Problems In Paradise: Bali Belly's Painful (and Gross) Reality

By Travel Destination 02 Feb, 2023 Post a Comment

Whether you’re in Bali reading this from the bathroom or still at home wondering if it’s worth cramming Pepto-Bismol into your already bulging suitcase, you’re not alone. The term “Bali belly” is a hot topic, with Google Trends showing a 750% increase in search volume.

But is Bali belly real?

Bali belly is a real condition. However, it’s a fancy name for any stomach issue that happens while you’re on the “Island of a Thousand Temples.” Travelers’ diarrhea, gastro, and food poisoning are other terms for Bali belly.

Disclaimer

Popular article: 9 Rice Fields in Bali That Instagram Doesn’t Do Justice.

I’m a travel blogger, not a doctor.

I have first-hand experience eating my way through Bali, coming down with a mild case of Bali belly. That doesn’t make me qualified to offer medical advice; I encourage you to see a doctor if you have Bali belly that’s not going away.

What I’m about to share is based on my personal experience and that of the travelers I spoke with.

So, take what you wish from this article and leave the rest.

The Basics

“Be careful of the meat in Bali.”

Such advice is common from well-meaning strangers who’ve experienced Bali belly. But as a vegetarian, I can assure you that this condition isn’t exclusive to carnivores.

The Bali belly meaning can be frustrating for those of us who like pinpointing a condition. Instead, common symptoms and health issues that fall under the “Bali belly” classification include:

Vomiting
Food poisoning
Stomach cramps
Traveler’s diarrhea
Gastroenteritis (AKA gastro)

The bottom line is that Bali belly can put a kink in your rice terrace or beach outing very fast.

What Is Bali Belly?

Bali belly is a gastrointestinal illness caused by bacteria, parasites, or viruses on infected food or in affected water that your body isn’t used to. In worst-case scenarios, you can become ill from two or more of these microorganisms at the same time.

Not fun.

That said, E. coli is the most common cause of Bali belly. According to a clinical review, the enterotoxigenic strain of E. coli accounts for 30% to 60% of travelers’ diarrhea across the globe.

While E. coli can thwart a trip, did you know that all humans have these bacteria in their intestines? Most E. coli strains are harmless.

Can Bali Belly Kill You?

Bali belly can kill you, but it isn’t likely. Although bacteria like E. coli result in approximately 1.5 million deaths per year, much of this is due to dehydration from people in developing countries who don’t have access to (or can’t afford) medical care.

As a tourist with the means to buy a plane ticket to Southeast Asia, the chances are high that you’ll be able to find enough rupiahs for a trip to the hospital if you’re unwell. So, Bali belly isn’t dangerous for the average traveler.

Can Bali Belly Come Back?

It’s possible for Bali belly to come back after you start feeling better. Since microorganisms cause this condition, particularly in the form of bacteria or parasites, taking an incomplete dose of medication or not being prescribed the right amount of medicine can cause your symptoms to improve before flaring up again.

Of course, you could also acquire a different bacteria, parasite, or virus that doesn’t sit well with you after you recover from your first bout of stomach issues. In that case, it’ll seem like your Bali belly returned when another microorganism is really to blame.

Can you get Bali belly twice?

Yes, you can get Bali belly twice. There are many species of bacteria, protozoans, and viruses that cause Bali belly, and getting Bali belly once won’t make you immune to falling ill again.

That said, the amount of time you spend in Bali matters; your microbiome can adapt to its environment.

Researchers found that people immigrating to the U.S. had a higher chance of developing metabolic diseases because their gut microbiomes lost diversity. On the flip side, the longer you stay in Bali, gradually working your way up to eating street food, raw veggies, etc., the more diverse your gut bacteria will become.

And the more diverse bacteria you have living in your gut, the stronger your immune system will be.

Is Bali Belly Contagious?

Bali belly can be contagious depending on whether you have a virus, bacteria, or parasite. So, it’s always best to treat it as a contagious illness.

