Traveller's diarrhea on RS Turkey tour

mimi,

You might want to delete your duplicate post before someone replies in that Thread.

Cheers!

Take a supply of Immodium with you.

Hi Mimi,

We traveled around Turkey in May and didn't have any problem. If you're concerned drink bottled water. I don't think that it will be an issue.

I have used Pepto Bismol tablets as a preventive measure again diarrhea when traveling to countries where I was afraid that I might get sick. So far, I have not gotten sick, although my husband has. He didn't take the P.B. Maybe I was just lucky! Do a Google search about it.

Thanks, folks.

Best ck with CDC website for travelers guidelines. Also remember stay away from fresh fruit,uncooked vegetables, ice, bar drinks in general. If it is not cooked well or boiled do not eat/drink. better safe than sorry. everyone's stomach is differnet while traveling. Me, Yogurt is a bad one.

Good ol'Pepto Bismol has a webpage filled with
info on how to keep your innards happy on the road.
Thanks, Martha.

And here I was depending on yoghurt to keep me safe
from harm - back to the drawing board.

We were there in October 2007. Nobody had any problem so likelihood of this happening is not that high.

If you do get sick, don't mix Pepto Bismal and Immodium AD; choose just one or the other. I did it once and it caused a complication that required an embarrassing visit to the doctor. Fortunately the complication was easily treatable.

John, thank you so much for your advice - this is
exactly the information I need and I'll contact
my doctor before I go to get the meds.

As a pharmacist, I recommend that you obtain, if possible, a prescription for Lomotil (diphenoxylate/atropine) to treat traveler's diarrhea instead of over-the-counter Imodium. It is much, much better. Also, you might want to obtain a prescription for Cipro to get rid of the bug once you have it. If you explain to your physician that you will be traveling to a "third world country", he/she will probably oblige. Pepto Bismol is pretty much worthless for this type of diarrhea. Since you will be on a bus tour with or without a restroom on board and unknown stops along the way, it is better to be safe than very sorry later.

John has great advice and I think it's prudent to take preventative measures. If it makes you feel any better, my husband and I ate (delicious!) street food nonstop in Turkey and had no problems.

Yogurt is great in Turkey and I've heard it helps prevent stomach troubles.

Enjoy your tour in this amazing country!

We just returned from a trip to Turkey and Jordan. We ate everything - - salads, lots of fresh fruit (including apricots and mulberries right off the trees), street food, etc. and none of us had a problem at all. Maybe we were lucky, but nothing bothered us. We always travel with Imodium, but found no need for it. Don't worry, just enjoy! The food was great!

Ah, Kim, thanks for your succinct answer to my query.
However, if you refer back to my question you will
see I was asking how the personnel in charge of the
tour would handle the situation.

As an adult, of course I follow the advice I receive
from my doctor although I thought John the pharmacist
offered good information for me to take to the clinic and for that I thank him.

I'm presuming your last comments were said in jest
otherwise they could be construed as mean-spirited.

Thanks again to all who gave me advice - I've
travelled independantly to many, many countries
without running (!) into any problems but after
reading trip reports on the RS tour feedback I
was slightly concerned about the number of tours
where GI problems occured.

This is where icons come in handy - so you can tell
the jests from the testiness - lol.

I'm having enough problems fitting in a month's
worth of clothes in my carry-on - the packs of
Depends are just not gonna happen!

And I can spell 'independently'.

And why would you be fitting a months worth of clothes in a carryon. You need a steamer truck for that... And I didn't anything was mean spirited about Kim comments. And you always have to take postings with a certain understanding that it mostly personal opinion. Just like, the yogurt comment. Have never heard of yogurt causing problem but for that one person it does -- also could be the dairy. I make it point to having yogurt everyday (and not just when traveling) and thought it was a great aid. Must be psychological. But it works. And I too thought PoB was worthless -- nice to have it confirmed.

Hate to contradict the pharmacist, but several years ago I was lamenting to a physician I worked with (who is a highly respected infectious disease doctor who specializes in travelers' diseases) my experience with a pretty serious and trip stopping case of traveler's diarrhea. He told me that in the future when I travel to take pepto-bismal at the first sign of diarrhea. He said to always have cipro (has to be prescribed and filled before you leave)and to take that as well. He said those 2 meds will take care of it. Just passing along his advice. Haven't had to follow his advice, thankfully.

The best source of information for travelers health information is the CDC website:

http://www.cdc.gov

According to the website, water in Turkey may or may not be safe. Avoid fresh vegetables, non-bottle water, non-pasteurized dairy products, and street food. Fruit is OK if it has to be pealed (ie, oranges are OK, apples not).

I'm usually against self-treatment with ciprofloxacin, because although this usually works for common traveler's diarrhea (caused by E. coli), it can make diarrhea from other causes (like C. difficile) worse, potentially even lethally so. It's always best to seek out a physician, especially if the diarrhea persists for more than a few hours, or is accompanied by certain worrisome signs, such as a fever, blood in the stool or abdominal pain.

Wow, talk about a running commentary!

P'haps those who suffered after eating street food
are trying to forget the episode entirely or they
didn't survive the experience. (GRIN)

No comment from anyone on an actual tour bus.....
I'd still like to know whether the victims were
herded into a large latrine, or left to languish
in their hotel room, or doctored with obscure
Asian remedies. And would Turkish towelling be
employed?

I do hope for the intestinal fortitude to escape
this situation.

