Must-Have Travel Gear for Backpacking Southeast Asia

Best Traveler’s Diarrhea Treatments for Symptom Relief

Barbara Bolen, PhD, is a licensed clinical psychologist and health coach. She has written multiple books focused on living with irritable bowel syndrome.

Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more.

Ashley Baumohl, MPH, RD, CDN, CNSC is a surgical dietitian. She provides medical nutrition therapy at Lenox Hill Hospital and is based in New York, New York.

Traveler’s diarrhea can turn a trip into a nightmare. Food and water contaminated by germs, also known as pathogens, is not uncommon in certain areas of the world that are popular travel destinations. Consuming even small amounts of these germs can cause loose, watery stool, the main sign of diarrhea, Luckily, treatment options are available.

This article explains the symptoms of traveler’s diarrhea, how to treat it, and the best ways to prevent getting infected in the first place.

Symptoms

Symptoms of traveler’s diarrhea caused by bacteria or a virus usually appear six to 72 hours after eating or drinking something contaminated. With some types of pathogens, it may take a week or longer for stool to be affected.

Changes in your bowel habits it the main symptoms of diarrhea. At its mildest, diarrhea involves passing loose, watery stool three times a day. You may pass unformed stool 10 or more times a day in severe cases.

Other symptoms vary depending on the type of bacterial or virus you’ve been exposed to but may include:

More severe cases of traveler’s diarrhea may cause bloody stools.

Should You Go to a Doctor for Traveler’s Diarrhea?

See a healthcare provider if your symptoms are accompanied by fever or bloody stools, or they last longer than 48 hours.

Traveler’s Diarrhea Causes

The most common cause of traveler’s diarrhea is probably poor hygiene (lack of cleanliness) in restaurants. You’re most at risk when dining out in areas of Asia, the Middle East, Mexico, Africa, and South and Central America.

Pathogens are usually spread via the fecal-oral route. This means someone with the bacteria or virus excretes the germs in their feces. The feces may not be safely disposed of in a sanitary setting, or the infected person may not properly wash their hands before handling food and beverages. This allows germs to be transmitted to something you put into your mouth.

This cycle of contamination is most common in areas of the world that have specific conditions:

• Warmer climates that promote germ growth
• Poor sanitation (such as open sewage areas)
• Unreliable refrigeration
• Little education on safe food handling.

Common Bacterial Pathogens

The most common cause of traveler’s diarrhea is bacteria, which are thought to lead to 80% to 90% of cases. These include:

Ingesting these bacterium causes gastroenteritis , which means the stomach and small intestines become inflamed. This leads to diarrhea.

Common Viral Pathogens

Viruses can also be transported via the fecal-oral route. The most common types of viruses that cause diarrhea include:

Viral infections of the digestive system are often referred to as stomach flu. The illness has no connection to respiratory influenza, but like the “flu,” it usually lasts a short period.

Other Causes of Diarrhea

In addition to germs in your food and water, you could develop diarrhea from toxins, which cause the common symptoms of food poisoning.

Parasites, or protozoal pathogens, can also cause diarrhea. In these instances, you’re more likely to develop symptoms one to two weeks after exposure to the pathogen.

Complications

Dehydration is one of the most common complications related to any form of diarrhea. Multiple bowel movements that release a lot of fluid can cause you to have too little water in your body.

Severe dehydration can lead to problems such as:

• Fatigue and muscle weakness or pain
• Dizziness or lightheadedness
• Increased heart rate and breathing
• Confusion
• Kidney Failure
• Death

Dysentery is a serious condition that can develop from exposure to Shigella or parasites. It usually causes bloody stool, fever, and extreme dehydration. It can be fatal if it’s left untreated. In addition to being picked up from contaminated food or water, the bacteria or parasites that cause dysentery can be passed from person to person in close contact, or you can get it by swimming in unclean water.

Treatment for Traveler’s Diarrhea

Getting sick while far from home is more than just inconvenient. The sudden onset and severity of symptoms can be frightening. Often, symptoms will last a few days and resolve on their own, but you may need to manage the condition and take medication.

