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Traveler's Diarrhea

Frequently Asked Questions About TD


Public toilet in Southeast Asia

Not a place you want to spend a lot of time!

Photo by Greg Rodgers / Startbackpacking.com

Traveler's diarrhea may not be the most pleasant of subjects, but unfortunately it is a harsh reality for visitors to Southeast Asia. Unsafe food handling and exposure to new bacteria cause many travelers to develop the dreaded "Delhi belly" within the first few days of their trip.

A case of traveler's diarrhea is certainly no reason to panic or make drastic changes to your itinerary. Read this FAQ for surviving -- and curing -- a bad stomach.

What Causes Traveler's Diarrhea?

TD is typically caused by ingesting bacteria (usually bacterium from the E. Coli family) of which your system is not already immune. We come into contact with bacteria every day, however our bodies already have an immunity to many of the bacterias that we encounter at home. Changing continents means that we encounter new strands and must go through the process of building an immunity all over again.

The water in many Southeast Asian countries is unsafe to drink. Even if you drink only bottled water, don't expect restaurants and street hawkers to wash plates and cutlery in filtered water! A single drop of water left on a clean plate can contain an immense number of viruses and bacteria.

Some malaria pills -- such as Doxycycline -- are strong antibiotics. Taking antibiotics over a prolonged period can destroy the "good" bacteria that lives in our intestines. If you intend to take malaria pills, eat plenty of yogurt or consider bringing along L. acidophilus pills to take as a probiotic.

Can I avoid Traveler's Diarrhea by Not Eating Street Food?

Not necessarily; even safely prepared food in hotels and restaurants can cause traveler's diarrhea. Although street food unfairly gets blamed for many cases of TD, avoiding it entirely is not going to eliminate your chances of getting traveler's diarrhea. Cheap, delicious street food is one of the many joys of traveling in Southeast Asia!

What are Some Ways to Avoid TD?

  • Look for Volume: Stick to eating at popular places with a high turnover of customers. A high volume of business generally means that ingredients are fresher. Besides, word travels quickly; local customers would never return to an eatery if it made them sick.
  • Wash Your Hands: You can encounter diarrhea-causing bacteria just by touching surfaces. Many toilets in Southeast Asia do not have soap; carrying hand sanitizer is a good idea.
  • Use Bottled Water: Stick to drinking bottled water. Although many travelers use tap water to brush their teeth, remember that a single drop can carry a dizzying number of viruses. Read about using water refill machines and responsible travel.

What Should I Do if I Get Traveler's Diarrhea?

Drink plenty of fluids -- diarrhea is a sure way to become dehydrated in Southeast Asia's warm climate. Consider adding electrolyte drink mixes to your water bottle to replace lost potassium and sodium.

Luckily, traveler's diarrhea is rarely a cause for serious concern; most cases heal naturally within a few days.

If a case of TD persists for longer than a week or two, consider going to a clinic where you will probably be treated with antibiotics. Make use of your travel insurance -- get to a doctor promptly if you pass blood or run a fever.

Should I Take Anti-Diarrhea Pills?

Although anti-diarrhea pills should be an essential part of any travel first aid kit, they should only be taken as a last resort. Loperamide, commonly sold as Imodium, works by stopping the action of your bowels. While effective in the short term, this can trap harmful bacteria inside of your intestines which will only compound the problem later. Only take anti-diarrhea pills when the situation demands (e.g., you are about to embark on a long bus or train journey).

What Are Natural Ways to Beat Traveler's Diarrhea?

  • Bananas: Do as the locals do; eat bananas to keep your stomach in check. Banana shakes and yogurt lassis are a great way to calm a bad stomach in tourist areas.
  • Yogurt: Probiotics are your friend; yogurt drinks can be purchased in mini marts. Check the label for active cultures, many are just sugary drinks.
  • Eat Bland: Although Southeast Asian food can be wonderfully spicy, lay off the laksa and chillies for a few days until things get back to normal. Stick to a starchy diet of plain, white rice and noodles.
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