Never share food or drinks when you have Bali belly, and practice extra good hygiene standards, particularly with hand washing after using the restroom.

Is Bali Belly Common?

Bali belly is a very common condition. Anywhere from 40% to 60% of travelers experience travelers’ diarrhea worldwide, including that caused by bacteria, viruses, and parasites.

Add to that food poisoning, and you’ve got yourself a condition that most people have had at some point in their lives.

Furthermore, according to the Centers for Disease Control and Prevention (CDC), Asia is one of the highest-risk regions in the world for travelers’ diarrhea.

For a Laugh

You might need some comic relief if you’re already unwell from Bali belly. So, I’ll answer a couple of questions that people ask about this condition. And no judgment if you’re among those inquiring!

Who is Bali belly?

“Belly” isn’t the last name of a person named Bali. So, Bali belly isn’t anyone; it’s a condition.

Where is Bali belly?

Bali belly isn’t the name of a place. This gastrointestinal condition can happen anywhere on the island of Bali, Indonesia.

Common Causes of Bali Belly

So, what causes Bali belly?

The causes of Bali belly include eating food or water that’s contaminated with bacteria, protozoans, or viruses. Of these, it’s most common to have a bacteria-induced case of it from E. coli.

But I know that saying food and water causes Bali belly is general. So, below are some of the most common specific causes of Bali belly:

Contaminated ice
Poorly cooked meat
Brushing your teeth with tap water
Getting tap water in your mouth when you shower
Food left out too long without refrigeration
Water/coffee/tea that wasn’t boiled and/or filtered
Consuming raw vegetables washed in contaminated water
Eating peeled fruit that unclean hands touched
Eating fruit with peels that weren’t washed before being cut
Drinking/eating out of glasses/plates washed in tap water that aren’t fully dry

Gosh. Mother nature is out to get you according to this list.

And the reality is that no matter how careful you are, you’ll be in a country with microorganisms that your body isn’t used to. So, despite your best efforts, you still might come down with a case of Bali belly.

The bottom line?

Find room for that Pepto-Bismol in your suitcase, my friends.

How do you get Bali belly?

You can get Bali belly from eating food or water contaminated with bacteria, viruses, or parasites that your body isn’t familiar with. The local Balinese have built up an immune system for many (though certainly not all) microorganisms that cause gastrointestinal issues for travelers.

Nevertheless, even the locals don’t drink Bali’s water straight from the tap. Instead, they buy, filter, or boil their water.

For this reason, I never balked at drinking water they poured into my glass, including at non-touristy warungs. Nevertheless, your best chance of preventing a case of Bali belly is by sticking with bottled water.

Why is Bali belly so common?

Bali belly is so common because microorganisms that don’t settle well with the tourist’s stomach are everywhere. Trillions of microorganisms live within and on our bodies. They’re responsible for being the first line of defense for thwarting illnesses.

But even the good bacteria in our microbiome are no match for the many bacteria, parasites, and viruses in Bali that our bodies aren’t acquainted with.

The good news is that the microbiome is highly adaptable. So, if you stay in Bali long enough, the chances decrease of you having issues with Bali belly.

How Long Does Bali Belly Take to Kick In?

It typically takes Bali belly anywhere from a few hours to a few days to kick in after you eat or drink a contaminated item that doesn’t sit well with your stomach.

Johns Hopkins Medicine states that travelers’ diarrhea most commonly occurs in the first ten days of travel. So, since this condition doesn’t always happen right away, you could already be in your next destination, having Bali belly in Thailand or elsewhere but blaming your current country as the culprit of illness origin.

Bali Belly Symptoms

The first signs of Bali belly aren’t hard to miss-they usually involve gastrointestinal discomfort. You might feel bloated or gassy, and mild cramping is common.

If you’re lucky, that’s all that will happen.

