Bali Belly: How to Avoid Traveller's Diarrhea

Alexis
Modified on January 5, 2024

What is Bali Belly? You may have come across the name Bali Belly, without really knowing what it is. It is known accross the world under different names: tourista, Delhi belly or in plain english... traveller's diarrhea. You guessed it; it's indeed a type of diarrhea that affects some tourists in Bali, and it's caused […]

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What is Bali Belly?

You may have come across the name Bali Belly, without really knowing what it is.

It is known accross the world under different names: tourista, Delhi belly or in plain english... traveller's diarrhea.

You guessed it; it's indeed a type of diarrhea that affects some tourists in Bali, and it's caused by various factors that I'll try to clarify so that you can (try to) avoid them.

Main symptoms of Bali Belly

bali belly

The symptoms of Bali belly or traveller's diarrhea can vary from person to person. However, generally, the following major symptoms are observed.

Diarrhea: the main symptom of Bali belly

Unsurprisingly, diarrhea is often the first sign that you have Bali Belly.

There are no strict rules; it can be mild and temporary diarrhea or more intense and/or prolonged one.

Needless to say, having diarrhea when you are on vacation with a busy sightseeing schedule is, at the very least, (very) inconvenient.

Abdominal pain: often inseparable from Bali Belly

Diarrhea rarely comes alone. Unfortunately, it is often accompanied by abdominal pain before and sometimes during your round trips to the bathroom.

Here again, the intensity and frequency of abdominal pain can vary significantly from person to person.

Fatigue: traveller's diarrhea can be (very) draining

Fatigue is also one of the most common symptoms of tourista and, therefore, Bali Belly.

Like all stomachaches and diarrhea, Bali Belly puts a significant strain on your digestive system and immune system, which can be completely exhausting, even when diarrhea is not particularly disabling and does not come with a fever.

Fever: a possible but rare symptom of Bali belly

Saying that fever is never present during Bali Belly would be a hasty conclusion.

However, it is a symptom that is far from being there every time, and that's a good thing. Generally, people with Bali belly are not in great shape, but the fever is either very mild or completely absent.

In case of a high fever, it's better to consult a doctor as you may have more than just a simple Bali belly. But again, each body is different, so reactions may vary.

What causes Bali belly?

Now that the dice are cast, here's a general overview of how Bali Belly is usually contracted.

Viral contamination like gastroenteritis: a likely cause of your stomach aches

Many cases of Bali Belly are simply caused by viruses more or less related to gastroenteritis.

Tourists catch these viruses because their bodies do not yet have the antibodies to deal with them. In a place like Bali, you are in contact with people from all over the world, and therefore, there are simply many opportunities to encounter pathogens that your body has not encountered before and that are likely to make you sick.

Food poisoning from what you ate in Bali: often at fault

Hygiene standards are clearly not the same in Bali as in Western countries. Many cases of Bali Belly are, therefore, small food poisonings that probably would not make the locals sick but could wreak havoc on a body and immune system accustomed to everything being very sanitised.

warung bali

Exposure to pollution in dirty waters: a common Bali belly cause for surfers and divers

The ocean is a significant source of bacteria and other viruses. It is highly likely that your immune system is already insufficient to cope with clean water, given the many new pathogens in a tropical climate.

But the problem is, of course, accentuated by pollution, which can be very present in the waters of Bali, especially during the rainy season when rivers flow into the ocean.

So if you surf or dive often in Bali, even when the waters are at their dirtiest, you might have a probable cause as to why you experience the dreaded traveller's diarrhea.

Spicy food: a common and benign cause of diarrhea

Many tourists try local Balinese food, and should do so! However, be careful with chilies and spicy food in general. The stomachs of Indonesians that are accustomed to spicy food (not everyone likes it either...) are probably much stronger than yours.

Keep in mind this basic principle: if it burns in your mouth, it will burn even more the next day on the way down, and especially on the way out. Friendly advice.

Having diarrhea because you ate too spicy in Bali is perfectly normal and benign. You are not sick, you simply have a chili hangover!

Air pollution can sometimes trigger traveller's diarrhea

Air pollution can cause all sorts of illnesses, including diarrhea. This is especially the case for those who ride scooters for a long time in pollution. In my first months in Bali, I was always sick as soon as I drove for more than an hour...

If you go through Jakarta, which is one of the most polluted cities in the world, don't be surprised if you have various illnesses affecting you, including diarrhea.

Is it possible to avoid traveller's diarrhea during a stay in Bali?

Yes, it is perfectly possible to avoid Bali Belly or tourista during your vacation in Bali.

Most vacationers do not experience Bali Belly, and those who do often have it for a few days or even a few hours at most without disrupting their plans.

Tips to avoid getting Bali belly during your stay

Here are some tips to avoid tourista during your vacation in Bali.

Never drink tap water in Bali

Tap water in Bali (and everywhere else in Indonesia) is not drinkable. Even the locals don't drink it, despite their immune systems being more developed than yours.

If you are in a critical situation where you have no drinking water other than tap water, boil it, and you can drink it quite safely.

But drinking tap water in Bali without boiling it beforehand is the fast track to traveller's diarrhea.

Be very careful with fresh fruits, juices, and smoothies

fruits bali belly

Tourists often fear the wrong things when it comes to Bali Belly, neglecting what can actually make them sick.

Among the highly dangerous things, I would personally place fruits first, and by a long shot. Exotic fruits are indeed delicious but full of germs that your body is not familiar with. It may not be the expressway to Bali Belly, but it's clearly a fast lane.

Unfortunately, eating local fruits is part of the Balinese experience. So, you won't avoid all fruits during your stay either. But if you have a sensitive stomach, it's better to opt for less risky and, especially, cooked dishes.

