It’s been a hot minute since I’ve posted on the blog and it’s simply because life got busy. New job, nutrition school, big move to a new state, honeymoon in Bali — I’ve barely been able to keep up!
Today I want to talk about something I myself experienced while overseas, despite taking extra precautions to stay healthy, and that is: Bali belly. If you’ve ever been to Bali then you may already be familiar with it.
There are plenty of resources out there on the internet that describe this in full detail, so I’ll be brief. Bali belly is a sudden onset of diarrhea as a result of consuming bacteria from contaminated food or water. These bacteria are mostly e coli, shigella and salmonella. You are also at risk of contracting a virus like norovirus or parasites like giardia lamblia. The tropical climate and lack of knowledge around food preparation and storage create the perfect storm for contracting certain food borne and water-related illnesses.
A normal person with a healthy gut and immune system (such as my guts-of-steel husband who rarely ever gets sick… unlike me!) may be able to ward these bugs off more easily than someone who already has a compromised digestive tract and struggles with gut issues like leaky gut, IBS/IBD, autoimmune disease, Crohn’s disease, and so on. This is because those with gut troubles are missing some of the good gut bacteria and stomach acid needed to kill foreign invaders from the start. Your stomach is HIGHLY acidic, and for good reason: it is supposed to stop and kill any bacteria/parasites from passing into your intestinal tract where they form a new home.
As someone who has been host to parasites for a while now, I can attest to how this could go unnoticed without proper education and the wrath it can cause on your life and wellbeing.
That’s why I went to Bali with a plan. It wasn’t a perfect plan, but it was a solid plan to help keep me from being re-infected or contracting something worse.
That said, I unfortunately, still got sick in Bali, multiple times. And I have only myself to blame. Here’s the thing. I wanted to enjoy vacation and eat certain foods to a degree that I thought would be safe. The trouble with Indonesian food for someone like me who is already battling parasites, IBS and healing from leaky gut, etc. is that I couldn’t have a lot of the local foods: carbs (aka rice, which is bountiful in Bali), anything with sugar (desserts), raw/uncooked foods, and anything too spicy, so it was a real challenge. Because of this, there were a few hard and fast rules that I didn’t break while others I was more lax with, and I most likely suffered as a result of this. But what could I do? I couldn’t starve myself for two weeks, and while I came prepared with snacks, it wasn’t enough to subsist on without additional nourishment. Such is life.
I’ll share some general tips as well as my own personal learnings/missteps.
Do not drink the tap water, even to brush your teeth.
My husband and I watched YouTube videos ahead of time and that was one of the recommendations, but most people agreed it was fine to rinse your mouth with the tap water, as long as you didn’t swallow, so I didn’t think it was a big deal. Looking back, I probably should have just brushed/rinsed with bottled water. Why shouldn’t you drink tap water? Well, the water in Indonesia in general, while it is treated at water treatment facilities, there’s the risk of domestic sewage, industrial effluents, agricultural runoff, and mismanaged solid waste polluting the water. In fact, Indonesia ranks among the worst countries in Asia in sewerage and sanitation coverage, and especially in Bali where the weather is tropical and the water pipe infrastructure is poor, there’s a risk of the tap water containing pathogens like bacteria, viruses and other microorganisms. That’s why it’s recommended to drink only bottled water/beverages or boil the water beforehand.
Only drink beverages with ice if it is filtered.
Similar to the above, you just don’t want to take the risk. Most restaurants, especially hotels and reputable eateries will use ice from filtered water, or boiled tap water, but you never know. I did have ice in some of my drinks at our resorts and prominent restaurants because it was so damn hot, but again, maybe not the wisest choice.
Don’t eat any raw or uncooked foods. Period.
This one really sucks and was by all means the hardest to stick to, but it was also the one rule that I simply did not break. One of the reasons I contracted parasites in the first place was from being raw vegan and eating at raw vegan restaurants that probably did not have proper sanitation, even in the U.S. Raw fruits can contain parasites and other bugs that could infect your gut and raw greens (especially spinach) are host to bacteria like e coli and others. That’s why you should not eat any raw fruit or vegetables while in Bali. It’s just too risky, which is a bummer because Bali is known for its tropical fruits like dragon fruit (pitaya) and especially those beautifully photogenic acai and pitaya fruit bowls which are oh so dreamy and refreshing. It was really hard taking a pass on those, but I held strong.
For other bacteria, spinach and greens are susceptible to e coli. The good news is that e coli can be killed by cooking greens at 160 degrees Fahrenheit for 15 seconds.
Some places will advertise that they triple wash their fruit/produce with tap water and proper produce washes, and it’s up to you if you want to take the chance or not. At the first resort we stayed at in Ubud (Tanadewa Resort), which was less than 5 months old (opened in March 2019), I found a worm, most likely fruit larvae. Word to the wise — don’t stay here.
We actually moved to an Airbnb (Kubu Dharma in Penestanan, owned by Komang and lovely family) a few days into our stay because we couldn’t stand the food. Quality was terrible, and it was too far from the city center to go anywhere easily.
