Dirrhea and Dysentery
The most common health problems facing travelers in Asia are diarrhea and dysentery. Often given graphic names like "Delhi belly" and the "Kathmandu Quick-step", these chronic intestinal disorders are usually caused by ingesting food or water contaminated by certain pathogenic microorganisms originating from human or animal feces. Because sewage disposal and food preparation in Asia are not always up to Western standards, a few precautions regarding personal hygiene and what you eat or drink can help reduce the chances of getting diarrhea.

Wash your hands often with soap, especially before meals, and don't lick your fingers or use them as a toothpick. Drink only water that has been boiled properly or purified wit a form of iodine; this includes the tap water in Lhasa. The Tibetans and Chinese rarely drink water that hasn't been boiled first; their example is a good one to follow. Fresh fruits and vegetables should be peeled or washed in sanitary conditions before they are eaten.
Avoid food in restaurants that obviously has been sitting out for a long time or has been exposed to flies.

Most Chinese and Tibetan hotels and guest houses provide a thermos in every room containing safe, boiled water. Chhang, the popular homemade Tibetan beer, is made by mixing fermented barley berries with water, but the water may not have been boiled first. Butter tea and araa, a distilled clear alcohol, are safe because they have been boiled, but the cup or bowl it's served in could be your downfall.

The intestinal infections that cause diarrhea in travelers are usually selflimiting and often go away on their own within two days to a week. For most people, this is too long to wait. The best course is to identify the intruding microorganism by means of a laboratory stool test, then take an appropriate antibiotic, but if you are on a trek the only choice is to weig the evidence of your symptoms and make an educated guess regarding the proper treatment. Most cases of diarrhea fall into one of three categories; simple diarrhea, dysentery, or persistent diarrhea.

