Manager Ryne Sandberg said Utley played through the illness on Sunday in Chicago. Utley came to Citizens Bank Park on Tuesday morning, but the skipper had to send him home.
"He was sick as a dog," Sandberg said. "I told him to go home. He wasn't looking good at all."
Carlos Ruiz replaced Utley in the No. 3 hole in the starting lineup, the first time the catcher has batted in that spot in the Major Leagues. Ruiz entered Tuesday hitting .235 in five games this season.
"He's a guy I like a lot of places in the lineup, and in some ways, it keeps the other guys in place with some continuity there with the way that the guys have been swinging the bats," Sandberg said.
Sandberg also said pitching coach Bob McClure "is a little under the weather." McClure will be in the dugout during Tuesday's game, though.