Travellers’ Diarrhoea – or, I have a gut feeling its…

Summer is upon us soon; and that means its travel time again.

Whatever your reason for taking off to some faraway land, many seasoned travellers will agree that travellers’ diarrhoea(TD) is one of the most common illness to affect tourists. Many will recall that what was to be the perfect vacation has been spoiled by an attack of the ‘runs’. WHO estimates sufferers run(pardon the pun) into the millions yearly, more specifically 10 million per year.

It respects no time or place – hence the colorful colloqualisms by which TD is also known : Bali Belly, Bangkok Belly, Cairo Curse, Dakar Dash and Montezuma’s Revenge.

The symptoms of TD are abdominal cramps,bloating, fever, diarrhea, nausea and vomiting. In almost a third (1/3) of TD victims, the symptoms will be severe enough to require admission to hospital. TD occurs within days of going to a new area and is usually(but not always) caused by a visitor’s gut being not immune to the local variety of bugs. This explains why some locals can drink straight from the tap without ill-effects while the newly-arrived visitor will be sent scurrying to the nearest toilet after a few hours.

In this context, it would be useful for international travelers to be aware in which country that tap-water is safe for drinking. Check out to get the latest updates. The ratings for different countries are based on significant indicators produced by World Health Organization, Unicef & World Bank. It is significant to note that Malaysia belongs to rating 4(out of 5), which means that the main cities have safe tap water suitable for drinking and the prevalence of water-borne disease is low.

Been caught out with a bug that is giving you the runs weeks after returning home? Well, I came across such a patient who was finally found to have Giardia lambdia , a bug found in uncooked fresh-water seafood like oysters. This bug does not respond to antibiotics and one needs to take stuff like metronidazole.

The protozoa Giardia Lambdia that can cause you untold misery! The protozoa Giardia Lambdia (under the electron microscope) that can cause untold misery.

So what measures should the intrepid traveler take?

  • Before leaving home, take out health insurance and arm yourself with stop-gap remedies like Imodium, Lomotil and Travelan.
  • Do not consume uncooked salads and fresh fruit, especially when one did not observe its preparation. Make sure gloves are used to prepare foods.
  • Bottled water has been god-sent but make sure the caps are sealed. In some countries, the bottles are recycled with water from dubious sources.
  • Ice-cubes in high-risk countries are a no-no. The author survived on coke on a summer trip to India until the last day, when he had ice added, with severe recriminations.
  • Where immediate medical help is not available, rehydration is an important measure but the tummy should not be subjected to ‘difficult to digest’ foods. The use of probiotic-based drinks like Vitagen may help. Using Imodium and Lomotil is fine to stop the runs temporarily till you reach home, but, ultimately, the bugs need to be shown the door and antibiotics commenced to knock them off. So see the doctor as soon as feasible.

(I am making the usual disclaimer for this article – consult your doctor first before anything else)

One response

  1. I can vouch for that Giardia infection. When I got home from Indonesia, the doctors were puzzled till , after scouring the Internet, the answer came out!
    My advice is not to eat any kind of uncooked food at all.

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