Dealing with Diarrhea

[MrMan]

I figured it was time for a topic high on everyone's favorite list of topics, how to deal with diarrhea.

We get a lot of posts on 'first world problems' like "I can't get a girlfriend" or "the girls here aren't friendly." If you travel abroad, though, to some country where there are street vendors who don't keep the meat refrigerated, you can get diarrhea. You can get it even in upscale places. I've spent a lot of time in Indonesia. I don't think they have health inspectors, and with the tropical environment, there is a lot that can go wrong with the food.

In Indonesian, they even have a shortened combination of the words diarrhea and vomitting to describe the condition of both diarrhea and vomitting, 'muntaber' which is shortened from 'munta' (vomit) and 'berak' ('take a dump'). It's bad enough to get diarrhea. This 'muntaber' condition is much worse.

I'll give some Indonesia-specific advice and you guys can see if some of this applies in your country of choice. You could go to the doctor if you get this, but it sure is a hassle to drive to the doctor if you have diarrhea. The taxi driver may not appreciate deposits left in his car. Muntaber is awful, though, and if you get this, you don't feel like driving around.

A great thing about Indonesia is that you can just go buy a strip of amoxillin for about 50 cents in US dollars. Just go to your neighborhood apotek/apotik and ask for a strip and they will sell it to you without a doctor's presecription. They used to sell activated charcoal under the brand 'Norit'. Charcoal is also used for food poisoning and it is good for getting whatever junk you ate out of your system. But I heard they discontinued Norit. There are also medicines like attapulgit, that are made out of clay that you can get in tablet form to add some mass. Loperimide HCL is a very powerful medicine. In the US it is sold under the brand Immudium AD, but in Indonesia, there are other brands including Loperin. This stuff is powerful. A doctor told me taking it 8 times could shut down your digestive system for good. It causes your body to suck in those fluids, I think. You could be unable to walk almost because of diarrhea sapping your strength, take a Loperin, and in an hour or two have the strength to get up and go to the drug store and eat an actual meal.

But if you have muntaber, you won't be able to keep these medicines down. In Indonesia there are a couple of medicines. I might get the spelling of these wrong, but one is Oral-lit, and the other is Favorlit or Favorit or something like that. It's basically some salts and nutrients with glucose, almost like powdered Gatorade, but with glucose as sugar, which doesn't need to be digested like other sugars because it is in the form the body converts other sugars, too. It's weird that you can be sick and not be able to keep water down, but be able to keep this stuff down, if you sip it. Then it gives your body energy.

If you really have It is important, if you live somewhere like Indonesia, to have some people in your life to care for you, even if it is only a maid. I was fortunate when young and single to live in a bording house that had a maid. I asked them to give me some rice and soy sauce so I could get my strength up. If you develop some friendships, maybe you can make a deal to help each other out with these medical emergencies. Other expats in the same boat may help. Girlfriends could help as well. When my wife and I were dating, I remember one important step in our relationship was when she had some kind of digestive system problem and I came over with the medicine at some horribly early hour in the morning to help her out. She didn't have a maid. I just called the maid in the place I was living in and asked for help. I kept a stash of medicine.

In Indonesia, the medicine I'd recommend for an anti-diarrhea stash of meds would include oral-it or favorit, loperimide hcl, activated charcoal (if you can find Norit or some other brand around), New Diatabs (or another attapulgit), and antibiotics. Amoxillin is a cheap, easy to find, broad spectrum antibiotic which you could use for other things. A US doctor suggested bactrin once. That's more expensive, but it was effective.

[El_Caudillo]

Good topic. I was always amazed in Indonesia at those cooked pieces of chicken which stay out in the heat all day long as street stalls. You order up a piece and they recook it on the BBQ - I always thought it was going to make me sick but never did.

The sickest I got was from eating sate on the street, real ring of fire stuff - but as long as you are near a toilet its OK. I also had scarlet fever and a few other mystery fevers. Agreed, you need a friend to help, because sometimes you'll run out of water and be too sick to go out and buy more. I was recently in Indonesia for three weeks, I ate bakso and ayam goreng streetside, but stayed clear of the sate...no problems. However, I did get an infected cut, which was nasty and I had to get it surgically drained. Make sure you have medical insurance when travelling! Yes, Mr. Man it's true most of the guys on here are too focused on girls, being overseas in a developing country will through a thousand other challenges and experiences your way!

[MrMan]

I don't know that I"ve ever gotten sick from Sate, but I remember seeing a busy vendor on Jl. Sabang in Jakarta dipping raw sate in sate sauce, and I wondered if he dipped his cooked sate in the same sauce. I didn't see evidence of it, but it made me not want to eat his sate just thinking about it.

One time I got really sick after I ate at a pizza restaurant. I think it was my first time a California Pizza Kitchen. I asked for some pizza sauce so I could dip my crust in. I got very sick. Another time, I asked for the same thing at Pizza Hut and had the language skills to say I wanted to dip my crust in it. I was told they used unboiled water in the sauce. Then it occurred to me that that was probably the reason I got sick at the other place. It's strange that I got so sick after eating at a western restaurant.

