ScubaBrucie

Now first things first: I am not a medical professional of any sort. The following is just based on my own experience travelling the world a lot over many years. Use it at your own risk.

I have seen many a person lose dives because of the trots but, with a bit of knowledge, it can be nearly completely controlled.

Diarrhoea (‘diarrhea’ in the US) is a body defence mechanism, as is vomiting. It is your body trying to get rid of something it doesn’t like.

First it is necessary to understand that there are more organisms living in and on one human being than there are people on earth. Yep, you go happily along as one massive colony of life, most living in perfect harmony.

One of these organisms is e-coli. Forget the rogue versions you see in news stories; there are millions of the ordinary version in your gut. It is so universal that the number found in a sample of seawater is used as an indicator of how clean that water is.

The thing is that e-coli varies by region and your body doesn’t like seeing new ones, until it adapts. This is why you may have a few ‘loose movements ‘ when you go somewhere for the first time but are then okay on subsequent visits.

Then there are the genuine food poisoning bacteria. Campylobacter, Listeria and Salmonella all make the news and are found in food. The problem here is that they each put two agents into your body. Firstly there is the bacteria itself, then there is the toxin that it produces.

The problem with using Imodium to stop the trots is that it traps both of these within your body, by stopping the natural mechanism to get rid of them. I have seen people get quite ill this way.

You can also — far more rarely — get the trots from viral infections, which tend to run their own course, and from amoeba (also rarely) as in Giardia and Amaeboid Dysentry, which need a trip to a doctor. Also just the change of environment or the travel can lead to a short term upset.

So the first thing is to rehydrate: take some rehydration salts with you on holiday. A dose of the ‘Aztec two step’ really sucks the liquid out of you, and added to the hot weather and the dehydrating effect of diving you can soon be in big trouble. In the absence of rehydration salts some flat (stir a spoonful of sugar in to let all the bubbles go) Coca Cola is a well-proven backpackers remedy. My Chinese pharmacist friend says they use boiled Coca Cola. Whatever, just drink lots.

The gentlest and most natural preventative is Acidophilus, the bacteria that is in Yakult and all the other probiotic breakfast drinks. This is available in capsule and tablet form and if taken throughout (and probably slightly before) your holiday it has a well proven effect at preventing the runs.

The favourite cure was an accidental discovery made by the British Army medical corps. Digestive problems are common in the unhygenic conditions of combat and rapidy reduce a soldier’s fighting effectiveness so it is very important for them. They discovered that a single 500mg dose of Cyproxin (also known under various brand names) cured over 95% of problems very quickly. They call it Domestos because it kills all known germs.

I have used this many times. You can buy it ‘over the counter’ in countries such as Spain and Egypt, while in the UK you need to persuade your doctor to give you a private prescription or buy it over the internet.

The small print says there is a possibility of it not being good whilst operating machinery. I have never had this side effect with a single 500mg dose and neither has anyone I know. A more important side effect for divers is that it makes you more light sensitive, so put on some extra suncream.

The great advantage of this treatment is that it does not trap the bacteria and toxins in your body. Remember that you only need to take a single dose; a full course is not necessary. If your condition is truly horrendous you can take as much as 1,000mg as a single dose. I’ve done this only once and certainly would not recommend diving on it.

Imodium (Loperamide) works by slowing or stopping peristalsis, the natural muscular waves that move food through the body. If you just have a few loose movements you do not need this. However if you have full blooded Delhi belly then it can be useful. I find that one capsule slows things down but not too much. It can be handy if taken with a Cyproxin as you can keep diving and get cured at the same time.

Two capsules brings things to a near halt and three stops everything; I really would not recommend either of these options as it is interfering too much with you body’s desire to be rid of something. You really do not want to keep nasty bacteria and toxins inside your body. If for some reason you cannot get hold of Imodium then Codeine has quite a strong effect at slowing peristalsis.

But the newest tool on the block is Dukoral. This is an oral vaccine that immunises you against cholera for two years. This in itself is a good thing and is achieved with two doses. But the really useful bit is that they discovered that it has a side effect of giving you three months’ protection from travellers’ diarrhoea.

Subsequently another single dose gives you a further three months protection. I have tried this and it works, to the point where I felt bullet-proof and have eaten all sorts of risky things, with no problems.