Intestinal Troubles
Diarrhoea is the most common bane of travellers. When mild and not accompanied by other major symptoms, it may just be your stomach reacting to unfamiliar food. Accompanied by cramps and vomiting, it could well be food poisoning. In either case, it will probably pass of its own accord in 24-48 hours without treatment. In the meantime, it is essential to replace the fluids and salts you're losing, so take lots of water with oral rehydration salts (commonly referred to as ORS, or called Electrolyte in India). If you can't get ORS, use half a teaspoon of salt and eight of sugar in a litre of water, and if you are too ill to drink, seek medical help immediately. Travel clinics and pharmacies sell double-ended moulded plastic spoons with the exact ratio of sugar to salt. While you are suffering, it's a good idea to avoid greasy food, heavy spices, caffeine and most fruit and dairy products. Some say bananas and pawpaws are good, as are kitchri (a simple dhal and rice preparation) and rice soup and coconut water, while curd or a soup made from Marmite or Vegemite (if you happen to have some with you) are forms of protein that can be easily absorbed by your body when you have the runs. Drugs like Lomotil or Imodium simply plug you up - undermining the body's efforts to rid itself of infection - though they can be useful if you have to travel. If symptoms persist for more than a few days, a course of antibiotics may be necessary; this should be seen as a last resort, following medical advice. Sordid though it may seem, it's a good idea to look at what comes out when you go to the toilet. If your diarrhoea contains blood or mucus and if you are suffering other symptoms including rotten-egg belches and farts, the cause may be dysentery or giardia. With a fever, it could well be caused by bacillic dysentery , and may clear up without treatment. If you're sure you need it, a course of antibiotics such as tetracycline should sort you out, but they also destroy "gut flora" in your intestines (which help protect you - curd can replenish them to some extent). If you start a course, be sure to finish it, even after the symptoms have gone. Similar symptoms, without fever, indicate amoebic dysentery , which is much more serious, and can damage your gut if untreated. The usual cure is a course of Metronidazole (Flagyl) or Fasigyn, both antibiotics which may themselves make you feel ill, and must not be taken with alcohol. Symptoms of giardia are similar - including frothy stools, nausea and constant fatigue - for which the treatment is again Metronidazole. If you suspect that you have either of these, seek medical help, and only start on the Metronidazole (750mg three times daily for a week for adults) if there is definitely blood in your diarrhoea and it is impossible to see a doctor. Finally, bear in mind that oral drugs, such as malaria pills, and the Pill, are likely to be largely ineffective if taken while suffering from diarrhoea
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