How To Prevent Diarrhea On Treks

" Sir, I crapped in my pants !! "  :-) :-)

... and he threw the trouser after we reached the campsite  :-) 

If he had no extra trouser, he would have had a terribly funny story to tell to anyone for his lifetime.. washing, drying and then wearing it !! :-) :-)

Diarrhea is by far the most common problem we encounter on any trek. On an average, 1 out of 4 trekkers are affected by it. If not well handled, the same diarrhea might had been a nightmare for him, forcing him to retire from the trek itself !!  Mountaineers have died on Everest by slipping and falling to answer the call.

What Causes Diarrhea On A Trek ?

1. Use of contaminated water
2. Eating by unwashed hand
3. Eating fruits directly without washing them
4. Having Diamox
5. Eating excess dry fruits
6. Having excess unpasteurized dairy products
7. Uncooked or stale meat/fish

Ways To Prevent It

Firstly thing to mention here is that your immunity system mater a lot in these kind of environment and everyone has a different defense system towards the same water. Secondly, never compare yourself with others, specially the local guides and porters as they are brought up using direct water from the stream and their immunity system is well developed against it. 

Do not panic, and take proper prevention steps.

1. Makes sure that the water you have is clean and free of any germs. While on a trek you have natural water from streams, always make sure that you use running water as the source of your drinking water. Do not use stagnated water.
2. Treat your water. While the water in the cold is usually good and germ free, Its always recommended to treat your water. There ware various ways to treat the water you are using. You can use UV filters, Iodine or chlorine dioxide solution etc. We have detailed the best ways to treat you water in a trek in a on How To Treat You Water On A Trek
3. On a trek your hands are usually dirty which is unnoticed. Then in an energetic mood with group of friends, you usually forget to wash your hand before eating. Always remember to wash your hands before eating. Keep your hand sanitizer handy and remember to use it to clean your hand.
4. Before eating fruits, make sure you are washing them.
5. Reduce the intake of dry fruits, specially cashews and almonds.
6. Refrain from having non-veg items on a trek firstly because it is difficult to digest it on high altitude, and secondly, if you are to have it anyways, make sure you have it fresh and treated. There are ways in which you can pack meat on a trek - You can pre-boil it and then coat it with salt and turmeric before beginning the trek. Make sure you consume it within 2-3 days into the trek. This keeps the meat free of bacteria in a cold weather. Ensure that you are cooking it full and bring to boil.
7. If you are having diamox, have it post meals as having it before you meal has been found causing loose motion.

How to treat it if it hits you?

Even after taking precautions, there are chances that you are still affected by it. Do not start taking antibiotics immediately. At least wait for 3 flushes before you start on antibiotics. Antibiotics along with bad bacteria, also destroys all the good bacteria.

Below are the ways to treat diarrhea on a trek

• Sip ORS to replenish the salt and fluid loss.
• Continue to follow the precautionary steps as mentions above 
• Have a full course of antibiotics -          

         Norfloxacin 400 mg twice a day for three days
         Ciprofloxacin 500 mg twice a day for three days
         Ofloxacin 400 mg twice a day for three days

• Its a good thing to take Tinidazole to protect against Protozoal  infection as well.     

     
        Tinidazole 2 grams at bedtime for two nights  ( Norflox TZ contains both )
        Metronidazole 500 mg three times a day for seven days


Anti-motility drugs
 

These medicines do not treat the infection, but actually slows down the bowel movements, reducing the number of flushes. They are useful to treat cramping and should preferably be used with antibiotics to treat the actual infection. 

        Diphenoxylate (Lomotil®)
        Loperamide (Immodium®)
        Codeine and other narcotics

Again, depending on the time of onset and seriousness of the case, we need to decide if to go on Antibiotics + anti motility drugs, just antibiotics or just anti motility drugs.