Well, since I’ve spent the past two days sick and in bed it seems like the perfect motivation to talk a little bit about getting sick in Thailand and Bangkok. It’s true that many travelers to Thailand experience diarrhea and if you know some Thai’s you’ll find out that even they can fall to the bacteria, but there is very little chance of anything serious.

Thai food is amazing and eating is part of the experience of this wonderful culture. Take a few simple precautions and you’ll run little risk of getting anything more serious than some passing intestinal problems.

There are many intestinal parasites, bacteria and viruses which can be transmitted via food, water and eating utensils. Usually, the most serious one is hepatitis A.

The number one thing you’ll want to do before traveling to Thailand is get a hepatitis A vaccination. Learn more about hepatitis A here

Some other things you can do to protect yourself while in Thailand are to avoid drinking the tap water. While it is said to exceed cleanliness specifications it is not recommended for drinking. You can use it to brush your teeth. Many expats in Thailand will also use it for cooking since boiling will kill any bacteria present. Typically though people drink bottled water here and that includes the Thai’s. Take note that water is not sterilized by freezing so try to avoid ice as well, although I know this can be difficult and I don’t generally follow my own advice regarding ice.

When deciding what to eat in Thailand a little bit of common sense can go a long way. Food from major hotels and restaurant chains are usually safe to eat. Even from sidewalk vendors the food is generally safe. A good practice to follow when choosing a sidewalk restaurant is to go to places that have a lot of Thai’s eating there. Trust me, the locals know which restaurants to avoid.

Avoid places where the food appears to have been sitting for a long time or where there is an abundance of flies. Make sure the food you’re eating is cooked properly. Most problems come from undercooked foods, foods that have been sitting for a long time after cooking and foods handled by vendors who are not sanitary with their hands, especially fruits and vegetables.

Many Thai dishes are spicy as is typical of tropical regions. This is because some spices help to preserve foods from the rapid onset of bacteria. However, spices can also cause stomach upset among those who are not accustomed to eating them. If this is you, eat spicy food in moderation when you first arrive in Thailand.

Most importantly – Do Not Eat Shellfish! This means no clams, mussels, oysters and even prawns. Even though Thai’s can eat them all the time without any problems many expats and visitors to Thailand have gotten very sick after eating shellfish in Thailand. The two times that I’ve been the most sick in the past 10+ years of visiting Thailand were once when eating fried rice with prawns from a vendor in Nontaburi and once when eating sushi in Bangkok. Yes, stupid I know.

Keep in mind that hygiene is very often not that good in Thailand. Many times I have been in the toilet, even in upscale hotels and restaurants in Thailand, and seen the kitchen staff leave without washing their hands. And many toilets don’t have toilet paper or even soap. Thai’s will often use just water to clean themselves.

So, in review always try to follow these precautions when visiting Thailand:

· Don’t drink tap water. Only drink bottled water.

· Get a hepatitis A vaccine before traveling.

· Try to avoid ice in your drinks.

· Don’t eat food that has been sitting for a long time or food that is undercooked.

· Check for dirty glasses and utensils every time you eat.

· Check for debris in your water and ice (if you use it) every time you get a drink.

· Never eat shellfish.

What to do if you get sick

When you get diarrhea and/or vomiting, the most important thing is to avoid dehydration.

Get yourself to a hospital emergency room, I recommend Bumrungrad in the Sukhumvit area or BNH on Soi Convent off Silom (near the Sala Daeng BTS station). Don’t worry about the cost. It shouldn’t be more than 2000 baht for everything including the prescriptions.

The usual doctor’s prescription is a drug to stop the symptoms (diarrhea and/or vomiting), an antibiotic to help your body deal with bacteria, and electrolyte beverages to rehydrate. In more severe cases, they will give you an intravenous infusion of fluid.

Make sure that you take all of the antibiotics that are prescribed to you. Usually you will start to feel better before the treatment is done, but it is important that you finish it because all of the bacteria haven’t been destroyed yet. The small amount of bacteria that are left are usually the toughest ones so if you don’t fight it off you will get a relapse of this tougher strain.

When you start eating again you should have bland foods like toast, crackers or rice. Carbohydrates are much easier for your stomach to deal with at this time. Try to avoid fats, proteins and spicy food for at least 1-2 days.

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