When 'D-Day' Strikes

Diarrhea or "D-Day" is not exactly my favorite topic. Nor is it likely to be the subject of normal conversation. But like it or not, the problem is bound to crop up sooner or later, especially if you're not concerned about the food or drink you're taking.

Overeating itself does not cause diarrhea. While a brief attack may be due to overindulgence in alcoholic beverages like wine and beer or by eating overripe fruits and raw vegetables, the common culprit is food that's contaminated with bacteria.

Known as "food poisoning", "turista" and gastroenteritis, this problem is rampant in places where there is poor hygiene and lack of clean food and drinking water.

"The run-of-the mill gastroenteritis, familiarly known as 'turista', 'Montezuma's revenge' or the 'Aztec two-step' that tourists contract in developing countries is usually more of a nuisance than a serious threat. It is almost always due to Escherichia coli, a bacterium normally present in the gut," explained Dr. Isadore Rosenfeld of the New York Hospital -- Cornell Medical Center in "Modern Prevention:- The New Medicine."

"Strains of this organism vary from country to country. If you pick up a different form of E. coli, you may have some watery diarrhea and abdominal cramps (usually without fever) for a couple of days," he added.

Food poisoning, however, is just one part of the picture. Diarrhea can follow periods of stress, the ingestion of chemicals like arsenic, lead, nitrate or cadmium, a virus infection or an allergic reaction.

The condition may also be triggered by certain drugs and serious and chronic ailments like a vitamin B deficiency, a stomach tumor or heart disorder. Whatever the cause is, diarrhea means frequent trips to the John and a great inconvenience for many of us.

"In cases of diarrhea, the irritant - whether it be a virus, a chemical, or bacteria -- disturbs the gastrointestinal tract in a way that interferes with the normal absorption of liquids and salts. The disturbance speeds up the peristaltic movements of the tract, causing body fluids and salt to pass more rapidly through the intestines and out of the body," explained Dr. Morris Fishbein in his "Popular Illustrated Medical Encyclopedia."

What then should be done to prevent diarrhea? If you're traveling to a place where you suspect that sanitation is poor, Rosenfeld recommends the following:

"First of all use common sense. Drink and brush your teeth only with bottled water. I've heard of empty bottles being refilled with local tap water (or worse), recapped and sold as 'pure and safe.' So carbonated water is the best bet. Dine only in restaurants recommended by your hotel. Avoid food from street vendors. All your dishes should be cooked, especially vegetables, and you should eat only those fruits you can peel.

"Shun creams and custards, especially in warm weather. Finally, take your cocktail without ice, since the ice is usually made from local tap water and the organisms it contains are not affected by the alcohol or the freezing. Don't ease up on any of these precautions, including the ice on the homebound flight. The airlines usually stock up in the country you're leaving," Rosenfeld warned. (Next: Preventing dehydration from diarrhea.)

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