacteria have been found to be causative agents for food poisoning. Bacillus cereus is commonly found in contaminated fried rice, Salmonella specie in partially cooked meat and eggs, and E coli in salads and beef. Once there is colonization of the foodstuff, adequate cooking/heating may not render the food safe as a number of these bacteria produce heat stable toxin. These toxins are not degradable by heating and can produce symptoms once ingested. Symptoms Abdominal cramps, diarrhoea, fever and vomiting are the common symptoms of food poisoning. The onset of symptoms is dependent on the causative agent. It can be as short as 1 hour after ingestion of the contaminated food or up 10 days as in the case for Campylobacter infection. However, most people with food poisoning will present with symptoms within the first 3 days. Treatment Rehydration and replacement The symptoms of diarrhoea, vomiting and fever can cause in loss of fluid and electrolytes. Intravenous fluid replacement should be considered early in the young infants and elderly individuals. Intravenous replacement should be considered also for anyone who is unable to retain oral fluids. Prolonged period with dehydration can cause impairment of kidney and brain function. Among patients who can still tolerate oral intake, oral rehydration solution (ORS) should be used. In the event when ORS is not available, rice water has been used in the pediatric setting with good results. In most food poisoning cases, rehydration and replacement of electrolyte may be all that is necessary. It is important to remind the patients that the output (diarrhoea episodes) is not dependent on the amount of oral rehydration, as some patients will restrict intake to reduce output! Symptomatic relief The use of anti-diarrhoea drugs (Imodium/Lomotil, activated charcoal, kaolin) can reduce diarrhoeal attacks. It is useful in mild cases especially when the patient is traveling. However, one must be warned that although there is a decrease in the number of episodes, the volume of loss is usually the same. Therefore the mainstay of management is still adequate rehydration and replacement. Anti-microbial/probiotics Most patients with food poisoning do not require antibiotics. The use of anti-microbial is indicated in elderly and immuno-compromised patients who have fever or invasive nature of the infection. Most physicians will give a 3-day course but a single dose has also been shown to be effective especially in travelers' diarrhoea. There is also a recent interest in the use of probiotics in the treatment of diarrhoea. There were some reported benefits in the use of lactobacillus in patients with food poisoning. However, there is lack of data from well-designed controlled trials to support its efficacy. Public health measures This is important when there is an epidemic or a cluster of cases in a particular location. As food poisoning is transmitted via the fecal-oral route, contamination of water may be a source of spread. Public health measures must be instituted early to prevent an outbreak. Good personal hygiene is also crucial in preventing the spread of the disease. Prognosis The outcome in most food poisoning cases has been excellent. Most food poisoning episodes are self-limiting. Most patients recover from acute diarrhoea without any sequelae.