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Rushing to the bathroom with an upset stomach is the last way you want to spend your holidays. Traveller's diarrhea can affect people travelling anywhere, but most frequently affects tourists visiting developing countries. It is a relatively common travel sickness but the symptoms aren’t pleasant. Bali Belly, Montezuma's revenge, the Rangoon runs and gastro all refer to the same thing - stomach cramps, diarrhoea, vomiting, aches, and pains. These are the kinds of symptoms that can derail carefully planned holiday itineraries. It is nasty, painful and can leave you not wanting to venture too far from your hotel toilet.

In 2017, Cover-More customers had 1457 reported cases of gastro, costing almost $2 million in emergency expenses. You can get traveller’s diarrhea anywhere, including when there’s outbreaks in Australia that spread through offices and schools. It is more common for travellers to be exposed in countries like Indonesia, Thailand, Cambodia, Vietnam, Peru, and India. Africa is also a big culprit.

As one unlucky Cover-More customer found out, a case of gastro in the USA can leave you with bills of around $100,000. Long hospital stays, IV drips and multiple medical tests can add up. If you are prone to serious infections, suffer from IBS, or are diabetic, you may be more susceptible. Have a chat with your GP or travel doctor prior to departing on your holiday so you can prepare and hopefully reduce the risk of catching Bali Belly.  

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Symptoms of Bali Belly

Bali Belly or traveller’s diarrhoea can often be picked up in the first week of travel. Your body is exposed to new and unfamiliar bacteria and viruses. After contamination, it can take between two to five hours for symptoms to appear. Your first symptom might be a sudden onset of rumbling stomach, bloating or nausea. Other symptoms can include:

  • Loose or watery stools (diarrhoea)
  • Urgency/frequency in going to the toilet
  • Abdominal cramping, bloating and pain
  • Mild temperature
  • General malaise (weakness or discomfort)
  • Loss of appetite

You can seek professional medical help if you are unwell while abroad. If you are still experiencing symptoms after a few days, consider booking an appointment to see a medical professional. Blood or mucus in the diarrhoea, a high fever, and significant abdominal pain can indicate a more serious illness. You should consult a medical professional immediately. Dehydration can be a serious consequence of traveller’s diarrhoea. If you think you are suffering from dehydration, see a doctor as soon as possible. It is better to be safe than sorry.

Causes of traveller’s diarrhoea

Traveller’s diarrhoea or Bali Belly can be caused by consuming contaminated food and water. Untreated water can carry pathogens such as bacteria, viruses or protozoans.  Poor sanitation practices can also lead to these pathogens appearing in your food. The majority of cases are caused by bacteria, with E. Coli being one of the most common. Eating off a wet plate, consuming food handled by someone who hasn’t washed their hands, or drinking tap water are all scenarios that could leave you sick.

While you might think to ‘do what the locals do’, there is a good chance they have developed immunity. A glass of untreated water might have no effect on them but the same glass might leave you retching. Play it safe so you’re not stuck spending your holiday unable to leave the bathroom.

male with stomach pain

How do you avoid Bali Belly or traveller’s diarrhea

There are a number of things you can do to help avoid getting traveller’s diarrhoea.

  • Only drink bottled or filtered water. You should also brush your teeth with bottled water and avoid getting it in your mouth in the shower. Even if the locals drink the water, your digestive system is not used to the new bacteria.
  • Ask for drinks without ice. Ice is often made with tap water.
  • Make sure your tea, coffee, or juices are made with bottled or boiled water.
  • Many street vendors will serve up food and drinks on freshly washed plates and cups. Make sure they’re completely dry before using them.
  • Be cautious about where you get your fruit and vegetables from. Make sure to wash them with bottled or boiled water.
  • Be vigilant about washing your hands and using a hand sanitiser.
  • Peeled and pre-cut fruits might look tempting but they can also make you sick. Buy whole fruits and cut them up yourself.
  • Avoid eating raw, rare or uncooked meat in developing countries.
  • Don’t eat food at room temperature, food that has been sitting in the sun or food from buffets.
  • Avoid unpasteurized dairy products, shaved ice or mobile soft-serve vendors.
  • Eat at popular restaurants with a high turnover. This means the food will be fresh and not pre-cooked.

Street vendors - Can I eat from them?

While Southeast Asia is one of the worst offenders for traveller’s diarrhea, it also has some world-class street food. Choosing whether to eat the street food or not is a personal choice. If you’re someone who gets sick easily, it might be best to avoid it. Here are some tips for eating street food.

  • Choose places that are popular. These places are more likely to be turning out fresh, hot food.
  • Avoid food that has been sitting at room temperature. It’s best to eat from places that are cooking the food in front of you.
  • Avoid places that are close to the road. You don’t want your meal seasoned by traffic pollution.

Don’t let traveller’s diarrhea or Bali Belly deter you from your travels. While it might be common, there are steps you can take to reduce the risk of getting it. But if you do end up with Bali Belly and you have Cover-More travel insurance, your medical visits can be covered and you’ll be reimbursed for any pre-booked tours or activities you missed* as a result of your Bali Belly. Consider protecting your holiday to Bali with travel insurance, or any other destination you're wanting to travel to. 

street food vendor

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*The International Premium Plan and the Inbound Plan do not automatically include cancellation cover. You can add the amount of the cancellation cover that suits you. Limits, exclusions and conditions apply. Refer to the Combined PDS/FSG for full details.

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