Fluid Replacement

To manage dehydration, you want to concentrate on getting enough liquids even if you feel like you don’t want to put anything in your stomach.

Drinking any safe fluids can manage mild cases of traveler’s diarrhea. Since tap water may be a source of infection, you need to boil non-bottled water and let it cool before you drink it. You can also drink boiled broth or prepackaged (non-citrus) fruit juice. Sports drinks like Gatorade are good, too, but not essential.

For severe dehydration, an oral rehydration solution may be needed. These are mixes or packaged beverages that contain glucose and electrolytes such as potassium and sodium. Pedialyte is an example of an oral rehydration solution for kids.

Sweating can cause dehydration as well. Try to find a cool place out of the sun to rest while you rehydrate.

Antibiotics

Antibiotics may be used for traveler’s diarrhea caused by bacterial infections. A stool test should be done to identify which antibiotic might work best.

Quinolone antibiotics such as Cipro (ciprofloxacin) are most often used when antibiotics are needed.

A single dose of 750 milligrams (mg) for adults is the typical treatment. Children may be given 20 to 30 mg per kilogram of weight per day.

In some areas, bacteria are resistant to quinolones, which means the medication won’t help. This is especially a problem in Southeast Asia. Another antibiotic, azithromycin, may also be used in this case, although some strains are resistant to it.

Upset Stomach Medication

Pepto-Bismol can provide short-term relief of symptoms. However, it may not be effective in small doses, and high doses put you at risk for a health condition called salicylate toxicity. Additionally, Pepto-Bismol is not recommended for people younger than 18 years because there’s a risk of a condition called Reye’s syndrome.

Antidiarrheal Agents

It might seem logical to reach for an anti-diarrheal product such as Imodium (loperamide) or Lomotil (diphenoxylate). However, these products should not be used if your diarrhea is related to dysentery or if you see any signs of blood in your stools.

An antidiarrheal agent should only be taken with an antibiotic. When using an antidiarrheal for traveler’s diarrhea, it is especially important to keep yourself well-hydrated. Discontinue the product if your symptoms worsen or you still have diarrhea after two days.

How Long Traveler’s Diarrhea Lasts

Most cases of traveler’s diarrhea last from one to five days. However, symptoms may linger for several weeks.

Prevention

To help prevent traveler’s diarrhea:

• Wash your hands with soap and water after going to the bathroom and before eating.
• At restaurants, only eat foods that are cooked and served hot.
• Drink beverages from factory-sealed bottles or containers.
• Don’t get ice in your drink since it may be made with contaminated water.

There is evidence that Pepto-Bismol may protect against traveler’s diarrhea. Studies have shown a protection rate of about 60%. However, not everyone should take Pepto-Bismol, including those who are pregnant or are 18 years of age and younger.

Don’t take antibiotics or antidiarrheal medicine like Pepto-Bismol as prophylaxis—that is, to prevent traveler’s diarrhea— unless it’s been recommended to you by your healthcare provider.

Summary

Bacteria and viruses can live in water and food. These pathogens (germs) are most common in areas where the climate is warm, refrigeration is unreliable, and there isn’t proper hand washing or bathroom sanitation. Infection with these pathogens (bacterial or viral) can cause traveler’s diarrhea.

Traveler’s diarrhea will often resolve on its own once the bacteria or virus is out of your system. However, you may need antibiotics. You may also need to manage symptoms by staying hydrated and using over-the-counter medications. You should contact your healthcare provider if symptoms last more than a few days.

When traveling to regions that have warm climates and relaxed hygiene practices, be sure to take steps to avoid eating or drinking anything that could have pathogens. Drink pre-packed or boiled water and ensure food is handled properly.

Frequently Asked Questions

It’s important to make sure that your child gets enough fluids. Diarrhea can lead to dehydration more quickly in kids than in adults. Check with your healthcare provider if your child has signs of dehydration such as dry mouth, few or no tears when crying, irritability, reduced urination, and drowsiness.

