What is travelers diarrhea?

Traveller’s diarrhea is one of the most common illnesses among travelers. It is spread through contact with other people or by consuming contaminated food or water. Traveler’s diarrhea is caused by a number of bacteria (including E. coli, Salmonella, Shigella, Campylobacter), parasites (Giardia, Cryptosporidium, Cyclospora and others) and viruses (such as norovirus and rotavirus).

Barsa Belly, Bali Belly, Delhi Belly, Rome race – Tokyo race – Tourist race – Turkey race, The Pharaoh’s Curse, Montezuma’s Revenge, The Rangoon Runs or Travelers Diarrhea: whatever you call it. It also doesn’t matter where you are in the world. Traveller’s diarrhea can leave you stuck on the bathroom or even worse, in a hospital bed.

Traveller’s diarrhea, commonly known as turista, is the most common health problem encountered by travelers. On average, one in three holidaymakers suffers from it.

It is a form of acute diarrhea, a sufficiently inconvenient concern (especially on vacation) to justify rapid and effective treatment.

As the traveler is exposed to unusual microbes, his gut is sensitive to the toxins secreted by the germs. These toxins cling to the intestinal wall and cause abnormal and abundant secretions of liquids. This causes diarrhea that can ruin a few days of long-awaited vacation…

In the vast majority of cases, it is a benign condition that disappears spontaneously after a few days. Its origin is mainly bacterial, sometimes viral and more rarely parasitic.

Even today, many myths persist in public opinion about the origin and treatment of traveller’s diarrhea. This is why international and national experts have looked specifically at this issue and have made it possible, through their conclusions, to dissociate popular beliefs and reliable treatment.

What’s the risk?

Travelers are at greatest risk when traveling to a destination with poor sanitation and hygiene conditions or eating in places with poor food handling practices.

How is traveller’s diarrhea transmitted?

Traveller’s diarrhea is spread by consuming contaminated food or water. The disease can also be transmitted from one person to another when hygiene rules are not respected.

What are the symptoms?
  • Symptoms vary depending on the bacteria, parasite or virus involved.
  • In addition to diarrhea, they usually include fever, nausea, vomiting, bloating, abdominal cramps and an urgent need to go to the bathroom.
  • Typically, the symptoms go away after a few days without any treatment.
  • In more severe cases, traveller’s diarrhea can lead to dehydration and death. This development is of particular concern in children, the elderly and people with chronic illnesses or weakened immune systems.
  • If you have blood in your stool, you should see a doctor even if the other symptoms you are experiencing are not very serious.
Can traveler’s diarrhea be treated?

Most symptoms go away on their own within a few days.

The most important treatment is to maintain proper hydration:

  • Be sure to drink plenty of fluids. This is especially important for children, people with underlying health conditions and the elderly. In moderate and severe cases, use oral rehydration solutions;
  • Be sure to always use safe water (boiled, disinfected, or from a sealed commercial bottle) for drinking or for preparing oral rehydration solutions.
  • In some cases, a drug that inhibits gastric motility can help relieve symptoms (frequent and urgent need to go to the bathroom). Do not take these medicines if you have bloody diarrhea or a fever. It is important to follow the instructions for each medication and the advice of the health care provider exactly.

Your health care provider can consider the possible use of antibiotics to treat severe diarrhea.

Where is traveler’s diarrhea a concern?

The risk of travellers’ diarrhea is present worldwide.

High-risk destinations include developing countries in Central and South America, Mexico, Africa, the Middle East and Asia.

The risk is moderate in Eastern Europe, South Africa and parts of the West Indies.

How to Avoid, treat Bali Belly, medication?

“Bali belly” is a term used to describe a type of traveler’s diarrhea that can occur when traveling to Bali or other parts of Indonesia. It is caused by consuming contaminated food or water, and it can cause symptoms such as diarrhea, stomach cramps, nausea, and vomiting. Here are some tips on how to avoid and treat Bali belly:

1. Avoid tap water and ice cubes

Only drink bottled water or water that has been boiled or treated with water purification tablets. Be careful with ice cubes as they may have been made from tap water.

2. Be cautious with food

Avoid eating food from street vendors and be careful with raw or undercooked meat, fish, and eggs. Stick to hot and freshly cooked food.

3. Wash your hands

Regularly wash your hands with soap and water, especially before eating or preparing food.

