Dr Jane Read

While Asia is a cultural destination widely loved due to culinary delights of the region, some have bad memories caused by the dreaded gastro bug also known as Bali belly. It is important to be aware of the traps people can fall into when travelling and eating in Asia.

Gastroenteritis, commonly termed ‘gastro’ or travellers’ diarrhoea, is an infection of the gut. About 20-50% of people travelling to developing countries will be affected by travellers’ diarrhoea, the majority of which are caused by bacterial infections, due to poor sanitation and hygiene. Other causes of gastro include viral infections, and parasites.

Gastro may result in a mild form of the illness, causing an upset stomach and mild diarrhoea. However, it may be more severe, with nausea, vomiting, significant diarrhoea and high temperatures. Symptoms should only last a few days, but sometimes can persist for longer leading to dehydration, possibly requiring medical attention.

Now knowing what gastro is and its effects, here are some helpful tips to avoid the illness.

Hygiene

It might seem like common sense but one of the most important things is to wash your hands before eating to prevent getting an unwanted gastro bug. A good tip is to carry some hand sanitizer or wipes in your backpack or handbag. You will never regret it!

Water and beverages

  • Drink bottled water and avoid untreated or unboiled tap water. Drinking or touching contaminated water can lead to vomiting and diarrhoea or other types of infection.
  • Avoid ice cubes, as these will be made with local water. Brush your teeth using bottled water.
  • Avoid fruit drinks, iced tea and iced coffee.
  • To disinfect water, it needs to be boiled for at least 1 minute, and then cooled. Boiling water will not however remove fuels or toxic chemicals.
  • Water purification tablets (containing iodine or chlorine) are also available, however these are sometimes ineffective against some particular bugs.

Food

  • Ensure that all the food you eat is thoroughly cooked and hot. Cooked food that has been stored needs to be thoroughly reheated.
  • Avoid uncooked vegetables and salads as they may have been washed in water that is contaminated. Eat only fruits that you can peel (bananas, mango, papaya) and avoid fruit that is already cut up into slices (you don’t know how long it has been on display). Avoid unpasteurized milk, cheese and yoghurt.
  • Avoid raw or undercooked meat, fish and shellfish.
  • When eating at restaurants, make sure it is a popular eating spot with lots of customers. These restaurants are likely to have better turnover of foods and hygiene practices.
  • Food from street vendors has been associated with a higher risk of illness. If you are tempted, make sure the food is well cooked (being made in front of you whilst you wait).

Preparing for you trip (Just in case)

Pack some oral rehydration fluids or salts, which are available at most pharmacies. These fluids have a particular balance of electrolytes, which allow them to be more quickly absorbed than plain water or juices.

Talk to your doctor about anti-diarrheal medication and antibiotic therapy you may wish to take with you.

Taking probiotics during your travels would seem like a good idea, however to date there is not enough evident to support probiotics in the prevention of travellers’ diarrhoea.

So now you have equipped yourself with some good tips to help prevent gastro while travelling, you can confidently go out and discover, enjoy and explore Asia and all it has to offer.

Dr Jane Read is a Sydney-based GP Registrar who also holds a Masters Degree in Nutrition and Dietetics from Deakin University in Melbourne. In addition to working in general practice, Jane works as a freelance nutrition and medical writer, and has been a nutrition consultant to various corporate clients.

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