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Digestive issues while touring

My doc didn’t recommend any anti diarrhea meds.

I figure worse case I could get something there at the pharmacy.

What do you guys think?

I’ll be in Istanbul alone for 2 days before the Best of Turkey tour.

Posted by
10307 posts

Don't even brush your teeth with tap water, much less drink it. The water pipes are old. Use and drink bottled water.

What sort of medicine did you have in mind? The go-to antidiarrheal is Imodium over the counter. Bring it with you.

Posted by
14167 posts

While I've not been to Turkey, for my regular travel to Europe I pack Immodium and Pepto Bismol. You never know if you will need this during the night and then might not feel up to going out and finding a pharmacy. If you are traveling with someone they can go searching but I travel solo and want things I know will work at my side.

On a first trip to Italy with brother and SIL, SIL got sick the first day, brother went out with the RS guide to the pharmacy but all they had was some kind of herbal remedy which she was reluctant to take. I've overloaded on Immodium and Pepto since then in case I need to share with others.

Posted by
4574 posts

Personally, when you are alone and need anti-diarrheals, you may not be in any shape to get to a pharmacy. Just take Immodium and Pepto Bismol with you.
As a solo traveler in a number of places with higher risks of acute gastric issues, that is what I do. (and how I handled issues on a recent India tour). It can at least help until you can get to a pharmacist who will prescribe for your symptoms. I have come to appreciate that medicines seemed to be created for the local bugs, so buying locally makes sense - when you are well enough to leave the toilet.
Alternatively, you can throw yourself on the mercy of the front desk and they can do a pharmacy run for you. I never expected that, but I did have a high end hotel in Cairo do that for me when they found out I had been ill. The medicine was magic and I carried it around until it was too expired to be trustworthy.

Posted by
27362 posts

I am not a medical person, but I've checked on this from time to time before traveling to countries where I thought I might run into food/water challenges. (I don't know that Turkiye is a problem in that regard.)

Pepto-Bismol is not sold in the EU; I don't know about Turkiye. I have read recommendations from reliable sources for taking some Pepto-Bismol before each meal (I don't know how much) as a preventive against development of minor digestive problems.

Imodium (loperamide hydrochloride) is an over-the-counter antidiarrheal often suggested once problems develop. Travel-medicine instructions used to include "Do not take if you have a fever" (fever would suggest a bacterial infection, I think, which Imodium wouldn't treat), but the current labeling on my bottle just says to consult a doctor before use if you have a fever (among other conditions).

I'd suggest doing some Googling to see what reliable websites, like WebMD, have to say. The CDC website has a page for each country, with warnings--where appropriate--about food- and water-borne pathogens specific to that area. Consulting your personal physician wouldn't be a bad idea if you are on any prescription meds, because my bottle of Imodium warns about potential interactions with some (unidentified) prescription medications.

Sticking to cooked foods and sealed bottles of water is a good idea if you have doubts.

Edited to add: I got the Hepatitis A/B vaccine before going to Ukraine; that's now recommended very broadly, I think. Hepatitis can be picked up here in the US if you're unlucky.

Posted by
8537 posts

Immodium, Bonine and Benefiber packets are part of my packing no matter where I go. (I'm set then no matter the digestive problem :)

Posted by
3984 posts

When we traveled to Turkey with our student group we were advised to take Imodium and pepto bismol with us as you can’t find the latter in Turkey and the EU. We were advised to take a dose of PB each day while there but I don’t remember the exact dose but it was higher than 1-2 tablets. We were also told not to use tap water for anything including brushing teeth. Non of us developed stomach issues and with 48 people I was a bit worried.

Posted by
16000 posts

Wise words above! I never travel without Imodium 'cause if the bug hits me in the middle of the night, I want the remedy RIGHT THERE to take RIGHT NOW. That can be especially important if there's somewhere you have to be in the morning. Even during the day, you might not be in any kind of shape to be far from the bathroom long enough to find a pharmacy.

Pack your preferred remedy when you pack your bag. :O)

Posted by
3965 posts

For stomach troubles in Europe I'd look at Iberogast, this is like a "European Pepto-Bismol" made in Germany but available all over the EU and maybe Turkey. Unlike Pepto-Bismol, Iberogast uses natural herbs and ingredients.

Posted by
83 posts

Wow thanks for all the great advice. I feel more confident now deciding what to bring.