If you’re pregnant, the most important thing to do is to drink enough fluids so you don’t get dehydrated. Your doctor may suggest using azithromycin if you need an antibiotic. Don’t use Pepto-Bismol (bismuth subsalicylate) when pregnant because of risks to the growing fetus.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Connor BA. Preparing international travelers: Travelers’ diarrhea. In: Brunette GW, ed. CDC Yellow Book 2020: Health information for international travel. Oxford University Press; 2017.

Leung AKC, Leung AAM, Wong AHC, Hon KL. Travelers’ diarrhea: a clinical review. Recent Pat Inflamm Allergy Drug Discov. 2019;13(1):38-48. doi:10.2174/1872213X13666190514105054

Shaheen NA, Alqahtani AA, Assiri H, Alkhodair R, Hussein MA. Public knowledge of dehydration and fluid intake practices: variation by participants’ characteristics. BMC Public Health. 2018;18(1):1346. doi:10.1186/s12889-018-6252-5

Strachan SR, Morris LF. Management of severe dehydration. Pediatr Crit Care Med. 2017;18(3):251-255. doi:10.1177/1751143717693859

Morof DF, Carroll ID. Family travel: Pregnant travelers. In: Brunette GW, ed. CDC Yellow Book 2020: Health information for international travel. Oxford University Press; 2017.

By Barbara Bolen, PhD
Barbara Bolen, PhD, is a licensed clinical psychologist and health coach. She has written multiple books focused on living with irritable bowel syndrome.

Must-Have Travel Gear for Backpacking Southeast Asia

If you’re planning on heading to Southeast Asia for the first time, it can be hard to know what to pack. Unfortunately, the thousands of packing lists available online don’t make it any easier and often offer conflicting advice — should you take jeans or not? Do you need a laptop? What about a first aid kit? Should you bring a backpack or a suitcase? Do you need hiking boots?

Whether you’re planning on lounging on the beaches of Southern Thailand, searching for orangutans in the rainforests of Borneo, exploring the temples of Angkor or partying on a cruise around Halong Bay, we have the perfect recommendations for you.

Choosing a Backpack

First things first, suitcases are incredibly impractical for Southeast Asia and you shouldn’t even consider taking one. The streets are frequently unpaved, full of potholes and many of the islands in Thailand, fo example, don’t even have roads.

You’ll need to bring a backpack, and the smaller the better. You should aim for a size between 40 and 60 liters and definitely no larger. While it may seem that bigger is better, remember that you’ll need to carry it on your back, sometimes for an hour or more, in an extremely hot and humid climate.

A small backpack will therefore remove the temptation to overpack. There’s no need to worry about forgetting something important either — Southeast Asia is incredibly cheap so anything that you do forget can be easily replaced at a fraction of the cost.

As for which type of backpack you need? A front-loading backpack will save on packing time and is easier to keep organized, a lockable backpack will help deter thieves, and it would be great if you could find one that’s waterproof — especially if you’re going to be traveling in the rainy season.

I’ve been traveling with an Osprey Farpoint for several years and couldn’t have been happier with it. I highly recommend Osprey backpacks because they’re durable, well-made, and Osprey has an amazing guarantee! If your backpack breaks for any reason at any time, they’ll replace it with no questions asked. That for me definitely makes it worth your while!

Clothing

There are a few places in Southeast Asia that are cold (Hanoi/Sapa in winter immediately springs to mind), but there aren’t many of them, so you’ll want the majority of your backpack to contain lightweight clothes, preferably made of cotton. Try to choose neutral colors so that you can mix and match in order to maximize your number of outfits. You don’t need jeans in Southeast Asia (they’re heavy, bulky and take hours to dry), but pack some lightweight pants for any chilly evenings or temple visits. If you’re female, you’ll need to pack a sarong to cover your shoulders as well.

For footwear, you can get by with just flip-flops or sandals most of the time, but pack some light hiking shoes if you plan on doing a lot of walking. I like Vibram shoes (yes, they look weird), but they’re good for all kinds of outdoor activities and pack down small. Bonus: everyone will be transfixed by your feet and you’ll find it far easier to make friends because of them!