But it’s more common for the condition to progress. After all, you’ve consumed a microorganism that your body deems as dangerous.

It wants it out. And quickly, at that.

Some of the most common symptoms of Bali belly include:

Diarrhea
Vomiting
Bloating
Weakness
Stomach cramps
Abdominal pain
Urgency to use the toilet

You may also develop a fever, though it isn’t common. But should a fever set in, research the nearest clinic so that you know how long it’ll take you to get to a doctor if you deem it necessary.

What Does Bali Belly Feel Like?

Bali belly often feels like a bomb going off inside your stomach. You might feel and hear gurgling. Your stomach might become painful and bloated with gas.

The worst part is often waiting for that bomb to make its appearance outside of your body.

There’s nothing wrong with taking medicine like Pepto-Bismol to manage the pain and discomfort that Bali belly causes. However, think twice about taking anything that will “plug” you up-diarrhea and vomiting are your body’s way of eliminating harmful microorganisms from your system.

We’ll talk more about treatments shortly. But for now, know that if you’re going to take medicine, it’s usually better to treat the root cause-killing the microorganism-rather than taking medicine to stop your diarrhea or vomit spells.

How Long Does Bali Belly Last?

Bali belly lasts anywhere from a couple of hours to over one week. The severity depends on the type of microorganism(s) in your body and how dehydrated/weak you become in the process.

In my case, I spent an hour on the toilet. And when I say “on” the toilet, I mean it in the most literal sense of the word. That one-hour was the grand finale of what was a few-hour episode prior to that, if you catch my drift.

But I was among the lucky ones. I ate lunch later that day and continued with my Balinese life without ever needing to take medication.

Can Bali Belly Be Mild?

Yes, Bali belly can be mild. It’s common to have some loose stool once you start eating Balinese food without having a full-out case of diarrhea or an upset stomach.

Technically, anything that causes looser stool is Bali belly. And provided you didn’t spend the night partying it up in Kuta, you can bet your vomiting episode is also Bali belly, even if you only get sick to your stomach once.

What to Do When You Get Bali Belly

The first thing to do when you get Bali belly is not to panic. It happens to many travelers. And although it can put a damper on your travel plans, most cases of this illness clear up on their own without medical intervention.

However, below are some things you should do when you have Bali belly:

Check for a fever
Stay well hydrated
Eat bland food
Get plenty of rest
Identify the closest clinics/hospitals

And, of course, stay near a toilet.

The bottom line is that knowing how to treat Bali belly doesn’t take a rocket scientist.

You’re not going to feel well enough to eat a plate of fried nasi goreng. And as much as it frustrates you, you’ll inherently know that swinging over the Tegallalang terraces could result in photos with a stained top or bottom.

What Helps Bali Belly?

Drinking water, consuming rehydration drinks to replace lost salt and minerals, and sticking with a bland diet all help Bali belly.

Should you visit a doctor, they may prescribe you an antibiotic or anti-parasite medicine, which will treat the root cause of the issue.

Steer clear of consuming spices, alcohol, dairy, and greasy food. All of these items can delay your gastrointestinal tract’s recovery process.

What stops Bali Belly?

The most effective way to stop Bali belly is to get a prescription from a doctor. Admittedly, this will help little if your symptoms are from a virus.

But if you have a bacterial infection or parasite and your doctor runs tests to know the exact strain, antibacterial or antiparasitic medicine is the fastest way to recover from a more severe case of Bali belly.

What’s good for Bali Belly?

Staying hydrated, getting plenty of rest, and eating bland food are good for Bali belly. Having Bali belly on a plane is no fun, and spending more days than you need to be trapped in your hotel room isn’t either.

So, when possible, do yourself a favor by taking a truly restful period. That way, you can return to exploring Bali faster feeling 100% well.

How Long Does It Take to Get Rid of Bali Belly?

It can take anywhere from a few hours to a week or more to get rid of Bali belly. The recovery time depends on the microorganism causing your symptoms and how long you wait to see a doctor if you decide to visit one.

