How Not To Spill Your Guts
Tummy trouble can spoil summer, here's how to avoid retching and the runs.

November 24, 2014

spill your guts

Every new year’s eve, you see colourful explosions. They’re 
usually a few hundred metres up in the air and elicit oohs and aahs. But if you’re unlucky, they can also erupt in the toilet and prompt prayers for a quick death. Summer is the season for braais, pool parties and camping trips – all 
settings that can light the fuse of gastrointestinal fireworks. In part, that’s 
because common triggers for vomit and diarrhoea – such as bacteria, viruses and parasites – never go on annual leave. But it’s also because summer is the season when you’re most likely to be visiting Hangoversville and taking a motion sickness-inducing boat or plane to get there. Don’t waste these months holed up inside the bathroom. We’ve assembled a survival guide that will help you squeeze the most out of summer – but not like that.

Unless you’re a model of self-restraint, you know what happens when too much booze goes down the hatch: you puke. But there’s also a hidden toll, including damage to your stomach lining, which can cause a painful condition called gastritis, says Greenwald. Add to that the GI abuse wrought by the byproducts created when you metabolise booze, such as congeners and acetaldehyde, and tying one
on seems more like pouring down poison.
shield your stomach
Stick to two drinks a day or less, and pace yourself at one per hour – your body can metabolise alcohol at about that rate, neutralising some of its effects, says Professor Alyson Mitchell, a food chemist at UC Davis. And any time you’re waffling about what to order, stick with clear liquors, which have fewer congeners.
calm the chaos
If you overimbibe, don’t attempt to head off a headache with aspirin, which can further irritate your already inflamed stomach lining, Rizk cautions. Paracetamol is worse: to process this chemical, your liver makes an enzyme called p450 – the same one it uses to break down alcohol. Since your liver can produce only a limited amount of p450 at once, you risk damaging the organ with unprocessed alcohol and those Panado you’re knocking back. Ibuprofen is the lesser evil, but frequent use may also cause ulceration in your GI tract. So go drug-free: place an ice pack or a warm, moist cloth – whichever feels better – on your head and neck. To relieve lingering nausea, stay hydrated and eat eggs – they contain cysteine, a compound that helps clear acetaldehyde from your system, Mitchell says. Or make an omelette with a cysteine-rich cheese, like Swiss.

When you’re on the ocean or in the air, your stomach may decide it’s time to show everyone what you ate for lunch. Blame an evolutionary glitch in your operating system, says Lee. He speculates that when something jostles the motion sensors in your ear, your brain interprets it as a sign you’ve ingested a hallucinogenic toxin and induces vomiting to eliminate it.
shield your stomach
En route, sit where there’s minimal motion – the front seat of a car, over the wing of a plane or the front or middle of a ship near water level. Then stare at the horizon. This helps your body distinguish between the motion of the vehicle and that of your body, say University of Minnesota researchers. At the same time, add Coldplay to your playlist. Researchers in Germany found that listening to relaxing, pleasant music helps stave off motion sickness better than jamming to livelier tunes or sitting silently.
calm the chaos
The problem is in your head, not your stomach, so remedies like Gaviscon won’t help much, Lee says. Instead, pop ginger root (try Nature’s Way, R330 for 100, 550-milligram capsules, A dose of two to four grams has been shown to ease motion sickness, Lee says, perhaps because a compound called 6-gingerol slows nerve transmissions that tell your guts to rumble. Then strap on SeaBands, a knitted elasticated wristband, which operates by applying pressure on the Nei Kuan acupressure point on each wrist by means of a plastic stud (R120 for two wristbands, Dischem).

Summer is wedding season (yup, turns out there’s a season for it)… and that could spell “best man speech”. If you feel sick before your big moment, blame the gut-brain connection, says Dr Roshini Raj author of What the Yuck?! The Freaky & Fabulous Truth About Your Body. Anxiety sends stress hormones surging through your bloodstream and eventually to your stomach, where receptors pick them up and start your intestines on a roller-coaster ride. This leads to nausea, cramping and that gotta-go feeling, Dr Greenwald says.
shield your stomach
Tell your stress that it’s game on! In a Hunter College study, anxious presenters who played a mobile phone game before speaking showed less stress reactivity, the juiced-up sensation that can rumble guts. Try chilled options like Zen Puzzle Garden and Stress Popper, or blast-the-screen 
numbers like Stress Baal (all available on 
the iStore).
calm the chaos
Even if you think you won’t be coherent without coffee, skip it. Caffeine will kick up your nerves and the acids may amplify gut troubles. A better hot option: peppermint tea. A study review in the Journal of Alternative and Complementary Medicine suggests that this minty brew calms queasiness, perhaps by relaxing stomach muscles. And UK research shows that the scent of peppermint can also increase alertness. Try Wake-Me-Up Peppermint Tea
(R18.95 for 20 bags, Woolworths).

