Sick from Food or water?

[Red_Girl]

They are so so right about the toothbrush hints. I was sick on my first trip to the DR - it didn't ruin my trip, but I was afraid to stray too far away from the washroom. Anyway, the first time I brushed my teeth in the tap water. Big mistake. After that first trip, I am very careful to keep my toothbrush away from the tap water, and I don't open my mouth in the shower. Immodium works very well, and so does Pepto Bismol as an easy-on-the-stomach preventative measure. They sell Pepto chewable tablets now. I took one every morning and every time that I felt the slightest twinge in my stomach, and I was fine. I even ate the cold salads from the buffet table. It's all about the toothbrush, I'm telling you.

[ricktoronto]

Imodium is not a preventative for turista, it slows down the natural muscle operation of the large intestine to allow water to be reabsorbed. Taking it before had will not prevent anything though if you want to be constipated for no reason it will do that.

For the truly paranoid there are two preventative measures for shorter trips - Cipro or similar antibiotic 500mg/ twice day for the duration (this is the same dosage if you get it). However most doctors will not advice taking antibiotics unless as a response to infection ( exception : heart patients having dental surgery sometimes are given one large pre-treatment dose of Gentamycin, etc., to prevent endocarditis).

There is a vaccine for E Coli called Dukoral, taken orally - two doses at least a week before and a week apart then subsequently one dose every three months. It also is a Cholera vaccine, not a huge DR risk right now.

If you get turista take Imodium as directed which is quite a lot actually, 2 doses right away then one every time you "go" up to a total of 8 doses a day. After a full day if it doesn't stop ( or horrors, gets worse) then Cipro 500mg every 12 hours. If that doesn't help in a day then it could be Giardisis or other protozoa/amoeba and you need a doctor, and preferably a real one like Clinica Abreu.

I would not trust a resort doctor and if they have no lab to analyze "it" they are a waste of time anyway. Away from medical help and with no effect from Cipro after 2 days, you can take a 2 grams of Fagisyn (Tinidazole) which is easier than the typically prescribed course of Flagyl for a month and a lot cheaper. Can't buy it in the USA (because it's cheaper than Flagyl by about 95% I suspect) but you can in the DR. NEVER drink alcohol (even mouthwash) with Flagyl or Fagisyn since it acts like Antabuse and you can get deathly ill.

And rehydration is critical for electrolytes - OJ, Club Soda - not Enruqillo but Canada Dry which has sodium and potassium salts, or watered down Gatorade (3:1) - straight Gatorade is too concentrated in the sweetener department but a weak solution adds water and minerals. You can buy oral rehydrations salts and add them to water as well. Litres and litres of liquid a day is required.