How to prevent traveller’s diarrhoea

Posted by Evan Haussmann on 26 April 2013

It goes by humorous names such as Montezuma’s revenge, Rangoon runs and Delhi belly, but when traveller’s diarrhoea strikes, it’s not very funny at all.

What are the symptoms of traveller’s diarrhoea?

Sufferers complain of cramps, pain and bloating of the abdomen. Many feel nauseous, develop a mild temperature and general malaise, but you know you have it if you have an uncontrollable urge to use a toilet, like, right now!

What causes traveller’s diarrhoea?

It’s often difficult to pinpoint the cause of diarrhoea and it gets put down to an individual’s gastrointestinal response to unfamiliar micro-organisms in oily, spicy or just plain different foods. Those that have been isolated as causing the runs include:

  • Bacteria: Escherichia coli (E. coli) is the most common bacterial cause of diarrhoea, though Salmonella, Campylobacter jejuni and Shingella aren’t far behind. Bacteria usually cause abdominal pain and fever.
  • Viruses: Less commonly, traveller’s diarrhoea is caused by Norwalk and rotavirus. The latter is most often contracted by children, who build resistance to the infection once they’ve recovered.
  • Parasites: Parasitic infections tend to last longer than bacterial infections and may result in bloody stools. Parasites responsible for causing diarrhoea are Giardia intestinalis, Entamoeba histolytica and Cryptosporidium parvum.

Prevention is better than diarrhoea

As a rule: cook it, peel it or leave it alone. It’s advisable, especially in less-developed parts of the world, to avoid the following:

  • Raw fruit and veggies unless you can peel them.
  • Raw or rare meat and fish.
  • Buffets, which are dangerous because temperature fluctuations promote bacteria growth.
  • Food that has been cooked and then left to cool for a long time.
  • Unpasteurised dairy foods.

Stay safe, drink beer

  • Tap water is difficult to vet for contamination, but it’s generally best just to avoid it by drinking only bottled water, cooldrinks or beer.
  • Make sure cap seals on bottles are intact, as touts in some places have cottoned on to tourists’ bottled-water lust and are reselling hand-filled bottles to turn a tidy profit, and inevitably your stomach.
  • If bottled water isn’t available, boil water for a few minutes or use purification tablets.
  • Also use bottled or purified water to brush your teeth, make ice and wash vegetables and fruit.

Keep it clean. And dry.

  • Wash your hands frequently with antiseptic soap or use antiseptic wipes containing isopropanol, ethanol, n-propanol or povidone-iodine. Make sure your hands are completely dry before preparing or eating food.
  • Crockery and utensils should also be dry before being used.
  • Money is an oft-overlooked source of bacteria. Some third-world bank notes have been in circulation so long the paper has become furry and lethal.
  • Cooldrink-can rims and bottle necks can also harbour unwanted lurgies, so wipe them down or use a straw.

When the lurgy strikes

There’s no vaccine to prevent diarrhoea and even the most fastidious traveller can fall victim. If diarrhoea has you on the run it’s best to:

  • Avoid dehydration by drinking lots of water. If possible, replace lost salts and minerals by adding an electrolyte such as Rehydrat or Vitathion.
  • Eat small amounts of food that are high in carbohydrates such as bread, rice or spaghetti as soon as you feel able to. Avoid spicy or oily food, dairy products and alcohol.
  • Though anti-diarrhoea medicine (loperamide) stops the symptoms, it should be used carefully. If the infection is bacterial, preventing stools from passing keeps the bacteria inside the body for longer.
  • Hang tight – traveller’s diarrhoea is self-limiting and will pass in a few days.

Pack this in your Anti-diarrhoea kit

  • A probiotic containing Lactobacillus reuteri normalises stomach flora. Some professionals advise taking a daily dose with breakfast, starting a week before departure and continuing for a week after returning home.
  • Imodium (or a similar anti-diarrhoea drug), but use it only if absolutely necessary.
  • Electrolytes, essential for the restoration of lost salts and minerals associated with excessive fluid loss.
  • Water-purification tablets. If in doubt, dose dodgy drinking water with a tab or two.
  • Antiseptic wipes and soaps to prevent transmission of bacteria in the first place.

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