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Marc Katz MD

Advice for medical trainees, cardiology, & everything in between

How To Avoid Spending Vacation on the Toilet- and other useful tidbits

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Before starting residency I traveled to Southeast Asia for two weeks with my best friend. Somehow neither of us managed to get sick…or robbed. Here are my best travel tips to stay healthy while traveling through Thailand, Cambodia, and the rest of Southeast Asia.

 

 

Only drink bottled water

Although I work in a hospital I prefer to avoid unnecessary trips to my place of work. Especially to hospitals in Southeast Asia. Drinking tap water in Thailand is like drinking tap water in Mexico, except in Thailand they don’t have a cute name for chronic diarrhea like Mexico’s Montezuma’s revenge. This isn’t ‘a bad burrito from Chipotle’ kind of diarrhea. I’m talking about 2-5 days of debilitating bowel movements that can leave you dangerously dehydrated necessitating a trip to the hospital for intravenous fluid replacement (probably not on your list of ‘must see’ places in Thailand). So how do you prevent yourself from getting sick?

  • Do not drink tap water. Period. To be extra safe use bottled water to brush your teeth.
  • Don’t consume anything cleaned with tap water. Avoid raw or undercooked fruit or vegetables. Seriously. You’re not being paranoid, you’re being vigilant.
  • When in doubt avoid the ice. I never got sick while in Thailand or Cambodia. This may be anecdotal but most hotels, hostels, and bars I went to used clean water to make their ice or bought ice from a manufacturer (although I have no idea where the ice came from for the buckets in Koh Phangan…). Better to be safe than sorry. So get whiskey straight and skip the rocks.

 

 

Pepto-Bismol as an appetizer

Two really interesting studies that I’m surprised more people don’t know about looked at using Pepto-Bismol prophylactically to prevent traveler’s diarrhea. The two studies showed a decreased risk of developing traveler’s diarrhea with the prophylactic use of Pepto-Bismol. Specifically, the second study ‘reported that two tablets [of Pepto-Bismol] chewed four times a day reduced the risk of developing diarrhea by 65 percent’. 1,2 So it isn’t a cure-all but it certainly seems to decrease the chance of developing traveler’s diarrhea. I took two Pepto-Bismol before each meal and it worked for me. Or maybe it did nothing and I wouldn’t have gotten sick regardless. I met many backpackers who had been traveling for months and had never gotten sick but I wasn’t about to risk it on the two short weeks I had to explore the other side of the world.

 

 

Immunizations before you go

Check out what the CDC recommends depending on where you are traveling and be sure to discuss what you find with your physician. Some medications aren’t routine for your pharmacy to have on the shelves so be sure to give yourself a minimum of one week to procure your meds. For instance, my malaria prophylactics meds had to be special ordered and were luckily able to be delivered the next day. Also be sure to note if your medications need to be refrigerated. For instance, the oral thypoid vaccine (one pill, once a day, every other day, completing the regimen prior to travel) would be rendered useless if I left it out.

 

 

Mosquito borne illnesses

As I reviewed in my post about Zika Virus, the best way to prevent mosquito borne illnesses is to prevent mosquito bites in the first place. Insect repellent sprays that contain DEET have been proven to be the most effective but still aren’t 100%3. You can decrease your risk of mosquito bites by wearing long sleeved shirts and pants when traveling through jungle terrain and other areas where mosquitoes thrive. Also avoid scented deodorants. If you do get bitten up, Tiger Balm is the only stuff that I’ve ever found to decrease the itch.

 

 

Did I miss anything? What guidelines do you have for yourself to stay healthy while traveling abroad?

 

 

Works Cited

1-DuPont HL, et al. “Prevention Of Traveler’s Diarrhea (Emporiatric Enteritis). Prophylactic Administration Of Subsalicylate Bismuth). – Pubmed – NCBI”. Ncbi.nlm.nih.gov. N.p., 2016. Web. 4 Apr. 2016.

2- DuPont HL, et al. “Prevention Of Travelers’ Diarrhea By The Tablet Formulation Of Bismuth Subsalicylate. – Pubmed – NCBI”. Ncbi.nlm.nih.gov. N.p., 2016. Web. 4 Apr. 2016.

3- “What’s The Best Way To Keep Mosquitoes From Biting?”. NPR.org. N.p., 2016. Web. 4 Apr. 2016.

 

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