Simple Diarrhea
Diarrhea is defined as and abnormally frequent number of unformed stools. The symptom can vary from mild discomfort and inconvenience to frequent watery stools accompanied by nausea, cramping, vomiting, or fever. Most cases of simple diarrhea are caused by a bacterial infection, particularly from certain pathogenic strains of E.coli. Once these bacteria enter the digestive system, they release a toxin that prevents the bowel from absorbing liquids, causing the feces to be expelled as a watery stool. This type of diarrhea usually begins with a sudden onset of symptoms. A person who suddenly has to run to the toilet in the middle of th3.140 80 GET /bbs/dispbbs.asp Boardid=8&ID=432&replyID=1491&skin=1 200 Mozilla/4.0+(compatible;+MSIE+5.0;+Windows+98;+DigExt) 2004-04-15 07:03:59 218.88.116.40 - 202.98.123.140 80 GET /bbs/images/LOGO.GIF - 304 Mozilla/4.0+(compatible;+MSIE+5.0;+Windows+98;+DigExt) 2004-04-15 07:03:59 218.88.116.40 - 202.98.123.140 80 GET /bbs/images/myLOGO.gif - 304 Mozilla/4.0+(compatible;+MSIE+5.0;+Windows+98;+DigExt) 2004-04-15 07:03:59 218.88.116.40 - 202.98.123.140 80 GET /bbs/pic/navspacer.gif - 304 Mozilla/4.0+(compatible;+MSIE+5.0;+Windows+98;+DigExt) 2004-04-15 07:03:59 218.88.116.40 - 202.98.123.140 80 GET /bbs/pic/msg_no_new_bar.gif - 304 Mozilla/4.0+(compatible;+MSIE+5.0;+Windows+98;+DigExt) 2004-04-15 07:03:59 218.88.116.40 - 202.98.123.140 80 GET /bbs/skin/default/topbg.gif - 304 Mozilla/4.0+(compatible;+MSIE+5.0;+Windows+98;+DigExt) 2004-04-15 07:03:59 218.88.116.40 - 202.98.123.140 80 GET /bbs/skin/default/bottombg.gif - 304 Mozilla/4.0+(compatible;+MSIE+5.0;+Windows+98;+DigExt) 2004-04-15 07:03:59 218.88.116.40 - 202.98.123.140 80 GET /bbs/skin/default/tabs_m_tile.gif - 304 Mozilla/4.0+(compatible;+MSIE+5.0;+Windows+98;+DigExt) 2004-04-15 07:03:59 218.88.116.40 - 202.98.123.140 80 GET /bbs/pic/Forum_nav.gif - 304 Mozilla/4.0+(compatible;+MSIE+5.0;+Windows+98;+DigExt) 2004-04-15 07:03:59 218.88.116.40 - 202.98.123.140 80 GET /bbs/skin/default/bg1.gif - 304 Mozilla/4.0+(compatible;+MSIE+5.0;+Windows+98;+DigExt) 2004-04-15 07:04:00 211.103.103.33 - 202.98.123.140 80 GET /images/menu61.gif - 304 Mozilla/4.0+(compatible;+MSIE+5.01;+Windows+NT+5.0) 2004-04-15 07:04:02 211.103.103.33 - 202.98.123.140 80 GET /images/menu71.gif - 304 Mozilla/4.0+(compatible;+MSIE+5.01;+Windows+NT+5.0) 2004-04-15 07:04:03 211.103.103.33 - 202.98.123.140 80 GET /images/menu11.gif - 304 Mozilla/4.0+(compatible;+MSIE+5.01;+Windows+NT+5.0) 2004-04-15 07:04:06 211.103.103.33 - 202.98.123.140 80 GET /TopOrder.asp num=1 200 Mozilla/4.0+(compatible;+MSIE+5.01;+Windows+NT+5.0) 2004-04-15 07:04:06 211.103.103.33 - 202.98.123.140 80 GET /images/site.css - 304 Mozilla/4.0+(compatible;+MSIE+5.01;+Windows+NT+5.0) 2004-04-15 07:04:06 211.103.103.33 - 202.98.123.140 80 GET /flash/ad.swf - 304 Mozilla/4.0+(compatible;+MSIE+5.01;+Windows+NT+5.0) 2004-04-15 07:04:06 211.103.103.33 - 202.98.123.140 80 GET /images/jian-point3.gif - 304 Mozilla/4.0+(compatible;+MSIE+5.01;+Windows+NT+5.0) 2004-04-15 07:04:06 211.103.103.33 - 202.98.123.140 80 GET /m_images/cjzjh_m1.jpg - 304 Mozilla/4.0+(compatible;+MSIE+5.01;+Windows+NT+5.0) 2004-04-15 07:04:06 211.103.103.33 - 202.98.123.140 80 GET /m_images/clhh_m2.jpg - 304 Mozilla/4.0+(compatible;+MSIE+5.01;+Windows+NT+5.0) 2004-04-15 07:04:06 211.103.103.33 - 202.98.123.140 80 GET /m_images/clzjh_m10.jpg - 304 Mozilla/4.0+(compatible;+MSIE+5.01;+Windows+NT+5.0) 2004-04-15 07:04:06 211.103.103.33 - 202.98.123.140 80 GET /m_images/cjhh_m11.jpg - 304 Mozilla/4.0+(compatible;+MSIE+5.01;+Windows+NT+5.0) 2004-04-15 07:04:06 211.103.103.33 - 202.98.123.140 80 GET /m_images/clhuangsu_m5.jpg - 304 Mozilla/4.0+(compatible;+MSIE+5.01;+Windows+NT+5.0) 2004-04-15 07:04:06 211.103.103.33 - 202.98.123.140 80 GET /m_images/clhuanghsu_m4.jpg - 304 Mozilla/4.0+(compatible;+MSIE+5.01;+Windows+NT+5.0) 2004-04-15 07:04:08 211.103.103.33 - 202.98.123.140 80 GET /images/menu71.gif - 304 Mozilla/4.0+(compatible;+MSIE+5.01;+Windows+NT+5.0) 2004-04-15 07:04:16 218.6.193.248 - 202.98.123.140 80 GET /bbs/index.asp - 200 Mozilla/4.0+(compatible;+MSIE+6.0;+Windows+NT+5.1) 2004-04-15 07:04:16 211.103.103.33 - 202.98.123.140 80 GET /images/menu81.gif - 500 Mozilla/4.0+(compatible;+MSIE+5.01;+Windows+NT+5.0) 2004-04-15 07:04:16 211.103.103.33 - 202.98.123.140 80 GET /images/menu81.gif - 500 Mozilla/4.0+(compatible;+MSIE+5.01;+Windows+NT+5.0) 2004-04-15 07:04:16 211.103.103.33 - 202.98.123.140 80 GET /images/menu71.gif - 304 Mozilla/4.0+(compatible;+MSIE+5.01;+Windows+NT+5.0) 2004-04-15 07:04:17 211.103.103.33 - 202.98.123.140 80 GET /images/menu81.gif - 304 Mozilla/4.0+(compatible;+MSIE+5.01;+Windows+NT+5.0) 2004-04-15 07:04:21 218.6NT SIZE="4"> Persistent Dioarrhea
Travelers who spend a month or longer in Asia are more prone to persistent types of intestinal infections than short-term travelers. Although these infections are sometimes bacterial, cases of nondysentery diarrhea (with no blood or pus present) that last more than a week are often caused by the protozoa Giardia lamblia. Animal feces are a common source of this waterbome parasite. Which is found throughout the world.

The symptoms of giardia are usually less severe than a bacterial infection and may take a week or two to manifest. Typically the onset is not sudden and may be preceded by stomach rumbles or mild cramping. The diarrhea is usually not watery but moderately frequent, occurring three to five times a day. A bloated stomach, intestinal gas and sulfurous, rotten egg-smelling burps or gas are common complaints. Fever rarely accompanies giardia and vomiting is uncommon. Unlike bacterial infections, this type of diarrhea can linger for weeks if left untreated.

The standard medication for giardia is tinidazole, which is available in most Asian countries but not in the United States. A substitute is metronidazole. Avoid alcohol while using either of these drugs.