There are few backcountry calamities more dreaded than diarrhea, aka trekker’s trots and Montezuma’s revenge. Unfortunately, it’s one of the most common wilderness afflictions (see Body Language, October 1997, for causes and prevention), and it carries an often-overlooked side effect: You lack the energy for hiking because you don’t feel like eating.
Believe it or not, food may actually help. In fact, some foods will make you feel better and shorten the duration of the illness. The BRAT diet, often recommended for diarrhea, consists of bananas, rice, apples (or applesauce), and toast (white). This bland menu puts soluble fiber in your system, which slows the passage of food through your intestinal tract.
While you probably won’t have ripe bananas and white bread in your pack, you can whip up a BRAT-like diet with typical backpacker fare:
- Rehydrate dried bananas and apples by cooking them in water until they’re soft and easier to digest. Eat the fruit and drink the cooking water for maximum fiber intake. Bananas will also replace some of the potassium the diarrhea is causing your body to lose.
- Cook up a rice dinner, but leave out the spices. Prepare the rice with extra water to create as much bulk as possible.
- Eat pasta (without sauce), plain crackers, and white-flour breads, such as plain flour tortillas or plain bagels, all of which provide fiber and are easy to digest.
- Choose bland hot cereals, like oatmeal, farina, or Cream of Rice.
- Mix up a batch of instant potatoes, adding a pinch of salt to replace what your body is losing.
- Boil a handful of baby carrots until they’re soft. Your body will absorb their nutrients more efficiently if they’re mushy, not crunchy.
Avoid fatty foods like gorp that contain nuts or chocolate, dairy products, alcohol, caffeine, and foods thick with insoluble fiber, such as whole grains, bran, beans, and leafy vegetables. Steer clear of backpacking staples like jerky, candy, energy bars, and raisins, which may worsen the diarrhea.
Most importantly, drink plenty of fluids to prevent dehydration. Drink at least 3 quarts a day, and twice that if you’re sweating heavily. For maximum benefit, take small slurps throughout the day instead of chugging at rest breaks. If you brought along sports drinks, dilute (4 parts water to 1 part sports drink) and sip them instead of water, since they help replace the sodium and potassium lost with each trip to the bushes.
When To Evacuate
Seek a doctor’s attention when diarrhea:
- Continues for longer than 72 hours
- Is accompanied by severe abdominal pain
- Leaves you dizzy or lightheaded (a sign of dehydration)
- Includes blood
- Occurs with a fever of 102?F or higher
Note: The more severe the diarrhea, the sooner you should see a doctor. Drink plenty of water and, if available, take an antidiarrheal medication like Imodium to slow the flow while hiking out.