Ask a GP: How can I prevent Bali belly?

Ask a GP: How can I prevent Bali belly?

Ask a GP: How can I prevent Bali belly?

Dr Jill Thistlethwaite

A doctor reveals how to avoid turning your trip into one between the hotel bed and toilet. 

Picture: iStock.

Bali is an attractive island holiday destination for many Australians. But with the spectacular views and exotic food comes the risk of contracting ‘Bali belly’.

‘Bali belly’ is not the result of too much time at the hotel buffet, and it is also not unique to Bali. More commonly known as travellers’ diarrhoea, it can affect between 20 per cent to 50 per cent of travellers and is caused by a bacterium, parasite or virus from contaminated water or food. That means your chance of having an uncomfortable episode of travellers’ diarrhoea is as high as 1 in 2.

While symptoms may start during your holiday, developing diarrhoea up to 10 days after your return is also part of the condition.

Travellers’ diarrhoea is described as a ‘self-limiting’ illness, because it typically gets better on its own. But if you want your holiday memories to consist of relaxation and good times rather than vomiting, fever, and severe cramps, here are a few tips on how to avoid getting sick, and how to cope if you do.

Generally, avoid untreated/unboiled tap water (including ice and when brushing teeth), raw foods such as salads, uncooked vegetables or fruits that cannot be peeled, and undercooked or raw meat, fish, shellfish and eggs.

Wash your hands often. This is especially important for children who crawl around on floors. Carry a bottle of hand sanitiser in case soap and water aren’t available. It’s easy, cheap, fast and convenient.

You will know if you have travellers’ diarrhoea … let’s spare the details. The symptoms are pretty unmistakable, and may last from about 1 to 5 days. So what can you do about it?

I’ve got it. What now?

Preventing dehydration is your first step. Over-the-counter rehydration solutions are easy to get hold of in most countries. Isotonic sports drinks (such as Gatorade or Pocari Sweat) are also helpful.

If you use rehydration sachets, make sure you mix them with bottled water, otherwise, mixing 1 part fruit juice with 4 parts of clean (sterile) water is a good option.

Your urine should look light yellow or almost clear. Stopping eating has not been shown to improve diarrhoea – if you do feel like eating, then you should but non-spicy food will be better tolerated.

Many travellers swear by anti-diarrhoeal medicines that contain the active ingredient loperamide (eg Imodium). These work by slowing down peristalsis, the wave-like contractions of the bowels that move digested food through the gut. They do not treat the cause of the diarrhoea, only the symptoms.

Loperamide should be used for mild diarrhoea and usually works quickly (within an hour). It is important to remember that the diarrhoea may return as the effects of loperamide wear off. Anti-diarrhoeal medicines are available in Balinese pharmacies (apoteks) or you can bring some with you (it’s advisable to keep it in original packaging).

If your symptoms are severe (more than 3 loose stools over 8 hours, with nausea, vomiting, bad cramps, fever or blood in the stools), or do not improve after taking loperamide, then you may have a bacterial type of diarrhoea that requires antibiotics.

What to pack for your trip

Visit your doctor or pharmacist before your overseas trip for medical advice and to check whether your vaccinations are up to date. This especially applies if you are pregnant or have a health condition that makes you more susceptible to illness or means you may need special care if you do get sick.

Items that may be useful include:

  • Oral rehydration sachets (used with bottled water)
  • Hand sanitiser
  • Don’t forget to pack any medicines you normally take and always ensure you have travel insurance

Dr Jill Thistlethwaite is a general practitioner with over 25 years’ experience. She is also a health professional education consultant and NPS MedicineWise Medical Advisor.

Wonderful Indonesia – Lombok Island3:43

Lombok is an Indonesian island east of Bali and west of Sumbawa, part of the Lesser Sunda Island chain. It’s known for beaches and surfing spots, particularly at Kuta and Banko Banko.


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