A very high percentage of people who travel to Phuket will at some stage get a dose of the trots. Generally it’s not because the food and drinks are unclean, it’s because their bodies are not used to the bacteria and other bugs that they try to digest.

Whilst it isn’t a pleasant experience at the best of times, for tourists, getting gastro during your long anticipated holiday is not fun.

The trots can be mild or severe and are normally associated with nausea, vomiting, watery or loose stools, abdominal pain and weakness. Infants and the elderly are more at risk of serious complications particularly dehydration. As our body loses more and more fluid from both ends, we get thirstier and thirstier to the point that we feel we can’t keep any fluids within our body.

When we ingest a bacteria or virus that our body doesn’t like possibly from drinking tainted water, eating unhygienic food or not washing our hands following contamination, our gastric and immune systems go into overdrive. The cramp we feel is our stomach and intestines constricting and relaxing to expel the contaminated bugs as quickly as possible. The watery stool is the result of our body’s attempts to dilute the bugs with fluid from our circulatory and other body systems. The vomiting? Well, it’s the quickest way to clean out the stomach. If your body doesn’t like what you’ve put into it, it will get rid of it. The problem is that sometimes it doesn’t know when to stop, and we keep dry retching, further adding to the pain and misery.

Unless you’re seriously dehydrated or have blood in your stool, a dose of the trots can be good for you, as your immune system will develop immunity to the newly introduced bugs and will be able to fight the next invasion. That’s why longer term residents of Thailand don’t get affected as frequently as newcomers. They’ve become immune.

It’s better to let nature take its course. I don’t recommend that you dive for the medicine cabinet each and every time you get a dose. Taking Imodium type medication will slow down the speed of your gut and will allow you to venture further away from the toilet, but it’s defeating the purpose. Taking antibiotics will also kill the bacteria in your gut, the bad ones and the good ones that your body needs to digest food. Most cases of the trots will resolve themselves within 24 to 36 hours so unless you’re on holiday, have important engagements or need to catch a flight, try to wait it out.

If you’ve indulged in the local spices and chilies, getting the trots can be even more painful as parts of your anatomy may feel as though they’re on fire. Avoid using toilet paper, certainly perfumed or printed paper which can further traumatise the delicate areas. Use water instead, and be gentle, very gentle.

Prevention is better than cure. To avoid the problem, wash your hands regularly, especially before meals. If you can’t peel it or cook it, consider leaving it. This includes reheated food. Salads should be properly prepared, using clean water. Never drink the tap water unless you’ve been here a while and have developed a tolerance for it. It’s a sure way to get a dose.

If you have a serious bout and you’ve blood in your stool or become dehydrated, you need medical help. You must not dehydrate, so frequent small amounts of fluid are needed. Drinking water and clear soft drinks with some sugar such as 7–Up, Lemonade or Sprite are excellent as the sugar gives you much-needed energy. Avoid milk and alcohol as these will make things worse. So will dairy products and fatty foods. Bananas, plain rice and bread are recommended. If you’ve taken antibiotics, also have some yoghurt (Yakult is a commonly available yoghurt drink) when the course of medication is finished. This assists your gut to grow back the good bacteria that are essential for digestion.

Peter Davison is the Manager International Services
at Phuket International Hospital.
Tel: +66 (0)76 249400. Email: info@phuketinternationalhospital.com.