Travel and prevention

Our brain receives information about our location from our eyes, muscles, joints, and inner ear. When you are in a moving vehicle that you are not controlling, your brain becomes confused by conflicting information. To signal that something is wrong, it sends a "vomit" signal to your stomach.

Motion sickness is a collective term for three types:

• Car sickness: This often affects people during long car journeys.

• Air sickness: In aeroplanes, people can feel quite unwell due to changes in air pressure, turbulence, and take-off and landing.

• Sea sickness: Everyone is familiar with the term "sea legs." If you don’t have them, the constant rocking of the waves, especially when the wind picks up, can make you feel very nauseous.

Motion sickness often begins with dizziness, yawning, and/or headaches, followed by a feeling of nausea, which may lead to vomiting. Sweating is also a common symptom of motion sickness. It is possible to experience only some of these symptoms.

If you know you are prone to motion sickness, there are several preventative measures you can take:

• The best remedies are driving yourself or sleeping. If neither is possible:

• Make sure to eat a light meal before travelling. Not eating can make you feel unwell, and fatty foods are poorly tolerated during motion sickness.

• During long journeys, it’s wise to maintain a routine of three light meals a day.

• Consider taking ginger powder or ginger tea. This is an excellent remedy for an upset stomach.

• Avoid alcohol.

• In a car or coach, sit in the front and avoid sitting backwards. On a boat, sit on the rear deck, and on a plane, sit near the wings.

• Avoid reading, writing, or using the internet while travelling, as these activities can make you feel nauseous. Instead, focus on the horizon to counteract the brain's confusion.

• Ensure fresh, cool ventilation.

Malaria is a disease that occurs in tropical and subtropical regions. It is caused by parasites and transmitted through mosquito bites. Malaria causes fever, headaches, chills, and muscle pain. It can also be fatal, which is why the potential side effects of malaria tablets are preferable to the risk of contracting malaria. There are various types of malaria medications, each working in different ways. Their purpose is to kill the malaria parasites, reduce fever, and prevent malaria attacks.

If you are travelling to countries where there is a risk of malaria, you will most likely be advised to take malaria tablets. There are several types of these medications, depending on your destination and personal circumstances. While many side effects of malaria tablets are known, they are far less severe than malaria itself.

The choice of medication usually depends on the local resistance of the parasites. Common side effects of malaria tablets include:

• Tinnitus

• Dizziness

• Headaches

• Hypoglycaemia (low blood sugar levels)

• Skin rash and/or itching

• Swelling of the eyelids

Less common side effects include vomiting, diarrhoea, insomnia or excessive sleepiness, and coughing.

Malaria tablets are taken as a course of treatment. It is important to complete the course. If you vomit within an hour of taking the tablets or experience severe diarrhoea, contact a doctor. Simply taking another tablet to replace the one you vomited is not sufficient, as it is part of a treatment course. Additionally, it is crucial to adjust your fluid intake. Vomiting or diarrhoea causes significant fluid loss, which must be replenished. Unfortunately, there is little that can be done to prevent the side effects. They are part of the treatment, and not taking malaria tablets is highly inadvisable. Malaria can have very serious consequences.

There’s nothing more unpleasant than diarrhoea while on holiday. It is usually caused by an infection with bacteria, a virus, or protozoa. You are at higher risk of infection due to:

• Food. Think of unwashed vegetables and fruits, raw dairy products (cheeses, unpasteurised milk, ice cream), unhygienically prepared shellfish, and raw or undercooked meat.

• Contaminated water or water not intended for consumption.

• Insects that can transmit bacteria or viruses. Be cautious of flies and mosquitoes, for example.

• Contact with the faeces or saliva of someone with diarrhoea. This can result from poor hygiene by the sick person or poorly maintained toilets and washing facilities.

When the intestinal wall is damaged or inflamed by bacteria or viruses, the intestines can no longer function properly. A key function of the intestines is to thicken stool by absorbing water. This function is disrupted in the case of diarrhoea. Less water is absorbed from food, and the inflamed intestinal wall loses additional water. Food also passes through the intestines more quickly than normal, preventing the absorption of essential nutrients.

Traveller’s diarrhoea is most often caused by an intestinal infection, usually due to bacteria, a virus, or protozoa. It typically occurs in the first few days of a holiday. Traveller’s diarrhoea always comes on suddenly and usually lasts a few days. Symptoms include three or four episodes of loose stools per day, often accompanied by abdominal cramps, nausea, and sometimes fever.

The most important advice to reduce the risk of traveller’s diarrhoea involves hygiene:

• If you buy food from a street vendor, ensure it is piping hot or dried. Even better, peel the food yourself.

• Avoid cold, raw, and unpasteurised foods.

• Avoid shellfish, such as oysters, lobster, and prawns.

• Ensure that meat, such as burgers and satay, is thoroughly cooked.

• Research the quality of drinking water in your destination country. If in doubt, use only bottled water with sealed caps, even for brushing your teeth.

• Always wash your hands after using the toilet, before cooking, and before eating.

If you already have traveller’s diarrhoea, it is important to stay hydrated. As mentioned earlier, the intestines are no longer able to absorb water from food, which can lead to severe dehydration. Therefore, drink plenty of fluids to quickly replenish your hydration levels! Ensure that you (or a sick travel companion) urinate regularly. If you have not urinated or have barely urinated for more than 24 hours, it may indicate kidney dysfunction. In such cases, contact a doctor immediately.

Note: If you are taking medication, including contraceptive pills, diarrhoea and vomiting can significantly reduce their effectiveness. Your intestines may not absorb the medication properly. Contact your doctor to discuss possible measures.

Medications

If you have a fever or blood in your stool, it is advisable to consult a doctor. This could indicate bacterial diarrhoea, which may require a course of antibiotics. If your diarrhoea persists for more than a week after returning home, it is also wise to see your GP.

Alternative treatments

If you have diarrhoea, it is important to stay hydrated. Avoid coffee and alcohol, as these drinks can dehydrate your body further. If the diarrhoea lasts for a long time (more than five days), purchase ORS from a local pharmacy or chemist. ORS stands for Oral Rehydration Solution and is a hydration supplement. Get ORS as soon as you think you need it; don’t wait five days. It consists of a mixture of salt and sugar that you can dissolve in water.

If you are severely bothered by frequent trips to the toilet, Loperamide (or Loperamide oxide) is available under various brand names. If it has no effect after 48 hours, stop using it and consult a doctor. Do not use Loperamide too quickly, as frequent bowel movements help the body eliminate the cause of the illness.

Reisziekte - Farmacotherapeutisch Kompas 

Malariamiddelen - Farmacotherapeutisch Kompas 

Acute diarree - Farmacotherapeutisch Kompas 

Motion sickness - NHS 

Malaria: Causes, Symptoms, and Diagnosis 

Traveler’s Diarrhea: Treatment, Antibiotic, and Prevention