Who wants to spend days in bed, crippled with pain, when you could be soaking up the sun with a coconut in hand, catching a tan? Travel might broaden the mind, but unfortunately it also increases your risk of picking up a nasty bug. Worldwide, ‘Bali belly,’ also known as the less catchy ‘traveller’s diarrhoea’, affects an estimated 20-50% of visitors to developing countries [1]. Here, I’ve dug deep to investigate which foods can help speed recovery and what you can do to avoid Bali belly.
Whether you’re planning a trip to Bali, already in the ‘Isle of Smiles’, or just keen to learn essential health tips, this post is for you 📖
Jump to a section:
- Symptoms of Bali belly
- What causes Bali belly?
- How to prevent Bali belly?
- The phases of Bali belly recovery – and how to deal with them
- The annoying truth about antibiotics
- Natural remedies for Bali belly
- Conclusion
What are the symptoms of Bali belly?
In the very early stages of Bali belly, you might feel bloated, feverish, and generally off colour. Within a day or two, the following symptoms of Bali belly can arise:
- Stomach cramps
- Fatigue
- Fever
- Vomiting
- Diarrhoea
- Loss of appetite
- Dizziness
Additionally, dehydration can also occur due to fluid loss, which is why you need to drink water and electrolytes [1, 2].
How long does it last?
Recovery from Bali belly usually takes 1-5 days (I’d say a few days, 1 is very optimistic). Seek medical attention if symptoms persist beyond 5 days: prolonged Bali belly can damage your gut lining, causing digestion issues even after you’ve recovered.
The symptoms of Bali belly can start within 1-45 hours after ingesting contaminated food, although in rare cases they may appear weeks later [3, 4].
What causes Bali belly?
Bali belly, or gastroenteritis, refers to a digestive illness and can be caused by a range of pathogens: bacterial, viral, and parasitic. Common viral infections responsible for Bali belly include the rotavirus and norovirus [5]. For bacterial infections, Escherichia coli (E. coli), Shigella sp., and Salmonella are frequent culprits. Parasites such as Giardia lamblia found in freshwater can also cause Bali belly symptoms [2, 3, 4].
Travellers typically get Bali belly by ingesting unsafe food or water.
Contaminated water.
The top way to avoid getting sick?
Don’t drink tap water, and avoid any ice! If you’re a tea drinker like me, you’ll be happy to know that boiled water (boiled for at least one minute) is safe to drink and cook with 🫖
- Drink only bottled or boiled water
- Say no to ice (unless its made from drinkable water)
- Daily reminder: brush your teeth with bottled water
- Avoid ingesting shower or pool water
Contaminated food.
The second top way to avoid Bali belly?
Be careful what you eat!
During my Bali visit, I remember scooting through Jimbaran, a busy suburban area in the south, when I glanced over at the street vendors. Out the front of one stop sat dozens of chicken skewers sitting on the road. They were packed in mini plastic bags, glistening pink, and fogging up in the intense sun. I couldn’t help but wonder which unfortunate soul was going to eat one for lunch, totally oblivious to their midday siesta.
Food, especially meat, spoils quickly in the tropical heat. Old rice is also notorious for being a bacterial breeding ground and can cause lethal food poisoning. Also, avoid any foods that have been washed in tap water, like salads.
Food tips to avoid Bali belly
Avoid meat and rice that haven’t been cooked fresh
- Don’t risk the leftovers that have been sitting out for hours at that cute warung down the street…
- Beware of water contamination on salads and wet glasses/utensils
- Steer clear of seafood (from experience, that beautifully presented tuna sashimi is not worth the risk)
- Eat well cooked food (this helps kill parasites, such as those found in pork and fish)
- Opt for peel-able fruit like bananas, salak, and mangosteen (not washed)
- Sanitise your hands before eating or touching your face
- Read restaurant reviews! 👀
Exceptions: Some popular places in Bali take extra measures to use filtered water for drinks, ice, and to wash leafy greens. However, it’s safe to assume this is not the norm.
The phases of Recovery
1. The early phase:
A niggling ‘uh oh’ thought enters your head. My stomach really doesn’t feel quite right. What should I do?
Prepare. If you have a typical case of Bali belly, expect to be recovering for at least three to five or more days.
- Have a safe and comfortable place to rest
- Have a toilet nearby
- Know the location of the best nearby medical clinic
- Ask a friend or sympathiser to check in on you regularly
2. The mid-stage:
POV: you’re in bed the entire day, barely moving, and thinking… ‘why did I ever come to Bali?’ During this tough period, helpful medications and therapies include:
- Anti-nausea and anti-diarrhoea tablets
- Paracetamol for stomach cramps (provided it doesn’t interfere with other medications)
- And continue to stay hydrated and take electrolytes…
For severe cases of prolonged vomiting, diarrhoea, or dehydration, seek medical attention immediately. IV drips can also offer relief.