I think a lot of food is 'tougher' than we give it credit for. Cooked chicken keeps pretty well for a while. Rendang, voted the most delicious food in the world, is beef (usually) covered with lots of spices. The spices preserve it and it is supposed to keep for weeks. We would refrigerate it if my wife made it, but if I had lots of food it was lower priority than a lot of other foods to get refrigerator space. It's good stuff if prepared well, but the stuff my wife made in the US was better. Indonesia exports the top quality spices and US beef is so much better. My wife made it without a chunk of gristle in the middle. Beef from Indonesian tends to be lower quality and beef is expensive in Indonesia. It's not really cattle grazing terraine like you find in the US, Australia, or New Zealand.

I avoid lettuce from street vendors and other vegies like that. Even in restaurants, they'll wash it in tap water. I don't bother to ask on the street. I just avoid it. If I got to a restaurant, I'll ask how they wash it. The workers at Hoka Hoka Bento, a Japanese fast food place washes, say they wash their cabbage in the water from ice. I've read that ice is manufactured for sale in hygenic circumstances, but may not always be so clean in transport. I'll risk it with ice. I think street vendors buy it. I've seen it transported in huge, long blocks.

It used to be, you couldn't eat martabak manis, a kind of fluffy buttery pancake desert that tastes a lot better than regular swedish pancakes, except from street vendors. The butter is what makes it good. If you never do street vendors in Indonesia, you can really miss out. I first tried Chinese pickled mustard greens and pork soup from a street vendor in a small neighborhood. I'd always hated mustard greens, but I liked the picked variety. The soup tastes something like 'down home cooking' to me. I'm from the south. I'd never had it, but it tasted like comfort food right off the bat.

[MrMan]

I got serious diarrhea or muntaber, the diarrhea-vomitting combo maybe two or three times before I got married. I depended on maids and a friend I lived with to feed me a bit and keep me water.

In Indonesia, if you live alone, it makes sense to have a diarrhea stash. After I experienced it, I kept a few bottles of bottled water under the bed that I never used. That way I'd have it if I got sick. You can change it out every so many weeks or months to keep it from expiring or getting old. It shouldn't be a problem unless the room gets crazy hot. It is also good to have some kind of water filter. They used to have this big round thing that you put tap water in that had a filter in the middle consisting of all kinds of rocks and stand with a carbon filter on the bottom. I was also a bit wary of not knowing when the filter went bad. You could put boiled water in the top. Those fast water boiler pitchers that you plug in are useful.

It's hard to find saltines here, but you may be able to find some kind of cracker that is fairly easy on the stomach to help get past vomitting or to give you enough energy to get up if you are too exhausted from diarrhea. That's what's dangerous living alone and you get this malady. It can sap your strength, fighting dehydration and being totally out of energy from not eating. The powdered Oral-it or whatever other brand really helps with that. You can gradually get yourself from the orang drink to a cracker. Take a Loperimide HCL, then in an hour you feel normal for a while until the diarrhea comes back. That works for diarrhea better for the type with vomit.

I've had dengue fever more than once, but both times I was married and I spent a week in the hospital.

As far as insruance goes, if you need a heart operation, you need it. But I would imagine if you go to a cheap hospital in Jakarta, you're probably okay with an emergency fund of a few thousand. But the care isn't always that great. Nurses forget to change the water bags and let the blood go up the line if you are on an IV, or the used to when I was sick. That was at a hospital owned by a friend of mine's family, so I won't mention the name. We took my son to one hospital that wanted to keep him for diarrhea, but the doctor didn't come to see him for a day. He was about two. We could have taken care of him better at home if he wasn't going to get any care. The nurses try to talk you into keeping him there (with his mom) in case he needs immediate care. We pressed them to let him see a doctor. It was a fungal infection. I had thought of just giving him the medicine they gave him, but didn't know if i could for a kid. Sure enough, he healed up really fast.

After a niece got the run-around like that in one hospital, a friend of hours insisted we take her to the SOS clinic. The doctor diagnosed her quickly and got her some antibiotics and sent her home and she healed up fast. Doctors in Jakarta, around 2000, would give out amoxillin and a strong antihistimine for just the common cold because their patients felt ripped off if they didn't get medicine. But I do like it if they at least give a kid with a cold some mild medicine to help with the symptoms. Some US doctors won't do it and they stopped selling a lot of kids medicines over the counter.

China will sell amoxillin over the counter. They did to me when I got there early this year. I flew in for an interview with some kind of throat infection. It cost $5 for a box of it. If you have a doctor's prescription, it is legal to bring it back to the US.

