Nobody likes it and certainly nobody likes to talk about it, but it happens and it is always a trip-ruining tragedy.  It is called by many names - the Pharaoh's Curse, Montezuma's Revenge, Delhi Belly - but they all refer to traveller's diarrhea. Where will you be when traveller's diarrhea strikes? Squatting over a barely glorified hole in the ground in rural Asia or in the middle of a crowded city where you can't read any of the signs? Hopefully in the sweet, sweet privacy of your hotel room, but probably not. Here are some facts that can maybe help you understand the dreaded mud butt, and maybe even help prevent it while travelling.


1. There are Three Main Causes of TD

There are three different causes of traveller's diarrhea - bacteria, viruses and parasites. Bacteria is the most common cause as it is found literally everywhere. However, luckily the most common kinds can be vaccinated against. Viruses are less common but travellers should do their research to see if viruses such as Norwalk or rotavirus are prevalent in the area. Parasites are the least common infection with only hikers who drink from streams, and those who drink untreated or unpurified water falling victim to parasites like giardia lamblia or cryptosporidia.


2. It Doesn't Matter Where You Go

Some travellers think they can avoid the terror that is traveller's diarrhea by sticking to the safe countries of the so-called 'first world.' This leads people to believe that they are safe from it and makes them a little more relaxed in their dining standards. While the food may be a touch safer in production, there are dirty restaurants in Paris and London just the same as Marakesh and Zhengzhou.


3. Some Places Are More Prone, However


Yes, it doesn't matter in many cases, but some countries have been reported to have an increased risk of traveller's diarrhea for travellers who play fast and loose with international health safety rules. Unfortunately, many of the countries notorious for TD include popular honeymoon destinations! 

These include:

  • Central and South America
  • Mexico
  • Africa
  • Caribbean islands
  • Asia (excluding Japan and Singapore)


4. Boil It, Cook It, Peel It, or Forget It

Boil it, cook it, peel it, or forget it is an old adage for eating in the Third World, and those that want to avoid chancing traveller's diarrhea will want to follow it religiously. Comparable advice is basically outlined in the CDC's Travel Safety Outside the Country Guidelines, but this old proverb is much easier to remember.


5. Observing Travel Safety Rules Don't Always Help

While observing the Travel Safety Outside the Country guidelines is a great start to not falling victim to traveller's diarrhea, it is not the end-all be-all protection against it. You can avoid all the tap water, fresh salad and uncooked fish you want, but where you dine should be as much of a factor as what you dine on. Avoid restaurants that are completely outdoors and have bugs flying around. Cooks should have a place to walk their hands and generally have some sort of facility to control the temperatures of food.


6. Eat Local and Popular


Aside from the usual rules, there are two extra tips that may help in preventing traveller's diarrhea - eat local and eat popular. It may be tempting to grab a burger at the tourist restaurant, but you will be better off eating food that locals know how to prepare well because you better believe they hate the runs too. If the restaurant is popular, even better! If food is going fast, it has little time to just sit around collecting bacteria.


7. You Don't Always Get It From Food or Drink

You may be cursing the name of the shady restaurant long into the night, but TD is it is not always the fault of common suspects like food or drink. The pathogens that cause TD can live for days on objects such as handrails, doorknobs or children's toys. Once you touch these, then touch your mouth, they can transfer inside the body.


8. You Are Not Alone

It may seem like it only happens to you, but you are definitely not the only traveller struggling. The CDC estimates that traveller's diarrhea strikes anywhere between 20 to 50 percent of international travellers. So while you're travelling partner may seem blissfully immune, most other foreigners you see abroad are enduring the same gamble every time they leave their hotel.


9. Once It Starts, It is Hard To Stop

Once you have TD, you pretty much have to wait it out. The only real lifeline here is that some doctors will prescribe some "just in case" antibiotics that will help shorten the run of traveller's diarrhea, but those without will just have to keep hydrated and limit their diet to diarrhea-friendly foods.


10. Sometimes It's Nothing to Worry About

Although it's uncomfortable and can lead to some occasionally horrifying trips to some unique public restrooms, usually traveller's diarrhea is nothing to worry about. Usually it will resolve all on its own within five days. However...


11. Sometimes It Gets Pretty Serious

When TD doesn't clear up on its own, it can be a pretty serious illness. Nothing is more frightening than having to be hospitalized abroad. Most cases of hospitalization from traveller's diarrhea happen due to dehydration. It is important to keep hydrated and seek medical attention right away if the runs are accompanied by a noticeable amount of blood/pus, fever or severe abdominal pain.


12. TD Could Be Present For You Back Home

While most will manifest traveller's diarrhea within several days into trip after being exposed to the cause, it can actually take up to two weeks before it manifests itself. Know that just because you made it home without incident doesn't mean you are out of the woods, but consider yourself a lucky one if you get to deal with it in your own bathroom.


13. Treating TD Like Regular Diarrhea Can be A Bad Idea

If you treat your TD by eating binding foods and drinking plenty of fluids like you would with regular diarrhea, you'll be fine. However, if you treat it by guzzling bottles of salicylate products like Pepto-Bismol, you might run into some trouble. It will take a lot of Pepto to take down TD which can lead to salicylate toxicity that can cause hyperventilation, vomiting, hallucinations and eventually hyperthermia when things get really serious.


14. Don't Try to Stop It Up

This is not the kind of runs you get from eating too much greasy food and it won't be solved with anti-diarrheal drugs. Those drugs slow diarrhea, but they don't actually solve the issue. Unfortunately, the only way to solve the issue is to get whatever is causing it out. Antibiotics will help make things go faster, but you're going to be spending some serious time in the loo.

15. It Is Infectious

If you find yourself tangling with traveller's diarrhea and your travelling party has blissfully missed out, you may feel spiteful, but giving it to them is a real possibility. If at all possible, avoid touching food that others intend to eat until a full two days after symptoms stop as the bacteria can survive on your skin and transfer.


16. There Is Hope

Scuba Diving

There's some good news for people just starting to realize how much bacteria lies hidden from the constraints of out eyesight. The longer you spend in a place, the more familiar your body is going to become with its bacteria. If you are spending a few years somewhere, you'll come out with an iron digestive tract, and dealing with a few bouts of this particular sickness will make your immune system stronger.


17. It Can Be Prevented

The prevention measures alone may not be able to stop this trip-ruiner. However, before any trip visitors should ask their doctor if prescription or over the counter oral vaccines like Dukoral may be right for them. These vaccines, paired with the preventative measures, can protect against traveller's diarrhea for up to three months.


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