Preventing Traveler’s Diarrhea

There are many great reasons to go traveling and to go on holiday. At once you now have an opportunity to relax and unwind in the sun, and at the same time you have a great experience and adventure visiting a new culture, seeing new scenery and enjoying a different climate.

There are downsides to traveling though, many of these revolving around missing your creature comforts and being constantly on the move. Unlike when you’re at home, there’s not the option now to curl up with a cup of tea and baths are not always forthcoming. That we can live with though, rather what’s really frustrating is Montezuma’s revenge, also known as ‘The Curse of the Nile’, also known as ‘traveler’s diarrhea’. Lots of things can set off traveler’s diarrhea and this is the most common complaint affecting travelers and holiday makers the world over. This then is unfortunately enough to completely ruin many people’s holidays leaving them unable to relax and constantly having to run to the toilet. Further, it can cause dehydration which can be very dangerous – especially in the heat of many holiday destinations – and it can sometimes be enough to leave you stranded in a single room. And then when you need to sit on the plane for several hours this can be an even bigger source of stress.

The condition tends to last no more than three days, but it can continue for as long as a week and in some cases can cause other complications. In roughly 20% of cases the individuals are confined to the bedroom as a result of the condition.

The Cause

The main cause of traveler’s diarrhea is drinking the local water. This water is usually perfectly healthy for the locals who have grown up with it, but for travelers the mineral content can cause diarrhea and stomach upset just because they’re not used to it. And there can be more wrong with the water too – in developing countries in particular it may be contaminated fecally (which can also cause hepatitis) and the water may also be carrying parasites such as ring worm. Bacterial enteropathogens are the main infectious agents in 80% of case. These then cause damage to the intestines directly or via the release of toxins. Other problems can come from heavy metals and toxins that enter the water and that don’t get filtered out as they do at home.

Of course it is not just water that can become contaminated fecally, and similarly dangerous are some foods. Some of these foods will have been prepared using water or will have water in their ingredients, and in other cases the foods themselves may have been contaminated fecally. The way this contamination occurs is usually through transference by flies or other insects which can land on manure and then fly and land on your food. The legs of the fly are no bigger than the hairs on your head; but try touching a pile of dung then dropping it your glass of water or rubbing it on your food and see if you still want to drink it… no? This is the exact same thing that happens when you drink water or food that has been left out in developing countries.

Preventative Measures

Avoid the Local Water

It is very important then to avoid drinking the local water out of the taps, and even if it’s not infected just the mineral content can give you cause for concern. Of course you need to drink though, so instead choose water that will be guaranteed to be clean – for instance bottled water with a cap screwed on and a seal, or bottles of juices. Alcohol meanwhile is almost always safe, and this is because it has disinfectant properties (this is why people used to drink so much alcohol in the dark ages – as the water was too unsanitary. Some people even believe that the enlightenment came about as a result of people drinking tea and water again). If you’re traveling in a developing country then and you are unsure as to the source of their water – ask to have a glass of beer instead.

Use the Kettle

If you are at the hotel and really need water then another thing you can do is to boil the kettle. Boiling the kettle isn’t a completely safe method, but it will kill off the majority of bacteria and is certainly a lot safer than other techniques. Worst case scenario you can make cold water by just boiling it then waiting for it to cool down in the fridge.

Order Wisely

Order your food wisely again and think about what’s likely to involve water. Ice cream for instance is not a good idea – if it’s made locally then it will have used local water and just have frozen it. Likewise you should avoid salad which will likely have been rinsed with lots of tap water. In general it is wise to order things that have been cooked rather than things that are raw, and you should always avoid anything that has been left outside (buffets may not be a wise move).

Stay Clean

Around your hotel/villa/other accommodation you need to make sure to be very clean and tidy. Leaving lots of plates out for instance will attract flies and food should be sealed away to avoid contamination. Make sure to wrap all food that you keep and put it in the fridge, and be sure to wash plates and cups immediately and to put them in the cupboards. Wipe sideboards down regularly too to avoid insects that spread illness.

Be Hygienic

Sideboards and sofas can get contaminated too, and that means you can transfer germs from your hands to your face. Make sure you avoid touching your face in general, and go to lengths to keep washing your hands. It can also be a good idea to keep an antibacterial spray.

Brush Safe

When brushing your teeth you need to make sure not to use the local water again (you’d be surprised how many people forget this) as you don’t need to swallow the water for it to affect you. Likewise it’s a good idea to carry some cellophane and to wrap your toothbrush when you’re not using it so that it’s not left out and wet.


If you’re traveling properly and you have no accommodation and nowhere you can get water from at all, then you may find yourself drinking out of rivers and other water sources. Of course this is again very dangerous, but there are ways to do it safely – such as by evaporating the water onto a cellophane surface and then licking it off or waiting for it to collect again in a cup. Only the water will evaporate so any metals or bacteria will be left behind.

Drink Lots

While you need to be very careful with what you drink, you also need to make sure you drink lots to avoid dehydration in the hot weather and to encourage your body to flush itself out regularly.


Carrying activated charcoal is a good idea as a way to fix any mistakes. If you drink local water then this means you’ll have bacteria and toxins in your stomach for a while before it gets absorbed into your blood stream. If you consume activated charcoal in this window of opportunity, then the porous nature of the charcoal and high oxygen content will cause it to absorb the toxins and bacteria preventing them from entering your blood stream.


There are risks associated with the use of antibiotics as a treatment or prevention. However in some cases the positives outweigh the negatives – such as in the case of ‘immunocompromized’ individuals who are more susceptible to illness. In this case a doctor may recommend prophylaxis as a preventative measure.

1 Comment

  1. In some countries bottled water is only tap water with the bottle resealed with maybe glue or even the bottom of the bottle accessed.

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