May 11 2012

Diarrhoea in Siem Reap

Published by at 12:54 pm under Health & safety


You’ll learn a lot of weird and wonderful things in Southeast Asia, some of it even quite useful. For example, I now know that no matter how loud I scream, the spider still won’t go away (or my husband come to the rescue anymore). I can enter, use and leave the tiniest bathroom without touching a single surface with anything other than the toe of my shoe. And I’ve learned that Cambodian food is not just dumbed down Thai food.

There may be trouble ahead...

There may be trouble ahead ...

But out of all the things I’ve learned, I think that if I were auditioning for Mastermind in the morning my specialist subject would really have to be poo. I can talk about that for days. Five years in Asia will do that to you. I can spell diarrhoea now without having to look it up. I can talk about colour, consistency, frequency, longevity, fragrance, causes, related symptoms, remedies, dehydration, fatigue, whether to eat or not eat, how to get your husband off the sofa to go buy you chocolate, stomach cramps, abdominal cramps, kidney functionality, water, water and more water, until I literally puke. And once I’ve done with that, I can start telling you about when I was peeing green in India.

Being blessed with a stomach that was only ever meant to consume food prepared by famous chefs in the pristine kitchens of expensive hotels has given me a special insight into the power of poop to take the shine off your day. In fact, most expats in Asia can talk fulsomely about poo, to the extent that we occasionally forget that people back home don’t always find the subject quite as fascinating as we do. Especially during mealtimes, apparently.

If you do come down with a dose of something unpleasant, you have first my sympathies and second, some of the things I’ve learned. Here they are.

You’ve got diarrhoea, and that’s really wonderful news! Honest. This means your body is doing what it needs to do to flush out evil aliens that don’t belong there, and everything so far is running according to plan. I’ve had the variety where all you get is the most agonising cramps, and it turns out that this is simply a trigger for the hospital to administer $1,700 worth of tests that you absolutely do not need. The morphine was jolly nice though.

Most bouts of diarrhoea last for one to three days, leaving you slimmer and clear-skinned, and all for the price of a meal that just happened to be dodgy. There are places in Thailand that charge thousands of dollars for the same result, with the additional torture of tofu. If you want to complain about that, well I just don’t know what to say to you. You do however need to do certain things while this is happening, to help your body do the excellent job that it’s doing.

Don’t ring your mum, she’ll only panic and imagine that you’re being eaten alive by ferocious, necrotic Asian bugs hitherto unknown to science. She’ll put the local funeral parlour on speed-dial and start sighing at strange moments, thereby freaking out the rest of the family who’ll conclude that she’s been given an unwelcome diagnosis and is hiding it from them. See how these things can spiral out of control.

Instead, drink lots and lots of water and get hold of some oral rehydration therapies (Royal D sachets from UCare at the top of Pub Street cost about 500 riel a packet and one should be taken after each bout). Drinking water on its own is not enough as you may be sodium deficient as a result of passing so much liquid through your system so rapidly. Also, and somewhat perversely, your body’s capacity to absorb liquid is diminished as a result so oral rehydration therapies don’t just introduce liquid, they also restore the body’s capacity to make the most of it.

Some say you shouldn’t eat when you’ve got food-poisoning, but I prefer to continue to eat small amounts of plain food that has lots of fibre as this can bind with the toxins helping to flush them out. If you don’t want to do that, you can also buy sachets of Smecta from the chemist. They may also have charcoal, which does the same thing, namely pass through your system while hopefully absorbing all the nasties on the way.

Cambodia doesn’t do kitten-soft toilet paper, so learn how to use the bum-gun. It is your friend, believe me.

No matter how tempting it may seem, wine corks are not the answer. Nor are other bum-stoppers like Immodium, unless you’re planning on going somewhere. Your body really is working with you not against you, though I know it’s doing things that feel more like treason than collaboration.

If, by day four, you’re still doing the wild-eyed tango in the direction of the loo, then you have a bigger problem. It is possible that you may have E. Coli poisoning, which can mean seven to ten days of black/bloody diarrhoea, very exciting cramps and nausea or vomiting, often with a mild temperature. E. Coli was my doe-eyed muse for this particular post. It usually finishes without further incident, but needs to be kept a close eye on. Oral rehydration should be continued at all times, while antibiotics and pain killers should be avoided if you think you’ve got an E. Coli infection.

Self-diagnosis is not the greatest idea however, especially when you’ve got travel insurance to back you up and you should seek out medical advice if you’re still sick after four days. It is also possible that you have giardia, which is a more serious condition, the symptoms of which include violent diarrhoea, excess gas, stomach or abdominal cramps, and nausea. Giardia can sit in your system causing disturbances for a long time, so needs to be checked out and you may be prescribed antibiotics.

If you show signs of a high fever or feel seriously weakened, then seek out medical advice instantly, regardless of how long the diarrhoea has been happening.

And finally, do use the opportunity to hog the remote in your hotel, pile up rubbishy books that you wouldn’t be seen dead reading in public and make sure you’re waited on hand and foot until it’s all over, and then an extra day, for luck.

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4 responses so far

4 Responses to “Diarrhoea in Siem Reap”

  1. Rosy Guesthouseon 12 May 2012 at 7:27 am

    Possibly my favourite Siem Reap blog to date!

  2. […] of our posts are, ever). For instance, natural alternatives to the dreaded Imodium or whatever for upset stomachs, herbal creams for heat rashes and prickly heat, balms for rucksack strap irritations, even creams […]

  3. Rebeccaon 25 May 2012 at 11:59 am

    Brilliantly entertaining and excellent advice. Thank you

  4. Tackling travellers’ tum… | Nicky Sullivanon 02 Apr 2013 at 3:35 pm

    […] I’m sorry, you can’t spend six years in Asia without spending a good deal of time thinking about poo. So here are the results of my ruminations, from Travelfish. […]

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