Point well taken Tom. If diarrhea is caused by C. difficile, you are sh*t out of luck, so to speak. It's a particularly nasty one. In that case, Lomotil just makes it hang around in the gut longer and the Cipro would kill off the good bacteria that would normally keep C. difficile in check. Pepto-Bismol would be like trying to shoo an elephant with a fly-swatter. However, I still don't leave the country without the former because they are useful for traveler's diarrhea caused by E. coli or Salmonella. Cipro is also useful for certain respiratory and urinary infections. Again, better safe than sorry. Now, if one did have a C. difficile produced diarrhea, one would probably want Flagyl (1st line) or Vancomycin (2nd line) to treat it. Kaopectate (attapulgite) or Kapectolin (kaolin pectin) [Donnagel MB in Canada] are clay-like medications that act to absorb excess fluid, bacteria, viruses, and the toxins that they produce. These are much better than Pepto Bismol in such a scenario.

In so far as not self treating, I disagree. I certainly wouldn't want my vacation spoiled by a bad case of diarrhea, especially in a very foreign land where you will have to seek out "qualified" medical help, be diagnosed properly, and have the needed medication readily available. Case in point, I recently vacationed in Italy and came down with severe diarrhea (bad eggs in Siena). I had the Cipro and Lomotil with me, and my vacation was saved!

Some tour buses have on-board facilities for "emergencies". The tour guide on the 1st escorted tour I took told us to let him know at the first sign of an impending "attack" -- not to wait until it was imminent (too late). Check with the tour company to see what plans they have in place to deal with this situation as I'm sure it is not an uncommon occurrence.
Food-borne illness is a problem in travelling whether or not it includes a bus tour. I know we will be travelling with prescription meds on our next trip in the spring.

"The tour guide on the 1st escorted tour I took told us to let him know at the first sign of an impending "attack" -- not to wait until it was imminent (too late)."

When you hear that announcement on the bus, it's probably not a good sign.

Here's what I don't understand about peeling f&v -
as you peel wouldn't your knife spread the
contamination to the flesh?

Also, I'm surmising Turkish yoghurt (and Greek too)
would be pasturized unless you're way out in the
boonies. Ditto common garden-variety cheese.

As I said before, I've been travelling for fifty
years w/o any problems but maybe, just maybe, it's
time to go cruising or stayvacationing if I'm even
thinking of these possibilities. Nah, gotta keep
going..........

For the record, I'll admit to four episodes of eating or drinking the wrong thing on a trip... two in places nobody on this forum is every likely to visit, once in Bulgaria (street food, I'm pretty certain) and once in... get ready... Paris! I'm not sure what did it in Paris.

I enjoyed a large bowl of mussels in Brugge several years ago. The next year, in Palermo, I ate a bunch of mussels. I felt lousy for the next day. When I got home I ate one mussel at a buffet to see if that was the problem. Bingo! I got really sick, like food-poisoning sick. So, I had developed a sensitivity (allergy?) to mussels. On subsequent travels and at home I have stayed away from mussels, and I'm not sure whether I should eat any shellfish. It's really a nuisance to be sick while traveling, so I am untra-conservative about what I will eat. I think fish is ok, so far (for me).

If you are in a country with questionable tap water, don't brush you teeth in it or let it get into your mouth when you shower. Avoid ice in drinks.

"don't brush you teeth in it". You can safely use tap water to brush your teeth. The fluoride in the toothpaste should kill most of the bacteria. Just rinse well with bottled water afterwards.

OK, I'll out myself as a food poisoning victim, too. I was out of commission for two unpleasant days once after eating delicious gozleme prepared my several charming Turkish women in a tent. So add "tent food" to "street food" as a possible infection source. But I have to admit, I do eat everything everywhere in Turkey, and it's the only bad experience I've ever had in probably six months worth of travels there.

And, just for the record, the sickest I have ever been was eating bad shellfish in New Orleans once--got paralytic shellfish poisoning and had to be hospitalized. So you don't have to travel far to be at risk.

The worst I've ever had was in Cairo. To make matters worse, it struck the night before I had to take a 12 hour bus ride to Tel Aviv. I literally drank an entire bottle of Pepto Bismal so I could keep it all "in" until I reached the border. Even though it was a modern air-conditioned bus, it contained no toilet. It goes without saying, I was never so glad to see an Israeli bathroom in my life. Anyone who has traveled to Egypt will understand that joke;)

"So, I had developed a sensitivity (allergy?) to mussels. On subsequent travels and at home I have stayed away from mussels, and I'm not sure whether I should eat any shellfish."

Oh, don't give up hope!

I ate seafood allll the time, and then I had a plate of clams+mussels+spaghetti here that broke me out in hives all over! I thought that was it for me. Definite food allergy.

I heard stories about how Mediterranean algae is different than Atlantic algae, and so on and so forth.

A few months later, I tried shellfish again. Nothing. Tried it again, nothing.

Sometimes 1 bad clam will cause a reaction, and that's all there is to it.

(This is not medical advice! Ask your doctor if you are worried about food allergies! Just one person's experience here! I always kept a Benadryl handy when experimenting with this stuff!)

Back to my suggestion of Pepto Bismol to help PREVENT diarrhea. I also had Immodium tablets to use in case I did get struck with the problem. The Pepto was used to hopefully prevent the problem. I consider myself to have a sensitive digestive system, and the thought of getting diarrhea while traveling terrifies me! Thankfully, it has not happened yet!

Good luck!