Washing your hands is a simple yet effective way to prevent the spread of germs and infections.

Here are some guidelines for practicing good hand hygiene:
  • Wet your hands with clean, running water (warm or cold), and apply soap.
  • Lather your hands by rubbing them together with the soap. Be sure to lather the backs of your hands, between your fingers, and under your nails.
  • Scrub your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice.
  • Rinse your hands well under clean, running water.
  • Dry your hands using a clean towel or air dry them.
  • If possible, use a towel or your elbow to turn off the faucet after washing your hands to avoid re-contaminating your hands.
It’s important to wash your hands at key times, including:
  • Before, during, and after preparing food
  • Before eating
  • Before and after caring for someone who is sick
  • Before and after treating a cut or wound
  • After using the toilet or changing a diaper
  • After blowing your nose, coughing, or sneezing
  • After touching an animal, animal feed, or animal waste
  • After handling garbage

By washing your hands regularly, you can help prevent the spread of infections and protect your own health as well as the health of those around you.

4. Take probiotics

Taking probiotics, which are live bacteria and yeasts that are good for your gut health, can help prevent Bali belly. They can be found in supplement form or in certain foods such as yogurt.

Taking probiotics can help prevent and treat Bali belly by restoring the balance of good bacteria in your gut.

Here’s an example of how you could take probiotics to prevent Bali belly:
  • Choose a reputable brand: Look for a probiotic supplement that contains a variety of strains of bacteria and has a high number of colony-forming units (CFUs).
  • Start taking probiotics before your trip: Begin taking probiotics at least two weeks before your trip to Bali to help build up the beneficial bacteria in your gut.
  • Continue taking probiotics during your trip: Take probiotics daily while you’re in Bali to help maintain the balance of bacteria in your gut.
  • Follow the recommended dosage: Follow the instructions on the probiotic supplement for the recommended dosage.
  • Look for natural sources of probiotics: In addition to taking supplements, you can also consume foods that are rich in probiotics such as yogurt, kefir, sauerkraut, and kimchi.

Remember that while probiotics can be helpful in preventing and treating Bali belly, they are not a substitute for good hygiene practices such as washing your hands regularly and avoiding contaminated food and water.

5. Stay hydrated

It’s important to stay hydrated if you have Bali belly. Drink plenty of water, oral rehydration solutions, or clear broths to help replace lost fluids and electrolytes.

Staying hydrated is essential for maintaining good health, particularly when traveling to tropical destinations like Bali where the climate is hot and humid.

Here are some reasons why staying hydrated is important:
  • Regulates body temperature: Drinking water helps regulate your body temperature, keeping you cool in hot weather and preventing overheating.
  • Aids digestion: Water is necessary for proper digestion and helps prevent constipation and other digestive issues.
  • Flushes out toxins: Drinking water helps flush out toxins and waste products from your body, which can improve overall health and well-being.
  • Supports the immune system: Staying hydrated can help support your immune system, which is important for preventing infections and illnesses.
  • Improves skin health: Drinking water can help keep your skin hydrated and healthy-looking.

To stay hydrated while traveling to Bali, it’s recommended that you drink plenty of water throughout the day, especially during outdoor activities or when spending time in the sun. You can also drink coconut water, which is a natural source of electrolytes and can help replenish fluids and minerals lost through sweating. Avoid drinking alcohol or sugary drinks, as they can dehydrate you and make it harder for your body to stay hydrated.

6. Over-the-counter medications

Over-the-counter medications such as loperamide can be used to treat diarrhea. Anti-bacterial medications such as antibiotics can be prescribed by a doctor if the diarrhea is severe or persists for several days.

Seek medical attention if necessary: If your symptoms are severe or if you experience fever, blood in your stool, or dehydration, seek medical attention as soon as possible.

It’s important to note that some medications, such as antibiotics, may not be effective against all types of Bali belly. It’s best to consult with a healthcare professional before taking any medication.