Don’t eat undercooked meat, and minimize/avoid pork.
Raw or undercooked meat, if not handled or stored properly, can become a breeding ground for bacteria. And pork is one of the biggest causes of parasite contraction, mostly because pigs are themselves are dirty and are host to parasites. Some of these parasites are not easily killed, even in cooking. There are many reasons why pig meat is easily contaminated, and you can read more about that here. I generally avoid pork, but when it became apparent that the only thing I could eat for breakfast were eggs and some kind of meat (especially bacon), I caved and ate bacon. I picked out the pieces that looked the most cooked but, I ate it, and usually I got sick after eating it. Lesson learned, I guess.
Don’t eat from questionable restaurants or road-side warungs that have food sitting out.
As already mentioned, most of the local street vendors/restaurants in Bali, also known as warungs, are run by local/small families and they may not be properly storing or cooking their foods. At a resort or reputable restaurant, you are likely safer, but still, the warm tropical temps create a breeding ground for bacteria, and food transportation is always unknown. There are so many warungs peppered across Bali, lining the streets, welcoming travelers to stop in for a bite of the local cuisine. If you see food sitting out, it’s best to skip it and move on. Food that has sat at room temperature for an extended period of time is typically full of bad bacteria. We were very careful about this ourselves, but to be honest, it didn’t seem to matter. I still got sick after eating food at our resort, which was a 5 star Radisson hotel and at other reputable restaurants. However, it’s hard to know if these places made me sick, if I was already sick, or if it was the hot chili peppers that caused digestive upset, which is common for me.
Consider taking digestive enzymes, vitamins, HCl and anti-parasitic herbs to give your gut proper support to help protect against foreign invaders.
I had a plan with my acupuncturist to try to reduce the risk of me being re-infected with parasites or other bacteria. I would up my level of digestive enzymes to take them between meals, too. Digestive enzymes help your body break down the macro nutrients (fats, carbs, proteins) when taken just before meals, but they are also important for restoring your intestinal tract to its normal state, making it unlivable for parasites. I also was taking a blend of traditional Chinese herbs that are anti-parasitic in nature to help keep things in order. I was also taking multi-vitamins to provide me with the minerals and nutrients I need to keep my immune system functioning on all cylinders. Another thing to do might be to take hydrochloric acid pills/tablets before meals if you suspect you have low stomach acid. This will ensure that your stomach is acidic enough to kill any unwanted bugs before they enter into your GI tract.
Find a good probiotic drink like coconut kefir to give your gut a dose of healthy bacteria.
I know this runs counter to my “don’t eat anything raw/uncooked” tip, but this was the one exception I made in Bali because a fermented drink is much different than plain old water. Kefir is a fermented beverage containing live enzymes and probiotics that can help restore the gut by providing healthy bacteria that fight infections, parasites, etc. Coconut kefir is made from coconut water, and coconuts are very popular in Bali! I found the best coconut kefir at a place in Ubud, called Alchemy. It’s a raw vegan restaurant and the only thing I got there was the coconut milk latte and cocobiotic drink. There was another beverage I found, Covita, which was made from fermented cactus. These drinks are low in sugar, which is good for preventing parasites.
Maintain general hygiene.
As with anywhere you are, it’s always best to wash your hands before and after meals, and going to the bathroom, but I am always cautioning people of anti-bacterial soaps because they also damage the good bacteria on your skin, the kind you need to ward off intruders. I brought with me my Dr. Bronner’s nontoxic castile soap to use in our hotel. I usually have a travel bottle of this soap with me at all times, I did not take it with me to restaurants, but maybe I should have! Also, try not to touch your face or mouth with your hands, which is easier said than done, but it’s one of the easiest ways to infect yourself with bacteria!
So that’s prevention, but what to do if you fall ill when in Bali (like I did) and it’s too little too late? Well, first things first, continue to follow the above steps. These preventative measures will still go a long way to helping ensure you aren’t continuing to consume food or water that is contaminated, and will help you recover faster. There is no real “cure all,” but there are some natural things you can do and take to help your body heal faster so you can get back to enjoying vacation. In addition to the above, also try to do the following things:
Stay hydrated and consume adequate electrolytes.
When you have chronic diarrhea, such as with food poisoning/contamination, you are easily depleted of nutrients and water. Staying hydrated, especially with the heat and humidity is key. Remember – bottled water only! And try to consume electrolytes. You can get this a few ways. One way is to sprinkle sea salt into your water for minerals/electrolytes. If you are wary of the salt in Bali, perhaps think ahead and bring some electrolyte tablets with you like I did! I generally advise against conventional sports drinks like Gatorade or Powerade because these are mostly sugar and artificial ingredients.
I like Nuun hydration tablets because they are low sugar/carbs and also have vitamins in addition to minerals/electrolytes. I drank this religiously throughout our trip to Bali. You can also consume the coconut kefir drink (probiotics will be your best friend when recovering from food poisoning) or coconut water, but I would practice caution with coconut water. Just be sure that it’s fresh and that it’s served inside the coconut (aka the original source).
