If watery diarrhea lasts longer than four days, seek medical advice Nasty but easily treatable to diseases such as giardiasis and amoebiasis must be tested for by a stool examination.
If there is at any time blood in your diarrhea, you've most likely got dysentery -this is rare, but far from unheard-of among travelers in the Middle East. The most important thing is to get a stool sample to a doctor to find Out which of the two main kinds you've got (although whichever it is, maintaining hydration levels is essential). Bacillary dysentery (shigella) is bacterial, and symptoms are cramping abdominal pains, fever, fatigue and lethargy. You'll eventually get over it, and, for all but the most serious cases, re-hydration is far more important than treatment with drugs. Amoebic dysentery is far nastier, and can recur many years if left untreated, with abscesses forming in the liver. This is caused by a parasite, transmitted by tiny eggs left on food, and leads to bloody, slimy diarrhea, fever, sweating and chills. You should be certain of the diagnosis – which can only be done by stool examination – before embarking on a course of metronidazole (Flagyl). You should also see your doctor as soon as you get home to make sure you’re entirely cured.
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