We don’t have figures illustrating this phenomenon (I can get it, knowing what I’m talking about), but I can tell one thing : travelers’ diarrhea, also called the runs, hits almost every long term traveler, but also people just going on holidays for two or three weeks, usually in developing countries. Some countries have the reputation to be risky. Of course we think about India, but we talk a lot less about other destinations where falling sick is also very common : Egypt, Ethiopia, Mexico, Uzbekistan, Tajikistan, China, Vietnam but also Georgia. In those countries, travelers’ diarrhea is impressively effective. Africa, South America, Middle East and Southeast Asia are areas where you really have to pay attention.

Khinkali, Georgia’s speciality! Very beautiful country, nice people and a safe place. But travelers’ diarrhea is all over the place!

We all know the symptoms : abdominal cramps, nausea and sometimes vomiting, the need to go to the toilets 3 to 10 times a day, and of course, stools are completely liquid. It usually lasts for a few days, but you feel weak and it feels like you hit rock bottom. Sometimes travelers’ diarrhea attacks you because you changed your eating behavior, and our organism tries to adapt the best it can. But often, it’s possible to avoid it just by taking some simple precautions. Let’s see together preventive measures to take, to avoid travelers’ diarrhea.

Toilets in the middle of nowhere. Inside, just a hole to pee (or to poo). I won’t show you how it is inside. Luckily you don’t have the flies and smells in front of your computer. When you fall sick in those kind of places, you have no choice…

Wash your hands regularly

It seems quite simple, however a LOT of people don’t do it. Washing your hands regularly is primordial if you don’t want to get traveler’s diarrhea, and all kinds of infections, germs, bacteria… Do not forget to wash your hands before, but also after eating (a few people do it after eating, but a lot of people don’t even wash their hands before!). If you’re in a restaurant, the best thing to do is to wash your hands after handling the menu, and after ordering (the menu is a haven for germs). If it’s not possible to wash your hands where you are (it happens in remote areas), use a hand sanitizer. But nothing replaces soap and water. Oh and of course, wash your hands after going to the toilets (once again, a lot of people “forget” to do it…).

When you spent the day outside, took the metro in some cases, touched coins and bills often dirty… Think about washing your hands when you get back “home”

Drink bottled water

Never drink tap water unless you’re 100% sure the water is clean and sterilized. And even if you see locals drinking tap water, that doesn’t mean your body is immunized. The best thing to do to minimize the risk, is to stick to bottled water, especially in developing countries. It’s even better if the bottle is sealed. Still, pay attention to the seal, in some countries they fill water bottles with tap water, and you stupidly get traveler’s diarrhea not even knowing how it happened. Don’t put ice in your drinks. Brush your teeth with bottled water. And when you take a shower, keep your mouth closed (same thing when you go swimming).

I took those three bottles of water at the market. As soon as I got back to the hostel, I noticed one of them had been opened already

Pay attention to street food

I wanted to say “avoid street food”, but in some areas in the world, it’s pretty much impossible. Anyway, when you like to eat (like me), it’s complicated not to give in to the various stands selling food, especially when they’re all over the place. Therefore you have to pay attention. First thing first : is the stand crowded with locals? If so, it’s a quality factor, the risk is limited, there’s a good chance you’re about to eat some good food, and you won’t fall sick (locals know the good addresses). Check how clean the stand is, how the person handles and prepares the food. Does the guy who just gave a dozen coins to a customer grabs some food with his hands to give it to another one? Do you notice food sitting around on the stand for hours, with some flies having fun on it? Are there women with their children? A mom would NEVER bring her kids in a place where they can potentially fall sick. All those little details are actually very important.

This buffet had been prepared a few moments before. Almost no risk (and I didn’t fall sick!)

Peel fruits and vegetables yourself

And rinse them with clean water (no tap water!). If you rinse and peel your fruits and vegetables yourself, it should be ok. Get bananas, orange or avocados. And avoid grapes and berries in general, no bueno!

Bananas go! Oranges go! Avocados go! Grapes no!

Eat well-cooked food

Eat well-cooked vegetables! Get well-cooked meat, ideally with no sauces (mayonnaise…). Avoid salads in general, we don’t know how it has been prepared (clean water or not). Avoid mollusks and crustaceans, shellfishes, oysters and seafood, tuna and raw fish. Stay away from food sitting around on a buffet, we don’t know how long it’s been here. Avoid ice creams, sorbets and juice from street vendors, we don’t know if they respected the cold chain. Also avoid desserts wuth creams like custard… (yeah that’s a lot of things to avoid!). And of course don’t eat in a place where the cleanliness is questionable.

Forget about salads for a few days…

I took all my precautions but I still got travelers’ diarrhea… What can I do?

As I said earlier, sometimes we take all the preventive measures but we still get travelers’ diarrhea (it happened in Bishkek, Kyrgyzstan…). Because sometimes we eat something completely new and it disrupts our digestive system, it has to adapt. The first thing to do (and we don’t always think about it), is to stay hydrated! Drink a lot of water! We tend to forget it, but having a liquid poo ten times a day dehydrates a lot! You have to drink! Do not fast or start a diet, you need to keep eating if you get hungry (food brings the necessary energy to reconstitute the organism).

You need to drink… water of course! Do not give in to alcohol!

Preferably food with carbohydrates and starchy food : rice, pastas, lentils, well-cooked potatoes… Also white meat and bananas. No dairy products, nor alcohol or coffee. Dairy products can cause bloating while coffee and alcohol can irritate stomach and intestines. Don’t forget to take an antidiarrheal. And of course “Boil it, cook it, peel it or forget it!“.

Please, do not hit the road without a travel insurance! It’s indispensable, and you won’t regret it if something happens to you!

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