Travellers Diahorrea and Food Poisoning

By Dr.Adam Huber (MBBS)

Ah yes, the conversation topic around many hostels and hotel common areas on which travellers seem all too happy to share the most intimate details.  What did you eat when you got sick? How long were you out? Just from one end? or the grand daddy? simultaneous vomiting and diahorrea?

If you travel for long enough it’s more a question of when rather than if you will eat or drink something dodgy.

Traveller’s diarrhoea means more frequent or loose bowel movements than usual.  If you usually go once a day then find yourself running to the toilet three or more times per day then you probably  have what’s considered traveller’s diarrhoea.  Most of the time this will not effect your travel plans.  It’s just a reality of travel.

Diarrhoea effects up to 50% of travellers to developing nations, while roughly 20% of people will get even if they are travelling to developed countries.  It’s caused by unfamiliar germs infecting your bowels. Unfortunately these little germs are happy not only in Mumbai street carts but also fast food joints in California.

Here are some rules to follow when it comes to your bowels

• Some bugs which cause diarrhoea are contagious. Don’t share any bowls, knives forks, towels with your mates, and wash your hands religiously.
• Unfortunately diarrhoea is not always easily dealt with and can sometimes be a symptom of something more serious.

You may get other symptoms such as bloating, cramps, vomiting, or ‘the ring of fire’ (the sting around the backside from frequent bowel motions). You may also have a slight fever and be generally feeling washed out and useless for days.

• The best thing to do any case is to try and do the right things by your body in the first 24 hours.
• Drink lots to replenish fluids lost. Powerade/Gatorade is good.  A sachet of gastrolyte (from any pharmacy) added to water will also help you recover faster.  If this is not available a litre of water mixed with about ten teaspoons of sugar (brown sugar is best as it contains potassium) and one teaspoon of salt will help you hydrate and recover faster.
• Drink small amounts frequently: this will help you keep fluids down.
• Try to eat. Don’t starve yourself.  Any type of starch is good; plain white rice, plain toast or potatoes will all help your gut recover faster.

When you need to see a doctor

• If your bowel motions contain blood.
• If you have a high temperature
• A sudden/violent onset of watery diarrhoea can mean dehydration in just a few hours; see a doctor if you can
• If you can’t hold any water down to help you rehydrate
• If you have diarrhoea for more than two weeks straight

Medication for diarrhoea

There are two major types of pills for the treatment of diarrhoea: ‘stoppers’ (or ’blockers’) and antibiotics.

• Blockers will ease the symptoms.  If having the shits is stopping you getting on a plane or bus you just have to catch; they are an effective way to ease the inconvenience of common traveller’s diarrhoea. These pills are not a cure!
• Antibiotics actually treat the cause of the infection by killing off unwanted germs in the gut.  See a doctor for advice on both of these agents.

When you might need to take an antibiotic

• If you have diarrhoea and a temperature/fever.  A fever might be a symptom of something more serious; always try to see a doc as soon as possible (especially in countries/regions where malaria is prevalent).
• If there is blood or mucus present in your bowel motions
• If you have more than four motions in the first 24 hours
• After a few days you are still on blast.  If fluids and rest don’t work anti – biotics are the next step. Again, see a doctor.

Your GP or travel doc will be able to recommend and prescribe antibiotics for your trip in case of diarrhoea.  Make sure they explain how and when the particular antibiotic should be used.

If even after you have finished a course of antibiotics the problem is still persisting then you really need medical attention.

For tips on food and water safety on the road check out the page: through the eye of a needle, food and water safety while on the road.

Food poisoning: what causes it?

There are basically two types of food poisoning and the type you have will decide on how long you will be sick.   The amount of time between eating the infected spring roll or burger (it can be anything) and getting sick is a good indicator of what type of food poisoning you have.  Of course you won’t always be able to tell what caused it (but that lingering taste of whatever you ate is an indicator).

The two types are:

1. Germs.  This is when you eat food containing a small number of nasty germs which then multiply in your gut and make you crook.  Symptoms (usually diarrhoea and maybe vomiting) may take up to 24 hours to develop and tend to last for days.
2. Toxins.  This is caused from eating food containing bacterial toxins.  That food in the window of the Chinese place or the fish sitting in the sun at the market will have had germs growing on it before you ate it.  As these germs grow they release waste products; which are the toxins that make you sick.  Symptoms will usually develop within 2-24 hours.  Lots of vomiting along with diarrhoea are the usual symptoms.  This is the body ridding itself of the crap you have eaten.

More?

If the information here is not enough for you then there is a Canadian website dedicated solely to travellers dihorrea.  It even contains a map of ‘higher risk’ areas for coming down with travellers diahorrea.   Check it out here:

Travellers diarrhea (travellersdiarrea.com)

The bottom line is you can get sick anywhere and it’s not usually worth worrying about to much, just do the right things if you get crook.  As proof the developing world has no monopoly on poor food hygine check out this article on an American kid whose fast food meal was unfortunatley his last (www.seattletimes.com/news)

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