Consider getting a microfiber towel as these can be huge space savers and are very quick to dry. A silk sleeping bag liner won’t be used much as guesthouses in Southeast Asia are typically clean and free of bed bugs, however, it’s still a good idea to carry one in case you end up staying somewhere that’s a little dirty. If you’re short on space, though, the silk liner is one you should skip — I’ve only used it once in six years of travel!

I have to mention that clothes can be bought and replaced for a couple of dollars in Southeast Asia so don’t feel as though you need to pack your entire closet for every possible occasion. If you forget to pack something, you’ll be able to replace it in most towns/cities in the region, and likely at a far cheaper price than you’d pay at home.

Medicine

Most medicines can be bought over the counter in Southeast Asia – including antibiotics and birth control pills, so you don’t need to worry about bringing an enormous first aid kit. Pack some Tylenol, Imodium, and Dramamine (and a general purpose antibiotic if your doctor will give you one) to start with and replace them as they run out. You can pick up almost anything you need from any pharmacy (including birth control pills) in the region as you travel

You should also pack some insect repellent and sunscreen for your first few days, and you can then stock them up while you travel around.

When it comes to anti-malarials, whether you decide to take them or not is a personal decision, and it’s worth speaking to your doctor before you leave to see what they recommend. I haven’t ever taken anti-malarials in Southeast Asia, but malaria does exist and travelers do contract it there. Whether you decide to take them or not, remember that dengue is a far larger problem in the region, so you’re going to want to wear repellent and cover up at dawn and dusk, when the mosquitoes are most active.

Toiletries

It’s worth investing in a small toiletries bag for your trip. It helps keep everything together and the rest of your luggage dry. If you’re in a rush when checking out, throwing damp shower gel bottles straight into your backpack is going to lead to smelly clothes and a gross backpack.

For travelers, I highly recommend picking up solid versions of toiletries: they’re inexpensive, they’re lighter, they take up less space, and they last much longer. Practically every toiletry product you can think of has a solid counterpart, whether it’s shampoo, conditioner, shower gel, deodorant, or sunscreen!

In addition, I recommend packing a small bar of soap instead of shower gel, a hairbrush if you have long hair, your toothbrush and some toothpaste, a razor, tweezers, nail scissors, and a diva cup if you’re a girl.

If you’re all about wearing makeup, aim to keep your looks natural and minimal in Southeast Asia, as the intense humidity will likely have you sweating off your make up within minutes of stepping outside. I recommend opting for some tinted sunscreen, a brow pencil, and some eyeliner for tight-lining, and you’ll quickly discover you need little else.

Technology

Laptop: Internet cafes in Southeast Asia are in rapid decline so if you plan on keeping in touch with friends and family, you’ll need to bring a laptop or phone. If you’re going for a laptop, look for one that’s as small and light as you can get away with, especially if you’ll only be using it for email, social media, and to watch movies. Try to get a laptop that has good battery life as well as an SD card slot for uploading photos.

Camera: Consider using a Micro 4/3 camera, such as the Olympus OM-D E-M10, which gives you SLR quality photos from a camera the size of a compact. If you’re not sure about carrying a camera around with you and would be happy with the quality of photos on your phone, then don’t feel the need to bring a camera with you.

Tablet: A tablet is a great option if you don’t want to carry around a laptop, but still want to get online and watch TV shows on long travel days.

E-reader: If you’re planning on doing a lot of reading on the road a Kindle Paperwhite is a worthwhile investment. The e-ink screen eliminates glare, so you’ll easily be able to read a book while sunbathing on the beaches in Cambodia. It helps keep your bag lightweight because you won’t need to carry any books or guidebooks with you.

Phone: If you’re going to be traveling in Southeast Asia, I’d suggest getting an unlocked phone and picking up local prepaid SIM cards as you travel. These SIM cards are the cheapest option for calls, texts, and data, and are available in most grocery stores. If you don’t have an unlocked phone, then opt for making phone calls using Skype over Wi-Fi.