You didn’t invite E. coli to your braai, but this bug – and its chums Campylobacter and Salmonella – may crash anyway. They’ll incubate on undercooked meats, creamy salads and egg-based sides sitting in the sun. You may not realise they made an appearance until later, when you see their calling cards in the toilet.
shield your stomach
Bacteria bask in the sun, but they can’t take real heat. Braai ground pork or beef to an internal temperature of at least 70°C, poultry to 75°C and steak to 65°C. Like your burgers rare? Shop-bought mince can be contaminated by cows’ intestines (E. coli’s prime hangout), so grind beef yourself or ask a butcher to do it, says gastroenterologist Dr Maged Rizk. Then carry burgers to the braai with a Large Divided Dish (R155,, to prevent cross-contamination. Now to make sure your deviled eggs don’t cause you to upchuck like a man possessed, go to the other extreme. Keep these and other foods in a cooler with large blocks of ice. (Freeze water bottles or milk cartons the night before.) Discard anything that’s been out two hours or more – or an hour if the mercury cracks 33°C.
calm the chaos
Most guys with the runs run to remedies like Imodium. Skip these if you see blood or slimy, gloppy mucus – signs of bacteria at work. Stifling the shits can cause toxin buildup, damaging your intestines. Instead, replace the fluids you’re ejecting by drinking plenty of water. Also, eat potassium-rich foods, like bananas and potatoes. (Peel the spuds to limit fibre.) Still perched on the porcelain after three days? Phone your GP. Make it sooner if you have severe abdominal pain, bloody diarrhoea or vomit, or a fever above 38°C. These symptoms may indicate that bugs have spread outside your GI tract, requiring antibiotics, says gastroenterologist Dr Daniel J. Stein.

Although they travel incognito as “stomach flu” and stow away on cruise ships, norovirus and its cousins have nothing to do with influenza. In fact, as they release toxins that send your guts into panic mode, they make the seasonal flu seem mild. Your intestines push water, sodium and potassium into your gut, leaving you with watery diarrhoea and a serious electrolyte shortage, says Dr James Lee, a gastroenterologist.
shield your stomach
Just one encounter with an infected person or a contaminated surface is enough for norovirus to turn your world – and stomach – upside down. “Often you can’t do anything to prevent yourself from getting it,” says gastroenterologist Dr David A. Greenwald. Still, you can lower your odds by washing your hands regularly before and after handling food or performing any, um, toilet-related tasks, such as wiping yourself or someone else. (Yay, nappy duty!) Scrub with soap and warm water for 20 seconds, especially if someone you know has had a stomach bug. Even if the victim claims to feel fine, don’t buy it – some people remain contagious for weeks after symptoms abate.
calm the chaos
It can feel as if your butt will never leave the bowl: your body may need two days to clear the virus. As you wait, it’s safe to slow the flow with Imodium. And drink a glass of clear liquid after every toilet trip, says Lee. Stick with water or a hydration drink for diarrhoea, like Rehidrat. You can also try a low-sugar sports drink. Avoid the regular kind – sugar pulls more fluid from intestinal cells, worsening diarrhoea. Warning: if you lose more than 5% body weight within a day, see your GP – you may need IV rehydration to prevent complications like brain swelling, seizures and even kidney failure, says Rizk.

Wildlife can ruin your camping trip without lifting a hoof: if Bokkie (or any animal) takes a dump near a stream that you drink from, you could be exposed to the parasites Giardia and Cryptosporidium. Other avenues for ingesting this duo include pool water an infected person swam in or unsanitary tap water. If these bugs latch onto your gut, you’re in for weeks of diarrhoea and stomach cramps.
shield your stomach
Tote H2O. For day hikes, take about 400ml for every hour you plan to walk; for longer trips, you’ll need about 7.5 litres a day, says Andrew Skurka, author of The Ultimate Hiker’s Gear Guide. For refills, pack a SteriPEN Emergency Portable UV Water Purifier (R719, When placed in water, its ultraviolet light kills 99.9% of waterborne illness-causing bugs. Or get some Aquatabs, tablets ideal for treating water when travelling (R40 for 50, Sportsmans Warehouse) – pop one in, wait 30 minutes and enjoy clean, bacteria-free water. Keep in mind that these won’t protect you from fruits and vegetables that washed in contaminated water.
calm the chaos
See a doctor if you suspect traveller’s diarrhoea. Most cases are bacterial and clear up in a few days, but if it lasts for weeks, odds are you’ve ingested Giardia or Cryptosporidium and need antiparasitic meds. Worst case: you experience respiratory symptoms, such as shortness of breath. If that
happens, call your doc stat, says Rizk – parasitic
larvae might be hatching in your lungs!