If you travel abroad to a cheap country and fly back, you can ask a doctor to prescribe you a year's worth of amoxillin or some other useful medicine they overcharge for in the US. I could get 10 amoxillin pills in Indonesia for 50 cents to a dollar. What are they in the US? Is it $30 or $40 for the same thing? And then you have to pay a doctor first? You could spend hundreds for a 50 cent medicine.

And the Democrats solution was for the government to take those costs into a national health care system instead of making our health care system cheap and affordable.

[MrMan]

Okay, world travellers. 'Fess up if you've had it.

[xiongmao]

Had plenty of problems in China, but then I was living in the poorest part of Guangzhou. The Koreans in my Mandarin class fared even worse - sometimes they would turn up for class and I swear they were actually green.

The good news is that China battle hardened me and in 6 months of living in Thailand I didn't have any major stomach issues at all, unlike the tourists who came straight from farangland.

[Johnny1975]

Here we go again, another shitty thread.

[Shemp]

You don't need food to keep your strength up. Even a lean man can go weeks without food and lose only a tiny amount of strength. What can kill quickly is loss of water and salt.

The best remedy for diarrhea is to let the illness run its course, while taking in water mixed with salt and glucose to keep from dehydrating. Water plus a few salty crackers or salty white bread or other easily digested salty starches is effectively equivalent, since these starches immediately digest to glucose in the mouth or small intestine.

[MrMan]

Let's keep the conversation flowing.

[MrMan]

Had plenty of problems in China, but then I was living in the poorest part of Guangzhou. The Koreans in my Mandarin class fared even worse - sometimes they would turn up for class and I swear they were actually green.

The good news is that China battle hardened me and in 6 months of living in Thailand I didn't have any major stomach issues at all, unlike the tourists who came straight from farangland.

Having a lot of stomach problems and recovering does seem to be good at preventing further problems. But if you live back in the developed world for a while, I think you can lose a bit of your resistance.

[MrMan]

You don't need food to keep your strength up. Even a lean man can go weeks without food and lose only a tiny amount of strength. What can kill quickly is loss of water and salt.

The best remedy for diarrhea is to let the illness run its course, while taking in water mixed with salt and glucose to keep from dehydrating. Water plus a few salty crackers or salty white bread or other easily digested salty starches is effectively equivalent, since these starches immediately digest to glucose in the mouth or small intestine.

Some kind of food or glucose is needed. If you are healthy, you can go a while without food and the hunger, while annoying, doesn't sap all that much of your strength. It lessens concentration and after a day or two, you can feel like you have less energy. But some people are more sensitive to low blood sugar than others.

But combined with sickness, low blood sugar can make some people feel rather miserable.

Bread, rice or crackers help a lot. The glucose-containing mix I mentioned is easier to keep down than bread or rice. It's probably more or less the same thing as pedialyte, but more practical since you can keep it in powdered form and it tastes a bit like Gaterade rather than Pedolyte. I've tried that nasty stuff when my little kids wouldn't drink it because it doesn't taste vary good.

[MrMan]

You don't need food to keep your strength up. Even a lean man can go weeks without food and lose only a tiny amount of strength. What can kill quickly is loss of water and salt.

The best remedy for diarrhea is to let the illness run its course, while taking in water mixed with salt and glucose to keep from dehydrating. Water plus a few salty crackers or salty white bread or other easily digested salty starches is effectively equivalent, since these starches immediately digest to glucose in the mouth or small intestine.

Some kind of food or glucose is needed. If you are healthy, you can go a while without food and the hunger, while annoying, doesn't sap all that much of your strength. It lessens concentration and after a day or two, you can feel like you have less energy. But some people are more sensitive to low blood sugar than others.

But combined with sickness, low blood sugar can make some people feel rather miserable.

Bread, rice or crackers help a lot. The glucose-containing mix I mentioned is easier to keep down than bread or rice. It's probably more or less the same thing as pedialyte, but more practical since you can keep it in powdered form and it tastes a bit like Gaterade rather than Pedolyte. I've tried that nasty stuff when my little kids wouldn't drink it because it doesn't taste vary good.

[Shemp]

Some kind of food or glucose is needed. If you are healthy, you can go a while without food and the hunger, while annoying, doesn't sap all that much of your strength. It lessens concentration and after a day or two, you can feel like you have less energy. But some people are more sensitive to low blood sugar than others.

The reason for glucose in the rehydration fluid is not to provide blood sugar, but rather to ensure sodium is absorbed from the intestine. Lack of sodium (salt) is what kills. Research this on the internet (oral rehydration therapy).

Please stop propagating junk medical advice. Your advice falls under the category of fatty mentality: thinking the solution to all problems is more food.

[MrMan]

Chill out. I'm not a medical doctor. If people follow my advice, it can still help them whether sugars in the blood help or sugars help absorb salts. I didn't know that was it was, but I guess that's good to know.

[MrMan]

Chill out. I'm not a medical doctor. If people follow my advice, it can still help them whether sugars in the blood help or sugars help absorb salts. I didn't know that was it was, but I guess that's good to know.