Medication to take backpacking: Our essential medical kit packing list

Before embarking on our adventure across SE Asia, I spent a lot of time researching what types of medication to take backpacking. We were planning to travel through remote places with little access to civilisation, let alone western standards of healthcare so it was important to prepare a solid medical kit.

Deciding what medication to take backpacking

There is nothing worse than getting sick on the road and in certain situations its simply not possible to reach a pharmacy (think long heady boat trips or hot deserted islands). From our experience, it is always good practice to have a well-stocked medical kit to hand. So without further ado, here is our recommended packing list of medication to take backpacking!

Medication Checklist

Malaria Tablets
Malaria still exists in certain parts of SE Asia so check your destination before you travel. We took a two months supply to cover us during our initial stay in West Papua and the Philippines, and opted for Malarone which had minimal side effects. Discuss this with your GP first – It isn’t recommended to take Malaria tablets for an extended period of time.

As we only bought a two month supply, when we went back to Raja Ampat for the second time (unplanned) we weren’t taking any Malaria precautions. This was a bit risky, but we made up for it by covering ourselves in clothing and Deet at dusk and dawn to avoid bites as much as possible.

Ibuprofen & Paracetamol
Pain killers are an essential regardless of where you are in the world! We took a good supply with us but have had to re-stock on numerous occasions. It’s possible to buy Paracetamol off the shelf in supermarkets and 7-Elevens across SE Asia, but if you want Ibuprofen this is only available over the counter. The good news is, its inexpensive and tablets are normally 400mg each, helping maximise space and minimise packaging.

Cold & Flu Tablets
Much like painkillers, these are an essential item. After experiencing a few rainy days and sleeping in a damp bungalow in Raja Ampat, Nick got sick – which just goes to show that it is still possible to catch a cold in paradise! Colds have a tendency to make you feel really lousy, so we also recommend packing some Lemsip sachets and throat lozenges like Strepsils to ease symptoms.

Top tip – Even after a couple of months of travelling, certain supplies had diminished, so we always try to stock up on our must-have items (like painkillers) if we are ever near a pharmacy.

Antihistamine
With a high chance of insect bites and jellyfish stings while in the tropics, it is sensible to bring along some antihistamine tablets. I was bitten by a horrible horse fly once and it made me feel sick and a bit dizzy, so I quickly popped an antihistamine which did the trick.

Immodium
For obvious reasons. You’ll likely be eating a lot of foreign food that your stomach may not be used to… The last thing you want is a bought of Bali belly ruining your trip!

Stomach Settler / Indigestion Relief Tablets
If you suffer from food poisoning or an upset stomach during your travels (which is highly likely) it is really worth packing a good supply of indigestion relief / stomach settling tablets to ease delicate bellies. We use Bisodol, which is very effective.

Motion Sickness Tablets
If you plan on travelling a lot by boat like we do, then motion sickness tablets may be advisable – especially on long ferry rides. Not all days are smooth sailing!

Water Retention Tablets
I personally suffer from excess bloat and puffiness after flying so I take water retention tablets like Aqua-Ban to help these symptoms when travelling. Aspirin is also a good alternative.

Oral Rehydration Tablets
ORT tablets are used to treat dehydration and replenish your body with salt and sugar. With temperatures well into the 30’s and a feeling of constant humidity it is very easy to get dehydrated in SE Asia. This can also be brought on through diarrhoea, therefore Oral Rehydration Tablets are a sensible addition to your medical kit

Multivitamins
It’s often difficult to maintain a consistently healthy diet while backpacking – especially if you travel on a budget like us. We try our best to keep things balanced, but in certain locations this can be challenging and we lack vitamins and minerals. It’s important to supplement this, especially whilst on the go. Multivitamins are generally cheaper at home, so stock up before you leave.

Ear Drops
For snorkellers and divers, ear infections are the most common ailment so if you’re planning on spending a lot of time in the water, be prepared. Infections are rife in places such as Raja Ampat where there is a lot of plankton in the water. As a preventative measure, we created our own homemade mix of alcohol and white vinegar and use this once a day after snorkelling or diving to help clean and dry out our ears.

