Traveler’s Diarrhea

By Ayu Deni, MD

As one of tropical paradise island has many things to offer beautiful scenery, unique artwork, and classical tradition, it make as international destination. Either enjoy of beautiful view, tourist from various country in the world come to Bali to taste some special Asian food also. Some of traveler usually had diarrhea, it’s called by “Bali Belly” the Balinese people named.

Bali Belly is known as traveler’s diarrhea. This illness can occur any time during the trip, even after the person gets home. It is self limited disorder, no specific treatment and need until four days for recovering. On the other way, its complication is dehydration which could be developed to other serious condition. There are some symptoms of traveler’s diarrhea; abdominal bloating, cramps and pain, nausea, urgency to go to the toilet, loose, watery stools passed frequently, mild temperature and general malaise (weakness or discomfort)

Consuming contaminated food is a major cause of traveler’s diarrhea. It caused by virus, parasite or bacteria. Escherichia coli (E. coli) Bacteria normally found of our intestine. There are many varieties of E. coli. If we infected with new varieties, the intestine reacted to produce  substances of toxic. The toxic will be able to interfere intestine’s ability to absorb the water and increased intestinal motility, it occurs in diarrhea.

Some high risk foods that should be avoided include:

  • Raw and peeled fruits and vegetables
  • Green leafy undercooked meats of any kind.
  • Seafood, particularly raw or inadequately cooked shellfish or fish
  • Sauces and mayonnaises
  • Unpasteurized dairy foods, including milk
  • Food from street vendors
  • Any hot food that has been left long enough to cool
  • Food buffets


The prevention of traveler diarrhea is to avoid of some high risk foods and contaminated food. There is no vaccine needed. But, there are some things that you have to do if get diarrhea.

  • Take plenty of water or take oral rehydration drinks (i.e. oralit, Pocari Sweat) to replace lost salts and minerals
  • Probiotic (i.e. yakult, yogurt) is beneficial yeast that can help maintain natural flora in your intestines to remedy and prevent uncomfortable diarrhea
  • Anti-nausea or anti vomiting drugs
  • Avoiding anti-diarrhea drugs if has high fever. It because passage of stools will only keep a bacterial infection and its poisons inside the body for longer.


Most cases of diarrhea without treatment. However, severe diarrhea can cause dehydration, which can be life threatening, they must call doctor. There are signs and symptoms of diarrhea that you seek medical attention

  • If diarrhea lasts longer than three days
  • If blood, mucus, or worms are seen in stool
  • If the person has pain in the abdomen or rectum
  • If the person has high temperature (>38,5 0C)
  • If a severe headache develops
  • If the person has signs of water loss including dry mouth, excessive thirst, little or no urination
  • If the person’s immune system is weakened by another condition such as HIV or cancer
  • If the symptoms do not improve when the individual drinks fluid
  • Vomiting prevents fluid intake

Antibiotics provide no protection against of viruses and parasite. So, taking antibiotic is not always best solution for diarrhea as people thinking. Because doing so, not indication for antibiotic it means that will contribute to the development of antibiotic-resistant bacteria. Doctor suggest by taking bismuth subsalicylate (Corosorb, Attapulgit, Licoped) which has been shown to decrease the intensity of diarrhea. However, do not take it more than three weeks.