Montezuma’s Revenge!
That’s a fancy way of saying: Explosive Diahrrea - It’s coming to get ya!
The most common travel related ailment you will face is travelers’ diarrhea. The key to prevention is food and water precautions. All surfers travelling to Costa Rica should bring along an antibiotic and an antidiarrheal drug to be started promptly if significant diarrhea occurs, defined as three or more loose stools in an 8-hour period or five or more loose stools in a 24-hour period, especially if associated with nausea, vomiting, cramps, fever or blood in the stool.
Most cases of travelers’ diarrhea are relatively mild and will not require either antibiotics or antidiarrheal drugs. However, adequate fluid intake is essential to helping mild cases run their course. If your diarrhea is severe or bloody, or if fever occurs with shaking chills, or if abdominal pain becomes marked, or if diarrhea persists for more than 72 hours, medical attention should be sought.
A few simple practices will help you avoid all this unnecessary pooing. Do not drink tap water unless it has been boiled, filtered, or chemically disinfected. Do not drink unbottled beverages or drinks with ice. Do not eat fruits or vegetables unless they have been peeled or cooked. Avoid cooked foods that are no longer piping hot. Cooked foods that have been left at room temperature are particularly hazardous. Avoid unpasteurized milk and any products that might have been made from unpasteurized milk, such as ice cream. Avoid food and beverages obtained from street vendors. Do not eat raw or undercooked meat or fish, including ceviche. Some types of fish may contain poisonous biotoxins even when cooked. Barracuda in particular should never be eaten. Other fish that may contain toxins include red snapper, grouper, amberjack, sea bass, and a large number of tropical reef fish.
Ask your family doctor or Travel Clinic which Antibiotic or medication to bring with you. Prepare for the runs in advance and don’t get caught with your pants down… literally. There are different medications that can be prescribed for diarrhea, so if you are interested in knowing more before you talk to a doctor, read the paragraph below:
A quinolone antibiotic is usually prescribed: either ciprofloxacin (Cipro)(PDF) 500 mg twice daily or levofloxacin (Levaquin) (PDF) 500 mg once daily for a total of three days. Quinolones are generally well-tolerated, but occasionally cause sun sensitivity and should not be given to children, pregnant women, or anyone with a history of quinolone allergy. Alternative regimens include a three day course of rifaximin (Xifaxan) 200 mg three times daily or azithromycin (Zithromax) 500 mg once daily. Rifaximin should not be used by those with fever or bloody stools and is not approved for pregnant women or those under age 12. Azithromycin should be avoided in those allergic to erythromycin or related antibiotics. An antidiarrheal drug such as loperamide (Imodium) or diphenoxylate (Lomotil) should be taken as needed to slow the frequency of stools, but not enough to stop the bowel movements completely. Diphenoxylate (Lomotil) and loperamide (Imodium) should not be given to children under age two.
There. You’ve got it. A few simple preparations and precautions that will make all the difference if you end up with travelers diarrhea as so many before you have. My last case was in Peru about 5 years ago. I ended up stuck in a hotel room for three days, halfway to where I was trying to go. It was an unpleasant little town with no reason to visit. Luckily for me, I spent the whole time on the toilet, which was probably the best place in town anyway.