For example, you might have Bali belly for five days, with the first couple of days being the worst and the days that follow leaving you feeling off but not so much that you can’t leave your hotel room.

In contrast, if you have Bali belly for a week without any improvement, you should see a doctor.

Does Bali Belly Go Away on Its Own?

Although Bali belly can last for more than one week, you could be weak from dehydration at that point, and there could be medicine that gets you better fast.

Bali belly often goes away on its own. Most people don’t need to see a doctor, as diarrhea and/or vomiting are the body’s natural way of expelling the microorganism that invaded it.

Baca Juga

Just because Bali belly usually clears up on its own isn’t a reason to discount a doctor right away, though.

When to See a Doctor

If you have Bali belly that’s not going away, or it’s day one of you not feeling well but you have a high fever, you should see a doctor.

Ultimately, whether you should see a doctor comes down to a combination of personal preference and necessity from being so unwell.

But, as a general rule, a case of Bali belly for three days without a fever isn’t usually a cause for concern. However, should you have Bali belly for a week-and especially if you have Bali belly for over a week-that’s a reason to consider a trip to the doctor even if you’ve been fever-free.

Furthermore, Bali belly and pregnancy aren’t inherently dangerous. But if you’re pregnant, it’s best to contact a doctor without waiting it out.

It’s even worth checking with your doctor at home before going to Bali to ask their advice on what you should and shouldn’t take in the event that you come down with Bali belly.

Ideally, your Balinese doctor should run a Comprehensive Digestive Stool Analysis (CDSA) to find out exactly what microorganism is causing your gastrointestinal issues.

That way, they can prescribe you the correct medicine on the spot, helping you to feel better quickly and to preserve as much of the good bacteria in your gut as possible.

Bali Belly Medicine

If you’re used to oral medicine in your home country, prepare for your Balinese doctor to come at you with a needle. Injections are a common way to clear up gastrointestinal issues in Bali.

IVs are another common treatment route, particularly if you arrive at the clinic dehydrated.

And if you have Bali belly with a fever, you can expect your doctor to give you fever-reducing medicine, perhaps even through the IV.

Treating Yourself at Home (Ahem…From Your Hotel Room)

Over-the-counter medicine you can use to treat Bali belly symptoms include:

Travelan
Imodium
Loperamide
Pepto-Bismol
Activated charcoal tablets

Just be sure to do your due diligence before taking any of the medications on this list. Some of them could be more harmful than helpful, depending on the situation.

If you’re into holistic medicine, you could also try coconut water. The benefit of drinking coconut water over regular water is that it contains lots of potassium and electrolytes, preventing you from becoming dehydrated.

7 Ways to Avoid Bali Belly

A plate of watermelon, pineapple, banana, papaya, dragon fruit, and lime.

If you’re one of the lucky ones reading this without being sick, below are some Bali belly tips for reducing your chances of having gastrointestinal issues in Indonesia.

1. Choose Water Carefully

The safest way to avoid Bali belly is only to use bottled water.

Notice that I wrote “use” and not “drink.” That’s because the safest option is to use bottled water to brush your teeth in addition to drinking it.

Admittedly, I didn’t do this. I don’t do it when traveling to other countries where the tap water is off-limits either. But I’m a long-term traveler, and my philosophy is to give my stomach a “base tan” version of foreign bacteria.

I’m not saying my approach is right or even safe-I got Bali belly, after all.

2. Avoid Ice

Knowing that the Balinese filter and/or boil their drinking water, I drank the non-bottled water and ice that restaurants and warungs gave me, no matter how fancy or hole-in-the-wall they were.

But to reduce your chances of developing Bali belly, it’s best to say “no” when someone offers to put ice in your drink.

That is, unless you know with 100% certainty that they make their ice with bottled water.

3. Eat Off Dry Plates

This might sound like an odd one, but most Balinese wash dishes with straight-up tap water.

