Traveller's Diarrhoea



This is a general guide and does not replace the advice of a medical practitioner or pharmacist. Neither I nor this website are liable for the contents of any external internet sites listed.

Introduction

If you are trekking in Nepal I'm sure you will be conscious of health risks. But don't think that purchasing a package to a more popular destination with a top end tour company means you can eat and drink without worry. On my up-market Nile cruise, despite the clean luxury ship, well presented meals etc. two people in my group of five had to retire to their cabins for 3 days.

There is a Cholera vaccine that provides protection against some forms of traveller's tummy.


On long trips don't go without:

  • Toilet Roll (I've stayed in hotels where toilet paper seemed to have vanished)

  • The new low-osmolarity rehydration sachets with potassium (diarrhoea reduces the stomachs ability to absorb water, these sachets add sugars, salts/electrolytes to water enabling it be absorbed together with lost "salts"). Buy from somewhere reputable like Boots, to ensure you don't end up with expensive sachets of sugar.

  • Imodium/Anti-diarrhoea drugs: To quote rehydrate.org "Use cautiously as they are said to prolong the illness and may increase the risk of a carrier state. They are useful in some cases, however, when it is important that you don't have diarrhoea (e.g. when travelling on a bus)." You should seek a doctor's advice, it's a temporary travel measure, not a cure. There are circumstances when Imodium shouldn't be used (e.g. if you have blood in your stools) so read the instructions carefully.


Prevention (boil it, peel it, cook it or forget it)

There's lot of advice available, you will have to make your own judgement and balance practicality and enjoyment against risk.

  • Check your travel guide for advice on safety of drinking mains water:
    • clean your teeth with bottled water.
    • boil water, or use iodine tablets and a water filter.

  • Drink bottled water; don't buy from a mobile vendor, and make sure the seal is intact when you purchase.

  • Never have drinks with ice. Don't use machines or chillers that dispense drinks such as coke or other liquids (they may have been diluted with untreated water).

  • Drink often and plenty in a hot climate.

  • Carry water with you in your day bag.

  • Milk may not have been pasteurised or sterilised.

  • Don't eat food that appears to have been kept warm all day.

  • Send your meal back if it is not hot throughout or cooked thoroughly.

  • Peel fruit before eating.

  • Beware of salads (you can't trust the water they were washed in)

Hygiene:

  • wash your hands before handling food/use a hand sanitizer
  • clean preparation and storage of food
  • storage to protect from insects




Treatment:

See a doctor.

Rehydrate yourself (most of the comments below are based on rehydrate.org's articles):

  • N.B. rehydrate.org states a solution containing more than 3% sugar can have a negative effect.

  • use your low-osmolarity oral rehydration sachet's (ORS) with clean water and follow the instructions to ensure appropriate ratio of water to contents.

  • If you don't have any sachets:
    • sports/soft drinks and soup have rehydrating properties (but probably won't provide potassium)
    • make your own rehydration solution
      • Clean Water - 1 litre - 5 cupfuls (each cup about 200 ml.)
      • One level teaspoon of salt
      • Eight level teaspoons of sugar
      • Stir the mixture till the sugar dissolves.

If your illness is prolonged bananas are a good source of potassium.

Maintain hygiene.


last updated 19 June 2010 | Author Andy W+