• Diarrhoea

    Diarrhoea is the most common complaint of travellers in their first 2 weeks away from home. This can be for many reasons, but is primarily thought to be related to the bacteria in the non-purified water of the developing countries. Normally, if a person gets diarrhoea the first thing they do is visit their doctor or GP who will make an accurate diagnosis and prescribe an appropriate course of treatment. High up the mountain this is unlikely to be an option, so self-diagnosis is vital. Although diarrhoea is rarely
    fatal, it causes they body to lose valuable water supplies, and in a mountain environment this can lead to an increased risk of altitude and cold related illnesses.

    Bacterial infection is not the only cause of diarrhoea – viruses, protozoa, some medicines, food intolerances and allergies can also be held responsible. This means that there is no ‘magic bullet’ which will cure all types and strains. It is especially important to recognise this, as if you take antibiotics in the hope that it will be the cure-all end-all you may inadvertently kill off any good bacteria which the body is using to fight the infection. Diarrhoea is complex, so you should descend and seek professional help and if it
    persists for more than a week, or is accompanied any of the following:

    • Bleeding
    • Fainting
    • Dehydration
    • A high fever
    • Pain

    Prevention

    As diarrhoea is a very unpleasant condition to have halfway up a mountain some people choose to take preventative medicines to protect against diarrhoea, but doctors are divided as to whether this is a good idea. Side effects can be extremely nasty, and even fatal. Altering the body’s natural makeup so far away from proper medical help could cause further complications. Fortunately there is an alternative as most types of diarrhoea are preventable if you are careful and practice good hygiene. Here are a few tips:

    • Always wash your hands thoroughly after using the toilet and before eating and drinking.
    • Purify your own water with a filter or by boiling or using iodine.
    • Avoid raw food. Either boil it first or wash, and if appropriate, peel it before consumption.
    • Only consume pasteurised dairy products.
    • Avoid ‘hidden water,’ such as drinks, and especially ice made from untreated water.
    • Wash cooking utensils or cutlery thoroughly before use.
    • Wash hands after any contact with animals, or throw away any food which has been in contact with animals, including flies.
    • Avoid contact with unhygienic infected people.

    In the case of mild diarrhoea, wait to see how the condition develops. It may be a one off in which case no medication will be needed. The other benefit of this is that you can be confident that you can carry on climbing. All that is necessary in a mild condition is to drink plenty of water to replenish what is lost, and be aware of the signals the body is sending, such as hunger and rest.

    Hints and Tips

    Although unpleasant there is not much that can be done to help people unlucky enough to affected by diarrhoea. The body will naturally, at some cost to the individual, eject the contaminated food and poison of its own accord. Try to:

    • Rest
    • Drink plenty of fluids, preferably water
    • Get at least 8 hours sleep
    • Stop all diary products for 3 days
    • Avoid ‘hidden water,’ such as drinks, and especially ice made from untreated water.
    • Wash cooking utensils or cutlery thoroughly before use
    • Wash hands after any contact with animals, or throw away any food which has been in contact with animals, including flies.
    • Avoid contact with unhygienic infected people

    Although the food available on a mountain is invariably limited, certain types of food can affect your recovery. Good foods for diarrhoea are ‘bulky’ and contain large amounts of starch and carbohydrates, such as:

    • Plain, boiled rice
    • Pasta
    • Dry toast
    • Crackers
    • Bananas
    • Vegetables

    However, it is best to avoid diuretics, acids and spices, which includes the following:

    • Curries
    • Fatty, processed foods
    • Citrus fruits
    • Alcohol
    • Tea/Coffee

    Types of Diarrhoea

    Giardia

    Giardia is especially common in Nepal, and is a water-borne parasite. It can take up to 10 days to develop, and up to 6 weeks to leave completely. Giardia presents symptoms similar to normal diarrhoea, although has some classic distinguishing symptoms:

    • Sulphur smelling wind
    • A gurgling and churning upset stomach
    • Cramping
    • Bloating
    • Constipation
    • Watery diarrhoea (less common)
    • Absence of fever, chills and nausea

    Amoebic Dysentery

    The onset of amoebic dysentery can be sudden and can cripple a person severely, to the extent where they can’t even remove themselves from the toilet. More commonly it has a slow start. Periodic mild diarrhoea which can virtually be ignored is typical, but the danger with this is that the body can be infected and the individual may not know. The body is still at risk and will be slowly deteriorating from the inside, but reassuringly, amoebic dysentery is fairly rare.

    Travellers/Bacterial Diarrhoea

    Traveller’s diarrhoea is a type caused by strains of bacteria that are unfamiliar to the body. It is usually the first illness to strike travellers when they arrive to a new country, and so is not specific to any particular country, or indeed to climbing. The symptoms include:

    • Fever
    • Chills
    • Nausea
    • Frequent watery diarrhoea
    • Stomach cramps

    The body generally copes with foreign bacteria quite well without the need for interference. It should be given time to clear up on its own before further treatment.

    Food Poisoning

    Again common on and off the mountain, food poisoning, although common can wreak havoc with a climb. The symptoms start to appear after 4 hours after eating the contaminated food, and lasts for up to 24 hours. These include:

    • Vomiting
    • Diarrhoea
    • Stomach cramps
    • Feeling weak