Traveler’s diarrhea is not only inconvenient and unpleasant, it can be a serious travel health risk. Here are the top tips to avoid getting traveler’s diarrhea or food poisoning.

I knew better, I really did. Still, that sauce from the buffet at the restaurant in Morocco looked harmless enough. Seems it wasn’t, and now I was making my way from toilet stop to toilet stop and praying the meds I had just started would work their magic soon. Traveler’s diarrhea (a.k.a. Montezuma’s revenge, Delhi belly, Aztec two-step, tourista, the runs, food poisoning, or whatever popular name you wish to call it from whatever part of the globe) is not only inconvenient and unpleasant, it can become a serious health risk.

On another trip to China’s Yunnan Province, every member of our small group ended up doing the bathroom dash and worshiping at the porcelain throne after one particular restaurant stop. For one member of our group, the unceasing diarrhea and vomiting led to an emergency room visit and I.V. drips for severe dehydration.

According to the Centers for Disease Control and Prevention if your travels will be taking you to Central America, South America, Mexico, Africa, Middle East, or Asia (excluding Japan and South Korea), you may be at increased risk of some form of traveler’s diarrhea.

Mild diarrhea may be brought on by the stress of travel or even a change in diet, some experts think, but then that passes quickly. Continuous tummy grumbles that send you running is most often caused by that infamous bacteria E. coli, the most common of culprits in travelers getting ill. Less frequently, the one to blame is the salmonella bacterium.

How do these bacteria cause such a ruckus in your body? At the risk of getting a bit gross, the onset of the squirts comes about after ingesting food or water that’s contaminated. That can come from bacteria from feces – animal or human – as well as hands that are not washed properly, water that is not purified properly, inadequate sanitation methods, and poor food storage techniques. And if you are wondering why the locals are not afflicted by drinking the same water and eating the same food, it is because their bodies have become accustomed to the bacteria and have developed an immunity of sorts.

The good news, though, is that you can take preventive steps to ensure you are less likely to experience diarrhea when traveling. How?

Prevent traveler’s diarrhea by following these universal rules:

1. Do not eat raw fruit or vegetables – e.g. fruit salad, salsa, fresh sauces. They may look fresh and yummy, but you have no idea how they were washed.
2. Only eat fruit you can wash and peel yourself – e.g. apples, oranges, bananas.
3. Only eat vegetables that have been cooked.
4. Do not drink directly out of soda cans, juice cans or bottles. Take along a metal straw and always drink from that.
5. Avoid fresh fruit juices from street vendors since you do not know how the fruit has been washed.
6. Do not drink tap water, ever! We use a variety of water purifiers that include the Grayl water bottle and the Katadyn BeFree. We use the water we have filtered for drinking and to brush our teeth at a hotel. In a restaurant, always ask for bottled water and insist the bottle be opened in front of you (there are reports of restaurants just refilling bottled water with tap water).
7. Never add ice to your drinks. Ice is likely made from impure water and will immediately flood even your bottled water with bacterial nastiness. I learned this lesson the hard way in Vietnam a few years ago.
8. Never eat off wet plates. If a waiter or waitress brings you a wet plate, dry it off thoroughly first – ask for extra napkins if need be. Maybe consider additional cleaning with anti-bacterial wipes
9. Don’t eat food that is sitting at room temperature for an unknown amount of time – like on a buffet. That was my mistake in Morocco…. The sauce was from a buffet. I knew better but dropped my guard.
10. Wash your hands after touching money, stair rails, door handles, or even somebody else such as after shaking hands. Anything you touch can be a Petri dish for bacteria and illness. Sanitize your hands frequently, too, with a traveler’s good friend, hand sanitizer.

So how do you know you have some form of traveler’s diarrhea?

• Feeling bloated with excessive gas and cramping is your first sign things might not be right down under.
• You feel an urgent and frequent need to defecate and stools are loose or watery.
• Vomiting is a sign that the food poisoning you are experiencing is a bit more serious. Often, you will be vomiting and feeling the need to defecate – yeah, things flowing from both ends, and it isn’t fun.
• Fever can happen with some people as well as chills.

What’s in our travel medical kit just in case?

This is what we carry with us in our medical kit when we are traveling anywhere traveler’s diarrhea might be an issue.

• Hand sanitizer – Washing your hands is best, but in between that or when you aren’t able, slather on the sanitizer after you touch anything, before you eat anything, or even shake hands with others.
• Anti-bacterial wipes – Use these to wipe eating surfaces, cutlery, plates, and glasses.
• Toilet paper – You can’t count on foreign toilets to have any on hand.
• Ginger tea or ginger chews, antacids, or even mint tea – Can help to settle an uneasy digestive system. Ginger can be very good for motion sickness, too.
• Imodium or other antidiarrheal – sufficient quantity for a week for each person.
• Zithromax (generic Azithromycin, commonly called “Z-pack”) – with a prescription from your doctor and used upon advice of your physician.

What do you do if you get traveler’s diarrhea?

Try taking over-the-counter medication. Consult with your physician in all cases. Medications such as Imodium can work to decrease the urgency and frequency of needing to use the bathroom. If your physician approves, this can be a lifesaver when your symptoms are not too severe, and you still want to explore a city, or ride a bus or airplane without feeling the need for a desperate sprint to a toilet every few minutes.

Mild diarrhea will often clear on its own. Mild cases of traveler’s diarrhea will typically improve on their own within one to two days and will clear up completely within a week.

Eat bland foods when you can eat again. Suggested are plain crackers, rice, bananas or plain toast.

Antibiotics are a last resort, and only in consultation with a physician. I swear by the Z-pack antibiotics I have taken on several occasions to knock down a severe case of traveler’s diarrhea when it didn’t go away in a couple of days. But like with any medication, you should not take anything without first consulting your physician to determine what’s best for you. And then be sure to take any antibiotics exactly as prescribed.

See a doctor or head to the hospital immediately if:

• Your severe diarrhea persists more than two days even after treatment
• You can’t keep fluids down and are likely to become dehydrated
• You have severe abdominal or rectal pain
• You have bloody or black stools
• You have a fever above 102 degrees Fahrenheit (39 degrees Celsius)

HITT Tip: Be prepared for anything. When travel goes bad, you must be prepared, which is why we never leave home without the right travel insurance and good travel emergency evacuation coverage. We rely on Global Rescue for emergency evacuation coverage and medical advice and IMG Signature Travel Insurance whenever we need additional protection beyond what is provided with our credit cards. Learn more about IMG Signature Travel Insurance, provided in partnership with Global Rescue here.

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