Thanks again to all.

Posted by
7403 posts

Pack anything that if needed during the night, you wouldn’t want to wait until morning. I bring along my OTC medicine for migraines & colds because I want them to start working immediately. Plus, I don’t want to find out during vacation that I have a bad reaction to a local option. I’ve had some cold medicines that won’t let me fall asleep - not something I want to find out on a trip.

Posted by
1514 posts

I traveled to Turkiye in 2019.
I took the oral typhoid vaccine. My traveling companion elected not to. It certainly isn't required.

We ate street food including fresh, raw vegetables.

We took packets of bismuth subsalicylate tablets. They were small and handy. Anytime we were eating uncooked vegetables or street food, we chewed one pack, two tablets. Doing this reduces the likelihood of any bacterial infection by 62%. We didn't get sick. One person on our tour did get sick and missed activities for 1 1/2 days.

We brushed our teeth with bottled water while in Istanbul.

Posted by
8597 posts

. . . Travel-medicine instructions used to include "Do not take if you have a fever" (fever would suggest a bacterial infection, I think, which Imodium wouldn't treat), . . .

My understanding is the reason is that immodium and similar shut down your intestinal tract, but if you have a bacterial infection, that would be locking it in. That could make it worse since you wouldn't be purging the bacteria.

Posted by
272 posts

Don't even brush your teeth with tap water, much less drink it. The
water pipes are old. Use and drink bottled water.

Not just Turkey, but anywhere you're advised to not even brush your teeth with the tap water,

Is it safe to wash your hands or face in? Why?

Is it safe to bathe/shower in? Why?

If you have a way to boil water, does that make it safe to use for brushing teeth?

Just asking for my own education.

Posted by
4574 posts

@Khansen, I was in India a few months ago and tried to use fewer plastic water bottles, so boiled some hotel water. It might have been safe, but it tasted terrible. I guess you could brush teeth, but no more. I did grt used to the taste of chlorine when I was working I Tanzania. Eater was supposedly drinkable, but the pipes were suspicious so I would add purification tablets to collected tapp ester and let it sit overnight with the lid off to try and reduce the chlorine smell and taste.
As to shower and washing, yes it is safe to do so. The concern with drinking water is bacterial levels. So you do need to avoid letting shower water get into your mouth as well. It is also about accumulation. We get sick not with one taste, but enough consumption to tip the balance of our internal gut to deal with the bacteria and then we get sick.

Posted by
8597 posts

@khansen, if water has illness-causing micro-organisms in it, the idea is to not ingest it, even just inside your mouth. Boiling water will kill the micro-organisms. On the other hand, your outer skin is very protective from water on the outside. But nothing is 100% effective..

Posted by
4865 posts

I went on the Best of Turkey and Best of Istanbul tours last May. Many of the tour hotels had signs in the bathrooms saying do not drink the water. Even some of the modern business hotels.

Over the Counter Meds
I carried Imodium (non-prescription) in my day purse and used it on several occasions, at the first sign of any digestive issues.

Prescription Meds
I called the Travel Nurse (Kaiser) and she gave me a prescription for an antibiotic. I never needed it. But my roommate got very sick and her Imodium or Pepto-Bismol did not work, so she took her prescription strength meds.

Bottled Water
The tour bus will have bottles of water available for purchase (honor system, keep track of how many bottles you take and pay the bus driver at the end - most people "overpaid" as a courtesy.) As you exit the bus at the end of each day, if you need water in your hotel room, you can grab some.

You'll also be able to buy larger bottles of water in shops and at rest stops, so you can refill your smaller bottles.

I used about half a 0.5 liter bottle of water to brush my teeth. You don't even want to rinse your toothbrush in the water, and it's very likely you'll forget for a while. (We started covering the faucet so we wouldn't forget.)

Cost of Water
Bottled water was very cheap in Turkey. At the time we went, it was 5 Turkish Lira for a 0.5 liter bottle on the bus. At rest stops, it was 3 TL; in tourist areas, it was 10 TL. So the bus price was very fair. At the small grocery/market near our hotel, it was even cheaper - I recall about $0.07 at the time.

Today, 5TL is about $0.26. With their inflation, all of these prices will have gone up.

Packing Tip
You may want to bring a couple of extra toothbrushes, in case you do forget and rinse yours in the faucet. You can also pick them up at the rest stops. I saw them for about 2 for $1.

