You planned the trip carefully, ate at what looked like a clean warung and then halfway through or on the way to the airport, you get hit with abdominal pain and even vomiting.
Bali belly is one of the most common travel health complaints among Singaporeans; it can happen anywhere food and water hygiene standards differ from what your gut is used to.
Here’s what to do if you have it and how to avoid it next time.
What is Bali belly?
“Bali belly”, put simply, is a colloquial term for traveller’s diarrhoea; An intestinal infection typically caused by consuming food or water contaminated with bacteria, viruses, or parasites.
It got its name because it happens quite often among travellers in Bali, but the same condition goes by different names depending on where you picked it up: Delhi belly, Montezuma’s revenge and so on.
How do people get it?
Bali belly or traveller’s diarrhoea usually comes down to consuming something contaminated. These are the most common ways:
- Food prepared with unwashed hands or in unsanitary conditions
- Raw or undercooked meat, seafood, or eggs
- Unwashed fruits and vegetables, especially those eaten with the skin
- Ice made from tap water
- Drinking tap water directly
- Buffet food that’s been sitting out
You don’t necessarily have to eat at a roadside stall to get it either; Contaminated food can come from a hotel buffet, a resort restaurant or even a fruit smoothie made with ice.
If your digestive system isn’t acclimatised to the local bacterial environment, even small exposures can trigger symptoms.
Is Bali belly contagious?
It depends on the cause:
Bacterial traveller’s diarrhoea (the most common type) is generally not easily spread person to person. But if your symptoms are caused by norovirus or rotavirus, then these spread readily through contact with contaminated surfaces, shared food or simply being in close proximity to someone who’s ill.
“Wash your hands frequently, especially before eating and after using the bathroom, and avoid alcohol and spicy food, and stick to plain, easily digestible food like rice and plain bread. Over-the-counter medications can help slow diarrhoea and are useful if you have a long journey ahead, but don’t use them if you have a fever or blood in your stool.”Useful Rule of Thumb
How long does Bali belly last?
Most cases of traveller’s diarrhoea resolve on their own within 3 to 5 days. Mild cases may clear up in 1 to 2 days.
If symptoms persist beyond a week, or if you notice blood in your stool, a high fever, or signs of significant dehydration, that’s when you need medical attention, regardless of where you are.
What to do if you have Bali belly
If you’re still overseas, prioritise hydration before everything else.
Diarrhoea and vomiting can cause rapid fluid and electrolyte loss, which is what makes people genuinely unwell. Take lots of oral rehydration salts (ORS). Sports drinks are a reasonable substitute if ORS isn’t available.
Rest, avoid alcohol and spicy food, and stick to plain, easily digestible food like rice and plain bread. Over-the-counter medications can help slow diarrhoea and are useful if you have a long journey ahead, but don’t use them if you have a fever or blood in your stool.
See a local doctor if:
- Symptoms are severe or worsening after 48 hours
- You have a fever above 38.5°C
- There’s blood in your stool
- You’re unable to keep fluids down
- You’re in a high-risk group: elderly, immunocompromised, pregnant or travelling with young children
A short course of antibiotics may be appropriate in moderate to severe cases, but this should be prescribed by a doctor and not self-medicated.
If you’re fully recovered by the time you land in Singapore, a GP follow-up is generally not necessary for mild cases, but you should see a gastroenterologist if:
- Symptoms continue for more than a week after your return
- You’re still passing loose stools intermittently
- You’ve developed new symptoms: bloating, cramping, or changes in bowel habits that weren’t there before
- You notice blood in your stool at any point
Some infections, particularly Giardia, can persist and cause ongoing gut issues like long-term bloating and loose stools.
Post-infectious irritable bowel syndrome (IBS) is also a legitimate complication after traveller’s diarrhoea, where the gut remains sensitised even after the infection clears.
In this situation, it’s in your best interest to consult a gastroenterologist to run the appropriate stool tests, identify any residual infection, and help you manage any lingering gut symptoms.
How to avoid Bali belly on your next travel
Don’t let Bali belly put you off going back to visit those beautiful beaches again; Just be more prepared next time.
A little mindfulness goes a long way:
- Only drink bottled or boiled water; if you do boil water, make sure you boil bottled and not tap water
- Skip the ice unless you know it’s made from filtered water
- Stick to food that’s freshly cooked and served hot
- Go easy on raw salads, raw shellfish, and pre-cut fruit from street stalls
- Wash or sanitise your hands before every meal
It’s also a good idea to pack a small travel medicine kit, so you have essentials on hand and don’t have to stress about finding medication, especially if you’re staying somewhere more secluded.
A basic kit should include oral rehydration salts, a gentle antacid and hand sanitiser. A little preparation helps and it’s a lot easier to enjoy the sunset over Seminyak when you’re not worried about where the nearest bathroom is.
Concerned About Ongoing Digestive Symptoms?
While most travellers recover fully from Bali belly, persistent symptoms should not be ignored. Ongoing diarrhoea, bloating, abdominal pain or changes in bowel habits may indicate an underlying infection or digestive condition that requires treatment.
At Richmond Gastroenterology Centre, Dr John Hsiang provides a comprehensive assessment of post-travel gastrointestinal symptoms to help identify the cause and guide appropriate treatment.
If your symptoms have not improved after returning home, or you are concerned about ongoing digestive issues following travel, contact us to arrange a consultation.
The content on this website, including text, graphics, images, and information, is meant for general informational purposes only and should not be used as a substitute for professional medical advice, diagnosis, or treatment. RICHMOND ENDOSCOPY AND GASTROINTESTINAL SPECIALISTS PTE. LTD takes no responsibility if the information on this website is used without consulting one of its specialists.
