Motion Sickness & Traveler's Diarrhea

Generally, the first symptom is unusual paleness of the skin. This may be followed by yawning, restlessness, and a cold sweat. As the symptoms progress, malaise and drowsiness may set in, sometimes accompanied by a slightly upset stomach, or "gastric awareness." Then follows excessive salivation, nausea, and vomiting. Vomiting brings relief, if only for a short time. While motion sickness can ruin one's pride, one's suit, or an entire vacation, it seldom causes severe health complications. In extreme cases, though, prolonged vomiting can cause severe headache, prostration, dehydration, and disturbed mineral balance.

PREVENTION

• In a car, sit in the front seat, looking ahead.
  
• In an airplane, choose a seat over the wing.
  
• On a ship, remain amidships (preferably on deck), rather than below.
  
• Lie on your back, in a semireclined position, and keep your head as still as possible.
  
• Look ahead, at the distant horizon. If that's not possible, it may be better to close your eyes rather than focus on fast-moving scenery or waves. Focus attention on something other than the motion of the vehicle.
  
• Overindulgence in food or drink can predispose you to nausea and promote the onset of other motion-sickness symptoms.
  
• Tobacco smoke and other odors, particularly from food, should be avoided.

TRAVELER'S DIARRHEA
TD, as it is known, affects 20% to 50% of travelers. In addition to frequent bowel evacuations, its symptoms include abdominal cramps, nausea, bloating, fever, and feeling lousy. High-risk areas include most of the developing countries of Latin America, Africa, the Middle East, Asia, and USSR. Intermediate-risk areas include southern Europe and a few Caribbean islands. Low-risk areas include Canada, northern Europe, Australia, and New Zealand.

The onset of TD is usually within the first week, but may occur at any time during the visit, and even after returning home. You get TD through ingestion of food or water that contains bacteria.

Before leaving home, do not take any antibiotics as preventive measures, since they can foster the growth of antibiotic-resistant bacteria in your body.

AVOIDING DIARRHEA
To avoid diarrhea and other internal distresses common to travelers, stay away from fresh vegetable salads, which can't be disinfected, and food that has been left out in the sun. In certain countries--but not all--you must never drink tap water or any drink with ice in it. Boil the water before drinking it or using it--even to brush your teeth. Better yet, stick to bottled water. Avoid uncooked vegetables, unpasteurized milk and milk products such as cheese, and eat only cooked food that is still hot, or fruit that you have peeled. Avoid undercooked and raw meat, fish, and shellfish. Safe beverages include bottled carbonated beverages (especially flavored beverages), beer, wine, hot coffee or tea, or water boiled or properly treated water. The eating place is important with private homes, restaurants, and street vendors listed in order of increasing risk.

IF YOU GET TRAVELER'S DIARRHEA
--one or two unformed stools within eight hours accompanied by cramps, nausea, and malaise; do not succumb to the temptation to immediately swallow some medicine to stop it. Fortunately, most cases of TD are usually short-term. You will need to replace fluids and salts lost. To treat, prepare one glass (8 oz.) of juice and one of water. Drink alternately from each until thirst is quenched. The first glass should contain orange, apple, or other fruit juice with 1/2 teaspoon of honey or corn syrup plus a pinch of salt. The second glass should contain boiled or carbonated water and 1/4 teaspoon of baking soda. You also can use carbonated beverages or tea made with boiled or carbonated beverages. Avoid solid foods and milk. Pepto-Bismol tablets taken during your travels may help prevent the problem.

Consult a physician, rather than attempt self-medication, if the TD is severe or does not lessen within several days; if there is blood or mucus in the stool; if fever occurs with shaking chills; or if there is dehydration with persistent diarrhea.