It didn’t take long once I was asked to write this health column to home in on my first topic-bowels. I’m not talking about the healthy kind. Think Montezuma’s Revenge, dysentery, schistosomiasis, food poisoning or just plain old diarrhea. The clients I see as a nutrition counselor typically get nervous when they have to describe the state of their bowels. But not Peace Corps Volunteers. In fact, there isn’t one Volunteer, trainee, or international veteran who, given half a chance and preferably over dinner, won’t gleefully regale you with a history of their intestinal adventures. Usually, among the volunteer crowd at least, things get down to details of color, texture, and odor along with humorously horrific depictions of the bathroom, outhouse or patch of desert bush involved.

The truth is you don’t have to travel to Mauritania, Belize or Kyrgyzstan to suffer from diarrhea, the traveler’s kind or more worrisome sorts. As I write this, my 11-year-old son, Sasha, and my ex- are stuck in the Atlanta airport waiting for a dense fog to lift so they can return to the DC area after a vacation from hell. It turns out the delicious Southern feast they shared with family members also involved either food poisoning or some virulent intestinal virus-sharing that has now made the rounds among seven of the twelve or so lucky souls in attendance.

Sasha was up most of the night having the contents of his gut cleared out. When he called me for the six or seventh time at 6 am, he was onto the diarrhea phase. “Mom, we’re getting ready to go to the airport and dad gave me Immodium — is that okay?” I muttered something encouraging but wondered silently about this common strategy that, while well-intentioned, could undermine the body’s ability to clear unwanted bacteria. I have heard dozens of stories about people heading off for an ten-hour bus or motorbike or even camel trip in the midst of an intestinal virus or amebic dysentery and popping a couple of Immodium to make it through. It works, usually, for a while; but it’s never good to force toxic digestive matter to remain trapped. I always encourage people to surrender to the body’s innate wisdom and allow it to do what it needs to do. The best thing we can do is get out of the way — “Do no harm” — and stay hydrated.

So, what kind of father would be so determined to make his flight back to DC that he was willing to drag his sick child and himself after a miserable night over and on the toilet to brave a 40-minute car ride, long walk through a major airport, longer wait at the gate, airplane flight and drive home on the other end?! The kind who once lived as a hard-core Peace Corps Volunteer in a dot of a village on the Equator and who never boiled his drinking water. The kind who claims that in more than two years of living in Africa his bowels were never once solid. Sorry to get so graphic, but I know some of you are nodding knowingly as you read this.

What should you do when your guts rumble and roil and then pour out of you? If the diarrhea is bloody, if you have a high fever that lasts more than 3 or 4 days, or if you throw up for more than 24 hours, then get to a doctor. If you suspect a bug or traveler’s diarrhea, do as little as possible besides rest and drink clear fluids: water, tea, broth — and no, vodka does not count. Give your system the chance to heal. If you’re not peeing, you’re not drinking enough. Ideally, urine should run clear or pale yellow. If it’s dark or bloody, seek medical attention. If your eyes look sunken or your eyeballs get dry, it may be difficult to drink enough and you may need IV fluids.

  • When I lived in Kyrgyzstan the local Russian women I knew all told me to drink a small cup of strong black tea with blackberry jam stirred in. Turns out the astringent properties of both the tea and cooked blackberries do help.
  • You can also make your own electrolyte solution, a healthier, cheaper version of Gatorade. Just take a small amount of a non-acidic juice, let’s say a fifth of a glass of grape or papaya juice, 4/5ths water and a pinch of salt. If you don’t have access to juice, dissolve a teaspoon or two of honey or agave syrup into a little hot water, add room temperature water and a pinch of salt.
  • Pepto Bismol is helpful and harmless-it supports the body’s efforts to manage the diarrhea.
  • Try boiling brown rice or white in plenty of water with salt and sip on the starchy liquid.
  • The Chinese, Thais, and Vietnamese are famous for their soothing rice soups, which are perfect for eating once you are past any acute initial phase. Barley broth is also effective. Eastern medicine traditions use cayenne/red pepper, ginger and/or cinnamon in their brothy soups as a remedy. Or, make a simple rice soup with short-grain white or brown rice, double the usual amount of water or broth, cooked with 3 whole, peeled cloves of garlic, a big sprinkle of ground coriander and a little cayenne. Simmer until the rice is soft– 20 minutes for white rice, 50 minutes for brown.
  • Always avoid milk and all dairy when your digestion is off in any way, even if someone tells you, as an Argentine friend of mine did, that ice cream is really good for stomach aches! Avoid juices, especially apple juice, and sodas — except for ginger ale.
  • If you can get or make ginger tea, that settles nausea and soothes abdominal cramping. Chamomille tea calms cramping and nerves. Other herbal choices such as a mild Vervain (Verbena) tea can also provide relief. Sip, don’t guzzle. Give your irritated digestive system time to absorb what you’re taking in.
  • And there’s the American old stand-by, the BRAT diet: Banana (not too ripe; very ripe bananas have a laxative effect), Rice (brown or white), Applesauce (or scrapings of raw, peeled apple) and/or Toast (saltine-type crackers work, too).
  • If you’re overseas, there is often a grandmother nearby with a local suggestion — usually a tea or soup and sometimes an herbal concoction. If someone suggests herbs or plants you don’t recognize, use common sense. Depending on your familiarity with the local culture, foods and plants, you may be better off politely refusing the brew you’re offered by explaining it’s against your religion or something. More often than not, though, whatever the wise grandmothers recommend will be worth trying. Some Chinese medicine practitioners recommend taking citrus seed extract daily to prevent common traveler’s diarrhea.

Finally, consider getting a Homeopathic travel kit of remedies that come in small sweet tasteless pellets you put under your tongue and allow to dissolve. I recommend ordering a travel kit and guide from Homeopathic medicine is a gentle but effective natural approach to health developed in the late 1700’s by a German physician. If you use one of the suggested remedies and it doesn’t “work”, the worst that happens is that it does nothing.

Wrapping Up
Well, Sasha has just returned, weary, yet full of excitement as he recounts the details of his torturous night. “Mom, we counted-I threw up 12 times!” Then he proceeds to volunteer a host of graphic details about the quality of his diarrhea. I guess the pride of surviving intestinal drama and then reliving it through colorful storytelling has been passed down through his father’s adventurer- writer genes. At least now that he’s home, Sasha can also benefit having his mother there to hand him a cup of healing ginger-chamomile tea sweetened with honey, and the most powerful medicine of all: a mother’s love.