Avoid mixed salads and fresh vegetables in general

Similar to fruits, mixed salads and fresh vegetables in general should be avoided if you have a sensitive stomach.

Let's say that at 30°C with humidity, everything can quickly turn wrong and make you sick if you are not familiar with local germs.

Avoid alcohol, especially Bintang, which is notorious for its purging effects

Alcohol is also one of the causes of diarrhea in Bali, and Bintang, the most popular beer here, clearly has the reputation of giving you the runs if you overindulge.

Moderation is important if you don't want to spend your trip in the bathroom. And your liver will thank you as well.

Go easy on the spicy dishes if you're new to spicy food

As I mentioned earlier, spicy dishes can cause diarrhea, and not everyone is equal when it comes to chili.

If you're not sure of your tolerance level, two options:

  • Find out by eating spicy, even if it means discovering the threshold the hard way.
  • Ask for non-spicy or less spicy dishes: not / less spicy in English usually works fine, tidak/kurang pedas in Bahasa).

Prefer dishes cooked on-site rather than food sitting in warung displays

If you venture into the warungs (and you should), it's better to prefer those where the food doesn't sit outside too much. Something that is cooked in front of you has little chance of making you sick compared to a dish that has been in the display for two days.

bali belly

Myths and other useless advice on the causes of Bali Belly

Sometimes, nonsense is repeated about Bali Belly, completely restricting the experience of some travellers and making them paranoid... for no valid reasons.

Here are some of these idiotic things that you shouldn't really listen to.

Ice cubes: don't worry too much; no one will give you ice cubes with tap water

Ice cubes made with tap water that cause diarrhea are a problem... in Europe, and elsewhere where water is drinkable.

In Bali, no one (except the really crazy ones) makes ice cubes with tap water, which is not drinkable, should I remind you. Almost everyone buys ready-made ice cubes at the supermarket, and others make ice cubes with drinking water.

In tourist restaurants, you have no chance of getting ice cubes with tap water, well water, or sewer water. Even in warungs, it's extremely rare.

Street food / warungs: most warung and street food dishes are rather safe

Some travellers go as far as avoiding warungs or street food for fear of getting sick. In truth, the vast majority of Indonesian dishes found in warungs are quite safe for several reasons:

  • Meats and vegetables are always cooked.
  • Many dishes are deep-fried.
  • Many dishes are soups.

In short, don't deprive yourself too much if you want to try local food. You have more chances of getting sick with a smoothie or a fruit salad in a fancy western hotel / restaurant than getting Bali Belly after nasi goreng or soto ayam.

Tooth brushing: you can brush your teeth without a problem

I've heard people say that you supposedly need to brush your teeth with mineral water in Bali... yes, yes.

Well, unsurprisingly, it's not really (at all) necessary, unless you swallow the rinse water, but then it's more about your brushing technique than anything else.

Bali's tap water is certainly not drinkable, but tap water remains well water or filtered public water, not sewer water, which is more than enough for brushing your teeth, showering, washing your car, or watering plants!

Some Indonesian tips and medicines to know if you have Bali belly during your stay

What to do if you already have Bali Belly in Bali? Here are some tips.

Activated charcoal or Attapulgite can help you recover from Bali Belly and make it almost bearable

Activated charcoal is an almost miraculous and natural remedy to alleviate the effects of Bali Belly.

Charcoal can not only absorb the bacteria that may have infected you, but it also slows down transit to reduce diarrhea.

If you have a virus like gastroenteritis, it won't be enough to treat the cause, but it can considerably make the symptoms more bearable.

Activated charcoal can be found almost everywhere in Bali's pharmacies and other organic stores. Otherwise, Attapulgite is sold in tablets in almost all minimarts and is essentially the same thing.

Tolak Angin (and other herbal medicines): widely used by locals when they have diarrhea

tolak angin bali belly

Tolak Angin is small packets made from honey and essential oils found in all Indonesian minimarts.

Indonesians consume them for masuk angin, literally "the air that has entered you," meaning all illnesses that could be called a "cold," but also diarrhea. Tolak Angin also helps with digestion, which can be handy if you're nauseous or bloated.

Two other popular products for diarrhea that are found everywhere are called Diapet, which is also an herbal solution, in capsules this time, and Entrostop, which is based on attapulgite and plants.

Bring Nifuroxazide from your country can be a safe precaution

The Nifuroxazide, known as Ercefuryl in France, can also be useful if you have Bali Belly, at least if its cause is bacterial.

Anti-diarrheal medications (Imodium...): as a last resort only

Like in most countries, there are many loperamide-based anti-diarrheal medications that simply block your transit, available over the counter in most pharmacies in Indonesia.

These medications are indeed effective, but they do not address the cause and remain more dangerous than tolak angin, activated charcoal, or other solutions that do not block your intestines. Every year, there are accidents and intestinal obstructions with these kinds of products.

It's better to avoid them unless you are really in a situation that requires them.

In case of persistent or severe symptoms, consult a doctor

If you have severe symptoms that you think are attributable to Bali Belly, do not wait and go to a hospital.

Symptoms like these should alarm you:

  • High fever
  • Blood in the stool
  • Dehydration
  • Dizziness
  • ...

Similarly, if your children are affected, it is better to seek the opinion of a medical expert rather than improvise anything.

Conclusion

Bali Belly is certainly very common but generally mild and not very intense.

To protect yourself, pay attention especially to anything that is not cooked, which includes fresh fruits, fruit juices, smoothies, or vegetable salads that are much more at risk than the rest.

Don't shy away from street food and warungs because you think that it might make you sick. It's actually quite unlikely since almost everything is cooked or fried!

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