It’s generally considered safe to eat off such plates and drink out of glassware as long as they’ve been thoroughly dried.

However, if you consume food or drinks from “wet” plates, dishes, or silverware, the microorganisms that cause Bali belly could be living in the water droplets.

4. Take Care With Fruit

If you’re wondering how to avoid Bali belly in the fruit department, the answer might surprise you-eating fruit that you must peel can be just as harmful as biting into fruit that you don’t peel.

That’s because certain microorganisms can live on the surface of fruit skin.

So, if you don’t wash the skin of a fruit before cutting through it, your knife could inadvertently drag the harmful bacteria, parasite, or virus into the fruit’s flesh.

5. Eat Thoroughly Cooked Meat

Vegetarians and vegans avoid an entire food group that reduces their risk of developing Bali belly. But there’s no need to steer clear of meat if you’re a carnivore.

Just be smart about it.

If meat doesn’t look well-cooked, or if it doesn’t feel very hot, it’s best to pass it up.

If you want to try meat at street food stands, try to choose one where they cook it right in front of you. That way, you’ll know that (the cooked version, at least) hasn’t been sitting out gathering bacteria.

6. Be Mindful of Warungs

I love a good warung (a family-run eatery in Bali). They were my go-to place to eat during my one month in Bali.

However, I primarily ate at warungs that prepared food on an as-ordered basis. That’s not the case for many warungs, though.

Instead, it’s common for warungs to have premade food that sits in a stand in the Balinese heat, sometimes with the sun beating down on the food. If you want to know how to avoid Bali belly, skipping such places is a good strategy.

But if you’d like the true warung experience, my recommendation is to choose warungs that have a lot of people stopping by. That way, there’s a higher chance that the food they serve is fresher and hasn’t been sitting out in the heat.

Should you stay in Bali long enough, you might be able to kick it with the locals at the other warungs, though. Your gut will be better acclimated to Indonesia’s microorganisms at that point.

7. Pass on the Fresh Veggies

A good way to get sick in Bali is to eat fresh vegetables washed in tap water.

Many warungs and other local shops use lettuce, tomatoes, and cucumbers as a garnish for their dishes. It’s beautiful to look at, but it could cause issues for your stomach.

That said, if you want to know how to prevent Bali belly without avoiding fresh veggies altogether, I recommend eating at more upscale tourist restaurants.

You can always ask how they prepare their fresh vegetables too.

What to Eat in Bali to Avoid Bali Belly

You obviously don’t want to be sick during your Bali trip. But you understandably want to try the local cuisine.

So, it might get you wondering-what kinds of Balinese foods are friendly on the stomach?

Although the answer is “It depends,” based on how the dish was prepared, below are a few Balinese dishes that are usually safe to eat.

1. Nasi Goreng

Nasi goreng with raw veggies and a fresh banana leaf bottom.

Nasi goreng is Bali’s national dish. It contains fried rice with fried veggies and a fried egg and/or meat.

All that frying does a good job of killing most bacteria.

The one thing to watch out for with nasi goreng is that it usually comes with fresh cucumbers, tomatoes, and lettuce. Furthermore, they often place the rice on a fresh banana leaf.

It’s a beautiful presentation, but depending on how (if) they washed the banana leaf, it could carry microorganisms.

2. Mie Goreng

Mie goreng is another fried Indonesian dish. They use a base of noodles with various fried veggies and meat of your choice.

Like nasi goreng, mie goreng often comes with a side of fresh vegetables and is commonly served on a banana leaf.

Here’s a quick Indonesian vocab lesson for you if you’ve picked up on the similarity between these first two dishes: “Goreng” means “fried.”

So, whenever you see goreng with a dish you’re interested in ordering, you can feel relatively confident that the high heat will kill any bad gut microorganisms.

3. Satay

Satay is a popular Indonesian dish that involves grilled or pan-fried skewers of chicken, beef, tofu, or tempeh.