Drink calming herbs/teas like ginger or antibacterial herbs like garlic, apple cider vinegar, basil, etc.
I understand that you might not have access to these things while on an island like Bali, but you can either plan ahead or wait until you return home if you are still ill. Ginger tea is great for soothing the digestive tract. The one thing I will say is that real ginger tea is available all over Bali, and because the water is boiled, it’s relatively safe to consume. I drank a lot of fresh ginger root tea to help calm my system as well as aid in digestion after meals. But I also brought organic ginger tea bags with me for the airplane ride and for when fresh ginger tea wasn’t available. Garlic is an herb that has been used for many years to treat parasites and bugs because of its antiviral, antibacterial and antifungal properties. Some people even drink garlic juice to help with diarrhea. Apple cider vinegar (with the mother) is also great for killing bacteria and soothing the gut lining. You want to dilute it in water, usually warm/boiled water and sip before and after meals as a digestive aid.
Get plenty of rest and try to avoid those problem foods.
Rest on vacation should be a good thing, just as long as you are staying properly hydrated and don’t get a sunburn! Your body doesn’t need more damage to fight off! You can also try to avoid problem foods that exacerbate diarrhea like milk and other dairy products, caffeine, greasy/fatty and spicy foods, as well as alcohol. Again, easier said than done in a place like Bali where spice is at the epicenter of most traditional dishes. This was a big problem for me. My body is not used to spicy foods and almost everything I ate had chili peppers or some sort of spice, even when I specifically sought out foods that weren’t supposed to contain peppers, it ended up being in the dish in some way or the other. Same goes for greasy/fatty foods, which is also in abundance in Bali. What made it worse was that I couldn’t consume carbs for fear of parasites feeding on the starches/sugars, so that left out a bland diet with rice or simple grains/carbs, which is usually a good idea to consume when one is sick with food poisoning.
Keep your immune system strong with supplementation of lysine, echinacea, vitamin C, propolis, licorice, etc.
Unfortunately, you’ll either have to bring supplements with you or wait until you get home. While there are pharmacies around most places in Bali, you won’t have wide access to holistic herbs/medicines like we do back in the states. I brought my supplements with me (I take Nutrient K950 from Pure Encapsulations) and when I got home, I started taking SuperLysine immune support from Quantum Health to ensure that I maintained a strong immune system.
You’ll notice that I left things like antibiotics and over the counter anti-diarrhea/stomach ache meds off of this list. Here’s the thing about food poisoning – you kind of just have to wait it out. Many conventional doctors will tell you to take over the counter solutions like Imodium or Tums for diarrhea/upset stomach, or painkillers/aspirin, or even worse, prescribe antibiotics to treat parasites. While I am not a doctor, and this is not intended to be medical advice, I strongly advise against this. The reason being? These man-made solutions can do more harm than good. Antibiotics are known to kill off your good gut bacteria, which has negative long-term effects and can actually exacerbate symptoms and lead to constant re-infection because your first line of defense — good bacteria — is gone. Pain killers like aspirin and NSAIDS may provide an immediate relief, but they have been shown long-term to destroy the gut lining and also increase the risk of heart failure.
And lastly, over the counter antacids and anti-diarrhea medications are also shown to have negative effects on the body. While your first thought is to stop loose stools right away, taking these meds can actually lead to constipation, and can keep the bacteria and toxins in your body for re-absorption, which is bad. Believe it or not, diarrhea is a way for the body to purge itself of unwanted bacteria, parasites, etc., so this is, in a way, a good thing — a sign that your body is trying to get rid of the bad and help heal. Chronic diarrhea, however, is serious and if persists for weeks at a time, best to consult a doctor.
Maybe it was the bacon. Or the tap water I brushed my teeth with. Or something else. I will likely never be able to know what caused me to get sick despite trying to do all of the right things. Did I get e coli somehow? Or was it a parasite? Or perhaps a virus? Unless I am tested, all I can do is take an educated guess and do what I can to heal. The good news is that these are all things I can overcome, in due time and with proper supplementation and nutrient support.
I knew it was a risk traveling to a place like Indonesia with my already compromised gut, but I didn’t want to simply stop living my life. I am not my illness. It does not define me. It shouldn’t define you either.
Bali is where we decided to go for our honeymoon. Might it not have been safer to go somewhere in the states? Probably. Would it have been any different in Mexico or another tropical island? Most likely no — the same risks would be there. Life is all about taking calculated risks and enjoying every moment. I can’t say I enjoyed being sick in Bali, but I can say that I didn’t let it completely ruin our trip. I am very thankful to have an understanding and caring husband who supports me, and I am grateful that we were able to take this trip together to celebrate the beginning of a lifetime together.
My point here is that you can follow all of these steps, and still get sick. And that’s life. I definitely didn’t waste my time by being so cautious. It probably kept me from getting sicker. But in the end, I still wasn’t immune. But that doesn’t mean that my preparation wasn’t worth it. And I hope that this article helps others getting ready for a big trip overseas from getting too sick and not being able to enjoy their time in a beautiful place.