(All prices were from my trip in May, 2022.)

Posted by
4173 posts

I've only been on the week in Istanbul tour, but my experience was as described by others. Our hotel was very nice but it was clearly signed that the water was not potable. We used bottled water for brushing our teeth. I did do some sink washing of clothes using the tap water and soap provided. Neither of us got sick.

One thing you need to know about Istanbul if you don't already is that you absolutely cannot flush toilet paper down the pipes because they are too small and the infrastructure has not kept up with the population growth. Every toilet we encountered, including at the airport and in fancy places, had bottom washers that you use first. The toilet paper is used to dry off. Then you put it in the trash bin that's always right next to the toilet. The cleanest and nicest bathrooms I experienced were connected to mosques.

If it's not on the tour, try to make time to visit the Basilica Cistern: http://yerebatansarnici.com/ Seeing it was one of the highlights of our time in Istanbul. It's been improved since we were there in 2014, and since it was used in the 1963 Bond movie, "From Russia with Love."

Be sure to try the apple tea available in many places and the absolutely delicious profitaroles at Inci Pastanesi: https://restaurantguru.com/Inci-Pastanesi-Istanbul

Last but not least, enjoy the many beautiful and often friendly street cats. My husband had a sweet one come and cuddle up next to him while he was sitting on a concrete wall waiting for me.

Posted by
2463 posts

My husband is one who is very prone to gastrointestinal issues. We always travel with Cipro. Over the counter meds simply don’t begin to cut it for him. Pepto and Imodium may work for you but you won’t know until it happens. Our former brother-in-law (physician) always travels with azithromycin. Check with your doctor.

Posted by
90 posts

I am trying to understand one thing. When you walk around Los Angales, Portland, San Francisco and other major American cities, you do not get sick smelling urine and human remains on the streets but you worry to get sick from tap water in Turkey? Turkish families do cook by using tap water so they do not get sick from it. Nobody uses bottled water to cook in Turkey. Yes most people do not drink it but even worrying about brussing your teeth is kinda exaggaration. Onething you would not worry about urine smell and homeless tents or people doing "their things" in the middle of streets in Turkey as I used to see in the USA. I travelled to the USA and I put my mask on in Phoenix Arizona in Jefferson St where homeless set up their tents and I could not walk from urine smell and the same in Hollywood Blvd.

Posted by
5046 posts

...but you worry to get sick from tap water in Turkey? Turkish
families do cook by using tap water so they do not get sick from it.
Nobody uses bottled water to cook in Turkey. Yes most people do not
drink it but even worrying about brussing your teeth is kinda
exaggaration...

When cooking with tap water, the water boils and kills any microbes that are present. Water that has boiled for a sufficient period, and the food that was cooked in it, would be perfectly safe to ingest. When brushing your teeth, it is quite likely that you will swallow some of the water. By your own admission, the locals don't drink from the tap. On vacation, one might prefer to be somewhat cautious, to reduce the possibility of a GI illness which could adversely affect their travels. Even if the local water has been deemed to be potable, it may contain a different mineral and microflora profile than the water one is accustomed to. This alone can be enough to cause an intestinal rebellion.

Posted by
272 posts

Thanks everyone for the responses.

Water that has boiled for a sufficient period, and the food that was
cooked in it, would be perfectly safe to ingest.

Had to laugh to myself about a young coworker. The county was under a boil water advisory. Our employer gave everyone a 24-pack of bottled water. She commented the next morning about not realizing how many bottles of water it took to boil spaghetti noodles for dinner.

"Well if you just let the tap water boil for 3 minutes BEFORE putting the pasta in, you'd be fine."

As far as "Don't even brush your teeth with it.", I think I'd be tempted to boil water if I could, let it cool, and sponge-bathe for the duration.

Local boil water advisory is one thing. But "this is the normal situation here" is quite another. I'd rather be any other kind of sick than this.

Posted by
11355 posts

Our doctor recommended that we take PeptoBismol tablets as an antidote before rack meal, upon waking, when going to bed. We never got any GI illness on our trip.

Posted by
15573 posts

A friend of mine used to spend six months each year in Ghana where the water is not safe to drink. She would complain that people would steal her bottled water. So I got her a Steri-Pen. She used it and said she never got sick once.

Or you could take a filtered water botttle like this one:

Brita Filtered Water Bottle