You can find satay in both restaurants and on the street. So, be sure the cook grills/pan-frys them on the spot if you choose to try them from a street stand.

If you order satay at a restaurant, you can expect it to come with rice and a raw salad.

Bali Belly vs Other Illnesses

If you’re still trying to wrap your head around the difference between Bali belly and other gastrointestinal issues, you’re not alone. That’s because Bali belly is a generic term, being a “diagnosis” for several different conditions.

Bali Belly vs Food Poisoning

Bali belly is food poisoning, and food poisoning is Bali belly if you consumed the microorganism making you sick while you were in Bali.

Approximately 48 million Americans come down with a case of food poisoning each year. That’s just Americans, and it’s safe to say that not all of them were traveling in Bali. So, using the best practices discussed here is useful even when you’re home.

Bali Belly or Parasite

If you get a parasite when you’re in Bali that causes gastrointestinal issues, that classifies as having Bali belly. Parasites are one of the causes of this condition, although it’s more common for people to get Bali belly from bacteria.

Bali Belly vs Gastro Issues

If you’re wondering whether you have Bali belly or gastro, you have both. Bali belly encompasses any gastrointestinal infection or issue, provided that the condition arose from something you ate or drank in Bali.

Bali Belly or Dengue

Initially, Bali belly can appear to be dengue and vice versa, given that dengue starts out with similar symptoms to Bali belly. Some of the symptoms that these illnesses share are vomiting, diarrhea, and stomach pain.

However, dengue progresses to a high fever, rash, and joint or bone pain. If you suspect that you have dengue, see a doctor immediately.

FAQs About Bali Belly

If you still have questions about Bali belly, read on.

How long does it take to get Bali Belly?

It can take as little as two hours to get Bali belly after eating or drinking the culprit microorganism. It’s common for symptoms to start with slight gastrointestinal discomfort or the feeling of a rumbling stomach.

Does Bali belly give you a fever?

Bali belly can give you a fever. However, it’s not a common symptom, and the fever is usually mild. If you develop a high or ongoing fever, you should visit a doctor immediately.

Does Bali belly make you vomit?

It’s common for Bali belly to make you vomit. However, some people only have diarrhea with Bali belly. Or, they may have both vomit and diarrhea.

Is Bali belly food poisoning?

Bali belly is a form of food poisoning. Food poisoning happens when you consume bad bacteria, parasites, or viruses (or the toxins they release), causing an upset gastrointestinal tract.

Is Bali belly a parasite?

Bali belly can happen because of a parasite, but it’s not a parasite itself. Some of the most common parasites that cause Bali belly include Giardia lamblia, Entamoeba histolytica, and Dientamoeba fragilis.

Not all parasites causing Bali belly affect people the same. Some people may have little to no symptoms, while others have severe symptoms.

How is Bali belly transmitted?

Bali belly is transmitted by consuming contaminated food or drinks. It can also be transmitted from human to human, which is why it’s important not to share food, drinks, or kiss for the duration of the symptoms.

The Bottom Line

A typical Balinese offering to the gods.

When people first hear the words “Bali belly,” they often picture gaining weight from eating delicious Indonesian food.

And while that can be the case, anyone who’s spent some time in Bali knows that this term is reserved for times when they ate food that didn’t sit well with them.

Now that you know how long it takes Bali belly to kick in, how to stop it, and the treatment options available, it’s time to get on the mend. Or, hopefully, not come down with it at all.

As mentioned earlier, I’m not a doctor, and none of the information here is medical advice. So, if you have questions, I encourage you to contact a medical professional.

P.S.-Once you’re on the mend, don’t miss the sunset at Tanah Lot. It’s a low-intensity activity, making it easy on the stomach once you know your rushing-to-the-toilet moments are over.

The post Bali Belly: Treating & Avoiding Trips to the Toilet appeared first on A Piece of Travel.