Changing time zones knocks people, add the stress of winding up at work and many people arrive feeling slammed, needing a holiday. This is the time you are most likely to get sick; try to take it easy, and definitely take multi-vitamin tablets.
In developed countries people take for granted clean drinking water, toilets that flush waste away never to be seen again and hygienically packaged food. While trekking in
All the water in the streams and rivers of
There are many different methods to purify water; in the lodges boiled water is normally available, while camping our crew provide thermos of boiled water. Sometimes you may want to purify water yourself; the most convenient method is Iodine tablets. If you have a water filter, ask us if it is worthwhile bringing it.
This is a common problem in developing countries, especially
First, diarrhoea will not normally kill you so urgent treatment is not necessary nor always recommended. Many people over-react and start taking drugs at the first loose stool. Instead wait a few days and see what happens.
Unless it is particularly severe, for example food poisoning, there is no need to stop trekking, just drink lots of water and listen to your body: if you feel hungry, eat, and if you don't then take lots of soup and light foods. If the diarrhoea is still definitely troublesome after a few days and you are fairly sure of what type it is then you may want to treat it, but this is still not entirely necessary.
If you have a pre-existing condition such as stomach ulcers, gall bladder problems, previously perforated intestine etc, be especially careful with self-diagnosis and treatment.
A. watery diarrhoea.
Giardia can also be virtually symptom less, just occasional soft stools or constipation even and a vaguely upset stomach. Some forms your body will clear given a month or so and a number of people have had it without realising however if it is obvious and a problem there are two drugs that are effective.
B. Tiniba - this can be bought at all Nepalese pharmacies (without a prescription). The name of the active chemical is Tinidazole. The dose is 2 grams, ie 4 x 500 mg (milligrams)) all at once then 24 hours later, the same dose, and 24 hours later, a third dose.. It is perhaps better taken in the evening because the usual side effects, a strong metallic taste in your mouth and nausea may be slept off. This dose is about 90% effective - it is possible that it may re-occur later. Do not mix with alcohol.
Alternatively take: Flagyl/Metronidazole. The dose is 250mg three times a day for 5 to 7 days. DO NOT not mix with alcohol.
Note! DON'T take Flagyl and Tiniba at the same time.
B. Amoebic Dysentery
Occasionally its onset is sudden and weakens a person severely, sometimes to the point of barely being able to lift oneself off the toilet. However it usually comes on slowly, a mild diarrhoea that comes and goes, something that can almost, but not quite, be ignored. This is when it is most dangerous because the symptoms can eventually clear up, but your body is still infested and being slowly damaged. If you suspect you have this then upon return to
C. Travellers / Bacterial Diarrhoea
The onset is often accompanied or even preceded by a fever and/or chills and nausea, next is fairly sudden frequent watery diarrhoea and often cramps. It is caused by slightly different strains of bacteria that your body is normally used to. This type of infection is normally the first to attack fresh from home arrivals to
This comes on suddenly and severely, usually from both ends - vomiting and diarrhoea. It happens about 4 to 8 hours after eating the contaminated food. Luckily it usually lasts less than 24 hours and recovery is quick, although you may feel weakened. There are no drugs that can help - the body just has to eject all the contaminated food and rid itself of the poison. Rest and, once the first severe bout or two is over, drink plenty of fluids. Oral rehydration solutions are helpful.