The annoying truth about antibiotics:
I know how tempting it can be to take an antibiotic as soon as you get sick, but antibiotics are only effective for Bali belly caused by a bacterial infection. Taking antibiotics if you have viral or parasitic Bali belly won’t help at all, and could even do more harm than good [3]. To find out what type of infection you have, consult a doctor.
How do I get an IV drip for Bali belly?
Many medical clinics in Bali offer phone consultations and will send a doctor or nurse to administer an IV drip at home, delivering electrolytes, vitamins, and, if needed, antibiotics. They will then monitor your progress and remove the IV drip after an agreed period of time.
Cost: This service can range between $150–350 NZD. I haven’t used it myself, but many Bali Belly sufferers have told me it was a life-saver!
3. The recovery phase
Things are looking up!
Continue to drink bottled water with electrolytes to replenish your essential fluids and salts. During this phase, you may want to try some ‘light’ foods like:
- Bananas
- Rice crackers
- Yoghurt & honey
- Boiled vegetables
- Black or green tea
- A thin soup or gruel
- Boiled white rice with salt
- Electrolyte drinks: e.g. coconut water, Pocari sweat
Steer clear of alcohol and foods that may upset your stomach – like fatty meals, dairy, or gluten. Your digestive system needs a rest!
Natural remedies for Bali belly: do they really work?
Studies examining the effects of certain foods and natural remedies on Bali Belly are limited – made harder by the fact that it is a catchphrase for a range of digestive illnesses with different causes. Based on what I’ve found, for bacterial-based Bali belly there are some remedies that may help:
1. Probiotics & Probiotics
If your digestive system was a garden, your gut-friendly bacteria would be the flowers, while invasive types of bacteria that cause illnesses, would be the weeds. Seeing your gut with probiotics (strains of gut-friendly bacteria) in theory makes it harder for bad pathogens to take root. Taking probiotics can also help restore your gut microbiome after taking antibiotics (which essentially strips both the good and bad gut bacteria from your system), and help shorten the duration of illness [3]. Scientific research is limited, although there is evidence that certain strains like Saccharomyces boulardii, might reduce the incidence of gastroenteritis [5]. Probiotics are available in tablet form (they often need to be kept cool) and products like Yakult.
Prebiotics are like the fertilizer for your gut – feeding your gut-friendly bacteria – and include a range of fermented and high fibre foods. Eating these may also help restore your digestive system after Bali belly [5, 6].
My secret weapon! In Bali I stayed in remarkably good health, and my go-to sweet snack was MOO Coconut Yogurt, available at PepitoMart. Not only is it 10/10 delicious, but it contains five strains of gut-friendly bacteria. Many other yoghurts also contain probiotics. Look for one with low sugar content to enjoy the best health benefits.
Note: Seek medical advice before using high strength probiotics if you are immunocompromised or under 18 years.
2. Manuka honey
Another secret weapon: not many travellers know about this one, but they should! High quality manuka honey has anti-bacterial properties, and has been shown to help kill certain nasty types of bacteria like E. Coli [7, 8]. You probably won’t find it in Bali, so I recommend bringing your own UMF 10+ honey from New Zealand. The UMF rating refers to the honey’s ‘anti-microbial factor’. A UMF of 10+ is the minimum standard for health-related use. Plus, it tastes amazing with pro-biotic yoghurt!
3. Raspberry juice
Berries are full of beneficial bioactive components and play an important role in digestive health [9]. I didn’t notice many fresh berries for sale in Bali, but according to research, raspberry cordial or juice may be your best bet: these have anti-bacterial properties which may help thwart the bad bacteria that cause Bali belly [10]. Just check that your cordial or juice is made from actual raspberries, not artificial flavouring!
4. Activated charcoal
Charcoal has been used throughout the ages to help with poisonings by trapping toxic compounds in the gastrointestinal tract and enabling their expulsion [11]. Although there’s been more research on its applications for cases of chemical poisoning or intoxication, it may also help control diarrhoea [12]. As with any natural remedy, the quality of the charcoal appears to influence its efficacy and do not exceed the recommended dose.
Conclusion: How to Avoid Bali Belly
Bali is a dream destination for many, and like any foreign country it has its share of unexpected surprises. But nothing ruins a trip faster than getting sick! To avoid Bali belly, always drink bottled or boiled water, steer clear of street food that’s been left in the heat and opt for freshly cooked meals. Be extra cautious with salads, ice, and seafood, as these can harbour harmful pathogens. Maintaining good hygiene—such as sanitising your hands before eating—is also essential. If you’ve caught Bali belly, focus on staying hydrated and replenishing electrolytes. In the recovery phase, you may want to try the foods above to help restore your gut health. But as they say, prevention is better than cure!
Are you a Bali belly survivor?
What worked best for your recovery? Share your tips in the comments below 🙂
How fantastic! What a great memory to have, your uncle definitely knew how to bring the fun 🙂