Top tip – It is important to wash out your ears with clean water straight after snorkelling or diving and if you are travelling by boat, cover them from the wind with a towel.

Eye Drops
Nick and I have had laser eye surgery which makes us prone to dry eye. So artificial tears are a must-have medication to take backpacking. Symptoms are generally worsened whilst flying and when spending a lot of time in air conditioning.

Skincare Checklist

Antibacterial cream
This is a med kit essential! Antibacterial cream is a multi-purpose item which can be used on a variety of ailments including cuts, bites, burns, coral stings, rashes and minor skin irritations. In hot, humid and often damp climates skin takes a lot longer to heal and is also prone to fungal infections, so make sure to apply cream ASAP.

Afterbite
Even after 12 months of travelling, we still hate mosquitos. But since they’ve become part of daily life we’ve learnt how to deal with / put up with them! By far the best solution is Afterbite, which includes ammonia. If this is applied directly to a fresh bite, the itchy side effects and swelling are minimised significantly. Afterbite is also great for other insect bites and stings, so if you’re planning on trekking though the jungle this will be a firm favourite in your kit.

Alcohol/Antiseptic Wipes
Alcohol and antiseptic wipes are a necessary addition to your backpacking medical kit, especially if you sustain injuries while on the go. These clean the wound, killing off any bacteria.


Tiger balm
We are a little bit obsessed with Tiger Balm with its primary use on our mosquito bites – the cooling sensation helps to ease itchiness. It’s also great for clearing nasal congestion, rubbing onto the temples to soothe headaches and muscular pain.

Top tip – If we’re staying somewhere a little on the stinky side (occasionally the bedding and pillows at homestays in Raja Ampat were a bit smelly) I rub Tiger Balm under my nose for soothing aromas to help me sleep!

First Aid Kit Checklist

Plasters
I like to keep a little stash of plasters in our day-bag in case of any accidents, and generally opt for waterproof or the super strong old-school fabric type. It’s really easy to sustain minor foot injuries like a stubbed toe or blisters during a hike.

Crepe Bandages & Gauze
We have crepe bandages and gauze in our main first aid kit, for any larger ailments and unforeseen emergencies.

Safety Pins
In case we need to use the bandages, we packed half a dozen safety pins. These also come in handy for other things such as temporarily mending holes in backpacks etc.

Surgical Tape
Surgical tape is strong and water tight so if you have an injury that needs sealing this will do the job!

Small Scissors
A pair of small scissors are a backpacking must-have. Of course they are meant for cutting plaster strips and bandages but you’ll be surprised how useful they are. We tend to use ours on more of a day to day basis – especially for opening packs of powdered coffee and instant noodle sachets!!

Mini Sewing Kit
Our clothes have sustained some significant wear and tear on this trip, therefore I highly recommend a mini sewing kit to our fellow travellers for mending clothing and bags while on the road.

Is this enough medication to take backpacking?

In truth we probably packed over-cautiously, because in most cases it is not difficult to pick up medical supplies in South East Asia. For example in Thailand you will always find a chemist in large Tesco Lotus stores and in Indonesia there are local ‘Apoteks’ in the most surprising of places!

Pharmacists generally speak English, so don’t be shy – its never been a problem for us to communicate our needs.

If you’re transiting through a town or city to reach somewhere more remote, its worth picking up any last minute supplies – even if you think you might not need them. Whilst we were in Raja Ampat I had to travel a long distance by boat to the Port of Waisai to grab medication for Nick. I really didn’t know what to expect, but thankfully found a very affordable and well-stocked pharmacy.

However, this is not always the case. So in our opinion, its always better to be safe than sorry!

We hope you found our list of medication to take backpacking useful! If you like our packing lists and want to read more blog posts like this one then please check out our Travel Guides. Have any questions? Give us a shout in the comments below!

Source https://www.verywellhealth.com/treatment-of-travelers-diarrhea-1944818

Source https://www.tripsavvy.com/travel-gear-for-backpacking-southeast-asia-3150310

Source https://remoteandafloat.com/medication-to-take-backpacking/