Traveler's Diarrhea is one of the most common ailments suffered by travelers anywhere in the world. For travelers to Mexico, it is often referred to as "Montezuma's Revenge" in a humorous reference to the Aztec ruler Moctezuma II, who was defeated by the Spanish conquistador Hernán Cortes, and many prefer this way to refer to the problem in polite company.
The ailment is usually caused by bacteria found in contaminated water and food and may be present due to improper food handling and storage, as well as poor sewage disposal. But sometimes it's just a case of travelers being exposed to heavy foods and spices that they're not accustomed to along with drinking in excess and not getting enough sleep.
Preventing Montezuma's Revenge
When you travel, there are some steps you can take to prevent being struck by this illness.
- According to the U.S. Centers for Disease Control (CDC), a preventive measure for adults is to take a bismuth-containing antacid medicine like Pepto-Bismol (the equivalent of two 262-mg tabs 4 times a day), which has been found to decrease the incidence of travelers’ diarrhea by half.
- In general, you should avoid drinking water from the tap in Mexico, although in some places the tap water may be purified, in which case there will be a sign advising you of this fact (It should say agua potable or agua purificada). You can buy inexpensive bottled purified water to drink but hopefully, you can refill your water bottle with purified water from a larger jug where you are staying instead of constantly buying disposable plastic bottles. Another alternative is to purchase a special water bottle that purifies tap water (such as the GRAYL Ultralight Water Purifier available from Amazon). Use purified water when you're brushing your teeth and also remember to keep your mouth closed while you shower.
- Besides water, you should also be careful about ice. Often in restaurants, your drink will come with ice in a cylinder shape with a hole in the middle. If this is the case, you can rest assured that it's purchased ice made in a factory from purified water. Other shapes of ice cubes may be made at the establishment and may or may not be made from purified water. Shaved ice that's sold in carts on the street may be tempting on a hot day, but it's not likely to be made from purified water, so it's best to steer clear of this treat.
- If you choose to eat from street vendors and in markets, look for stalls that are crowded; a high turnover means that the food is fresh, and the locals generally know the best spots. If you have a particularly sensitive stomach, you might prefer to eat in establishments that cater to tourists and avoid eating food from street vendors, but then you'll be missing out on some great food experiences.
- Most restaurants in Mexico will have salsa on the table for you to serve yourself. It can be problematic if the salsa is left out at room temperature for too long, so you may want to stick to salsa that you know is fresh.
- In most restaurants in the larger cities and popular tourist destinations in Mexico, raw vegetables will be properly cleaned. If you're traveling in rural areas and off the beaten path, it may be wise to skip the salad and opt for cooked vegetables instead.
- If you want to be on the safe side, stick to fruits that can be peeled, and preferably peel them yourself. Or, you can buy fruit in the market and clean it yourself.
- Fruits and vegetables purchased in the market can be disinfected with a product called Microdyn—just add a few drops to some water and soak your produce for a few minutes before eating. Microdyn can be found in grocery stores in Mexico.
- Make sure any meat you eat is well cooked.
- Wash your hands before you eat, or if this is not feasible, use a hand sanitizer.
What to Do in Case of Montezuma's Revenge
How strictly you wish to adhere to these suggestions may depend on your overall health, the length of your trip, and your sense of adventure—you may find it hard to pass by Mexican street food altogether!
A case of traveler's diarrhea is often accompanied by stomach cramps and nausea. Symptoms may last for a day or up to a week. Mild cases can be treated with an over-the-counter medication, such as Pepto Bismol, or Imodium. For severe cases, antibiotics may be necessary. If you have diarrhea, it is important to keep hydrated.