“Miss? Miss! MISS! STOP THE BUS! The luke warm llama testicles and re-fried cabbage we got second hand from the market stall appears to have by-passed my digestive system and headed straight for the lining of my trousers.”

How to avoid travellers' diarrhoea

We’ve all been there. (In my case Geneva airport, aged 18, returning from a ski holiday. Sooo embarrassing...)

Let's cut to the chase. We all know toilets and food are easily the most talked about, exciting, hilarious (and therefore, unfortunately, sphincter relaxing) form of chit-chat whilst on the road, so I’m only being ahead of my time by bringing this up now…

From Timbuktu to Ouagadougou (not actually that far, but it has a good ring to it), if there’s one thing that’s going to ruin your trip, it’s a ring-side seat and twelve rounds with the brown stuff.

So, without further ado, here are our top ten tips to keep you on top of the trotts…

Prevention:

1) Wash it, cook it, peel it or forget it. If anything is going anywhere near your mouth then remember this mantra. If you're feeling creative you could even put it to music and sing it in a round.
2) Alcohol! Although I appreciate spending your holiday time with students may encourage you to turn to the bottle, this stuff is actually for your hands! Grab a 100ml* bottle of hand-sanitiser from your nearest Boots (other chemists are available) and apply liberally to hands / spoons / Maglite / feet and anything else you're likely to put in your mouth. Use it after going to the toilet too. * 100ml bottles can be taken on the plane (clever hey?)
3) Money is dirty: And I'm not talking about drugs, that's a whole other blog post. Every Tom, Dick and Henrietta has touched that bill you're fiddling with, and who knows where Tom's friend Dick has been since lunchtime, so remember to revert to point 2 after handling money (and before nibbling at your nails).
4) To bottle or purify, that is the question... Purifying your own water is the way more responsible way to go (less plastic than plastic bottles, init?), but lets be honest, who actually likes drinking chlorinated or iodined H2O that doesn't come with a healthy slug of Ribena? Steri-pens and water filters are a good option, very effective and increasingly cheap. If you are buying bottled water, just mind out for the 're-filled' variety sold by the entrepreneurial individual on the 4th market stall on the right. Don't forget to avoid ice too - you've no idea what water it was made from.
5) Keep your mouth closed in the shower. 'nuff said.
6) Trotting about with the toothbrush: You've seen the Taj Mahal, the Great Wall of China and Machu Picchu - all in the same day (just for the record, you can't have booked this trip with us, as it would be rubbish. We like our clients to travel slowly and actually see something), anyway, my point is: You're tired. You've had a long day. You've eaten a truly scrumptious dinner (see commandment No, 7), had a quick beer/soda and then it's off to brush your teeth before bed and BOOM – you've done it, you've only gone and used tap water to brush your teeth. School boy error, see? Should have used safe water instead.
7) Food, glorious food: Ahh – one of the great joys of travel. Chickens feet in China, toasted terminates in Africa, and spit-roasted guinea-pig in Latin America. It's good to be adventurous when it comes to food but remember: Make sure food is freshly prepared and piping hot. Don't eat food that's been standing round for a long time - e.g. overnight (particularly chicken feet, it's never nice to see them standing around). If you are catering for yourselves, make sure those doing the cooking are well and without tummy bugs. Do not share eating utensils or water bottles - that's asking for trouble.

Management & treatment: (aka 'if the s**t hits the fan'):

8) Pill-popping: No I'm not talking about trying the local delicacies of Ibiza, I'm talking about loperamide. It makes that 8 hour busy journey on bouncy roads remotely bearable given that you've been up all night doing the toilet tango. If you've got a long journey that you simply can't avoid, then loperam... thingy can be helpful. Otherwise, "better out than in". You need to give your body time to get rid of what is causing the problems. With severe cases (e.g. squits with a temperature or squits with blood) where you think it might be more than just a case of traveller's diarrhoea, then you can't use lopera...thingy and need to get it checked out.
9) Treatment: It can be useful to treat traveller's diarrhoea with a short course of specific antibiotics. This will only be available from an understanding and knowledgeable GP or from a specialist travel clinic.
10) Life savers: Sorry, boys, Pamela Anderson won't be coming to your rescue here. You're going to need:

a) Loo roll
b) Re-hydration sachets
c) To keep really well hydrated – small, frequent sips of safe water / re-hydration solution, or even flat soda drinks.
d) A sense of humour (but just remember not to laugh too hard as that can have dire consequences.

Our thanks to James Moore at Travel Health Consultancy for his extensively knowledge of this, err, crappy subject and a few key editorial amendments to the original draft.