What To Do About the Doo: Traveler’s Diarrhea 101

That’s right folks, this post is about poop, because like it or not, everybody poops.  You know, in case you never read the book as a kid.  But what’s an even more well-guarded secret is that, when in a developing country, everybody poops soft.  Think you’re going to get away with going to a place like Central America without getting the shits at some point?  You won’t.  For me and Chris, the urge to purge hit us both simultaneously on what was meant to be our last night in Xela.  In a way, the timing was a blessing, both because then we could both be miserable at once and because this was a hostel where we didn’t need to worry about not being able extend our stay due to lack of room.

Before my plight, I really knew nothing about traveler’s diarrhea.  I didn’t know what to do about it, how serious it might be, or how long it would last.  My solution to my situation was Googling my malady of yellow shit and that only made me believe that I either had cirrhosis of the liver or hepatitis.  Hopefully this brief guide to treating traveler’s diarrhea will save you from a similar fate.

What it is?

Traveler’s diarrhea is a bacterial infection of the stomach and intestines, mostly commonly caused by the e.coli bacteria.  In almost all cases, it isn't serious.

How do you get it?

Poo knows! You can get traveler’s diarrhea for a wide variety of sources, such as eating food that has been contaminated, brushing your teeth in unclean water, or even touching a surface that was touched by someone who didn’t wash their hands after going to the bathroom.  With lax health and safety standards and an absence of restaurant health codes and regulations, there really isn’t any way to patrol the quality of food vendors in most developing countries.  Hell, you could start selling rotting meat out of the back of your car in Central America and no one would tell you not to.  And if you consider that most restaurants are really just glorified barbeques, it’s no wonder pretty much anyone who visits a developing country is bound to get the runs at some point.

When we told our hostel hostess that our stomachs weren’t feeling well, she gave us a small English publication, that month titled “Food in Xela: The Runs Down”.  How very appropriate.  And as this magazine put it, “Much like listening to awful music on a chicken bus or getting soaked through by a deluge of rain in the afternoon because you forgot to pack your umbrella (again, getting the shits is a fact of lie for those living in Guatemala.”

The article went on to detail the specific dangers of street food.  Some foods, such as cheveres and pupusas (a must try food) are pretty well safe.  However, if you take a chance with street tacos and greasy garanchas, both given a red alert level by the article, you might well regret it.  Ironically enough, the one night we ate out on the street in Xela during the Dia de los Muertos festival, we ate those two things.  The latter is actually known as the “Russian Roulette of street food”.  Naturally I would pick that.

Behold the dreaded garanchas.

Does that mean you should stay away from street food?  No way.  Street food is one of the cheapest ways to feed yourself and it’s a way to really get a taste (literally) of the local culture.  Don’t deprive yourself of the experience because you’re afraid of the shits.  Just be wary.

What are the symptoms?

Symptoms of traveler’s diarrhea are much of what you might expect:

  • Abrupt onset of diarrhea- You know, that awful bubbling in your bowels that just tells you to get to a toilet immediately.  Hopefully you’re close enough to one to make it.
  • Fever
  • Bloating and cramps
  • Loss of appetite
  • Malaise- Don’t plan on going on out while you have it.  Not only do you not want to be far from a toilet, but you get exhausted extremely fast.
  • Nausea and vomiting- You may or may not vomit.  Chris never did and I only vomited once in the middle of the night, though I didn’t really have much more than water and bile in my stomach to vomit up.  We felt nauseous all the time, but not really to the point of throwing up.  Maybe that was just a result of our mental will to not vomit.
  • Explosive diarrhea- Obviously.
  • Yellow, liquid poop- The yellow coloring is due to a lack of bile in your stool.  Don’t believe the online articles that tell you this means you have cirrhosis of the liver.  It’s more commonly just a sign or a nutritional deficiency.  Essentially, food doesn’t remain in your body long enough to absorb the nutrients.  The yellow stool can linger for days after the diarrhea until your body regulates nutritionally. 

How long does it last?

It varies, but typically a bout of traveler’s diarrhea lasts anywhere from 3-7 days.  The first three are the worst, accompanied by the symptoms that make you feel awful.  You’ll feel better for the last few days, but still might want to be conscious of where the nearest toilet is at all times.

How do you treat it?

You can’t treat traveler’s diarrhea really.  You just need to let it run its course.  You can see a doctor and get on an antibiotic to lessen the duration, but the cost of such an endeavor really isn’t worth it.  Traveler’s diarrhea is hardly serious enough in most cases to merit a trip to the doctor.  When I received my travel vaccinations, the doctor actually wrote me a prescription for Azithromycin in case I got traveler’s diarrhea.  I went to pharmacy to inquire about the cost of filling and discovered that 24 tablets costs over $100.  I’ll take the shits, please.

Instead of getting on an expensive antibiotic, just take some cheap, over-the-counter antidiarrheals.  You can get them in pretty much any pharmacy or grocery store.  Or you can bring some Imodium from home, which was something that did not occur to me until it was too late.  I travel with laxatives because I usually suffer from traveler’s constipation so the reverse never seemed necessary.

The most important thing to do to treat traveler’s diarrhea is to stay hydrated.  Whenever you’re expelling a lot of liquid, your body will begin to dehydrate so it’s important to drink a lot of water.  Try to find rehydration salts, a World Health Organization product usually found in developing countries, at a local pharmacy or grocery store.  Even though you won’t feel like eating, it’s important to try to get just a little bit of nutrition, even if it means eating something as soft and plain as a piece of bread.  That’s pretty much all I ate for the first 24 hours of contracting the illness.  It’s better than nothing.

All in all, just know that it will end.  As you’re sitting on the toilet, expelling more waste than you thought possible, especially when you haven’t eaten in days, it can seem like it will never end.  But it does.  Pretty soon you’ll be back to normal, chowing down on greasy garanchas without giving a shit… literally.