Name of Over-the-counter medications for travelers Diarrhea in Bali

Here are some examples of over-the-counter medications for travelers diarrhea that you may find in Bali:

  • IMODIUM (loperamide): This medication helps reduce the frequency and severity of diarrhea by slowing down the digestive system. It can be taken as a tablet or capsule.
  • DIATABS: or similar Antidiarrheal.
  • ORALIT: (ORS: Oral Rehydration Salts): This medicine is sold in the form of a powder. These salts can help replace fluids and electrolytes lost during diarrhea.
  • Pepto-Bismol (bismuth subsalicylate): This medication can help relieve symptoms of travelers diarrhea, including stomach cramps and nausea. It can be taken as a liquid or chewable tablet.
  • Probiotics: Probiotics can help restore the balance of good bacteria in your gut and reduce the duration of diarrhea. They are available in capsule or powder form.
  • Pain relievers: Over-the-counter pain relievers such as ibuprofen or acetaminophen can help relieve headache, fever or body aches that may accompany travelers diarrhea.

It’s important to note that these medications should be used with caution and only as directed. If your symptoms persist or worsen, seek medical attention immediately.

Read also: MEDICINES IN BALI | Preparing for your trip to Bali

The origin of travelers diarrhea

Traveler’s diarrhea is manifested by a sudden increase in the frequency, volume or looseness of stools and may be associated with nausea, vomiting, abdominal pain and sometimes fever.

Several causes are possible:

  • Microbes: the traveler must follow the rules of basic hygiene and food preservation;
  • Food intolerance or allergy: fat, alcohol, milk, lactose and many other products can cause diarrhoea;
  • Stress and anxiety: even on vacation, certain situations can be a source of stress;
  • Other medicines: some medicines have diarrhea as a side effect. Always consult their instructions.

All of these causes can stimulate intestinal fluid secretions abnormally.

Prevention

The risk of contracting traveller’s diarrhea can be reduced by observing basic hygiene rules.

  • drink bottled water and uncap it in front of your eyes
  • do not put ice cubes in drinks
  • do not drink running water (tap, shower, swimming pool, etc.)
  • prefer cooked or pasteurized dairy products
  • peel fruits and cook vegetables
  • cook meat and fish well, including the inside

Always carry an antidiarrheal with you in your travel pharmacy in case diarrhea should occur.

The treatment of travelers diarrhea

When discussing the treatment of diarrhea, two important criteria must be taken into consideration: the age of the patient and the symptoms.

Patient’s age

If it is an infant or toddler, the most important thing is to make sure your child is not dehydrated. A child is much more susceptible to dehydration than an adult. For this purpose, there are preparations available in the pharmacy such as oral rehydration solutions

In general, it is imperative to consult a doctor for children under 6 years old; this is crucial for children under 2 years old.

If it is an adult, treatment can be followed as soon as symptoms appear. The rule also applies: drink a lot.

Symptoms

If diarrhea is not accompanied by fever or blood in the stool:

Travel medicine specialists and the Institute of Tropical Medicine recommend loperamide (Imodium) for the treatment of traveler’s diarrhea.

This treatment, also recommended by international and national experts, acts quickly (often within 2 hours of taking it) and effectively reduces the number of liquid stools and the duration of diarrhea. In addition, a single dose can often already be enough.

Its unique mechanism of action already decreases in small doses, on the one hand the abnormal secretions of liquids caused by bacterial toxins or viruses and, on the other hand, normalizes intestinal transit and bowel movements. It should therefore only be taken when the stools are liquid to avoid the risk of constipation.

If the diarrhea is accompanied by fever and/or blood in the stool:

The use of an antibiotic is necessary and consultation of the doctor.

Recommendations in case of diarrhea

In summary, here’s how to do it:

  • Drink enough fluids.
  • Eat according to your appetite.
  • Treat diarrhea symptomatically with loperamide (some Imodium tablets such as Imodiumlingual 2 mg can be easily taken without water, regardless of travel conditions).
  • If the diarrhea persists for more than 2 days, consult a doctor; if this is not possible, use the antibiotic from your travel pharmacy as long as the symptoms persist. The combination with loperamide (or Imodium) provides faster relief.
  • In case of dysentery (bloody stools and/or high fever (>38.5°C or > 101°F), always see a doctor, they might give you an antibiotic.
  • In the case of an infant or toddler, give a suitable oral rehydration solution (ORS) and consult the doctor as soon as possible.
  • Talk to your doctor before you go on a trip abroad.

Information: Villa Carissa is not a substitute for a doctor. Always consult a doctor to treat your health condition.

Sources: PinterPandai, CleverlySmart, Mayo Clinic, The Johns Hopkins Hospital, Web MD

Photo credit: Pxhere (CC0 Public Domain)

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