How to Avoid Bali Belly: What to Know and How It Spreads

Bali belly is the local nickname for traveller's diarrhoea, the upset stomach that catches many visitors to Bali in their first week or two. Knowing how to avoid Bali belly comes down to clean hands, safe water and freshly cooked food, and most bouts pass in a few days with fluids and rest. This guide covers how to avoid Bali belly, what to do if you get it, and when to see a doctor.

Key takeaways

• Wash your hands before eating, drink only sealed bottled water, and choose food that is served steaming hot.
• Most bouts settle within three days; sip fluids often and use rehydration salts to replace what you lose.
• Blood in your poo, a high fever, severe pain or signs of dehydration need a doctor.
• Hepatitis A and typhoid vaccines are given in person by a travel doctor or clinic before you go.

Clean Hands Before Every Meal

Clean hands are the simplest protection, because the germs that upset a traveller's stomach often reach the mouth on your own fingers. Wash with soap and water for 20 seconds before eating and after the toilet, and carry an alcohol hand sanitiser for street stalls and beaches with no sink. The table sets out how to avoid Bali belly with a few everyday habits.

Care lowers the risk but cannot remove it. How long does Bali belly last if you do catch it? Most bouts settle in one to three days. Is Bali belly contagious? It can spread to people sharing your room or bathroom, so keep your hands clean, stay hydrated, and see a doctor if symptoms last more than three days.

Bali Belly Symptoms to Watch For

Bali belly symptoms usually start suddenly, a few hours to a few days after eating or drinking something contaminated: loose, watery poo three or more times a day, stomach cramps, nausea, bloating and an urgent need for a toilet. Some people also vomit or run a mild temperature, and feel washed out for a day or two.

Symptoms that start within hours of a meal often come from toxins in food that was not stored properly, while symptoms a day or more later point to germs picked up from food or tap water. Warning symptoms are blood or mucus in your poo, a high fever, severe or constant stomach pain, vomiting that stops you keeping fluids down, or dizziness, a dry mouth and little dark urine, which mean your body is drying out. Any of these needs a doctor, in Bali at a clinic or hospital.

Part of knowing how to avoid Bali belly is not mistaking something else for it: diarrhoea that starts after you are home, or lasts more than two weeks, can be a parasite such as giardia and needs a stool test.

The Bacteria and Other Germs Behind Bali Belly

Bacteria cause most cases, especially a type of E. coli that makes the gut pour out fluid, along with Campylobacter, Salmonella and Shigella; viruses such as norovirus and parasites such as giardia cause the rest. They reach you through food or water carrying tiny traces of poo, which is why how to avoid Bali belly is mostly about what goes into your mouth. What causes it is rarely the spice or a change of diet itself, though rich food and alcohol can unsettle the stomach too.

If you do get it, the first steps are fluids and rest: sip water from sealed bottles, and use rehydration salts mixed with bottled water to replace lost salt and sugar. There is no quick way to get rid of it, but plain food helps you recover: rice, toast, bananas and clear soup in small amounts. Keep up good hygiene so you do not pass it on, and wash your hands after the toilet and before handling food.

See a doctor for blood in your poo, a high fever, severe pain or signs of dehydration, or if it has not settled in three days, because bacteria that cause severe illness may need treatment.

Choosing Safer Places and Dishes to Eat

Busy places that cook food fresh in front of you are usually the safer choice, because a quick turnover means less food sitting out. Choose dishes served steaming hot, and be wary of buffets, salads and herbs rinsed in tap water, raw or undercooked seafood, sauces left on tables, and fruit someone else has cut. Ice may be made from untreated water, so it is safest to ask for drinks without it. Sealed bottled drinks, and tea and coffee made with boiled water, are safe choices.

Some travellers take probiotics before and during a trip, but the evidence that they prevent an upset stomach is limited, so they do not replace care with food and water. Cocktails and spirits from unlicensed bars can contain methanol, a poison that has blinded and killed travellers in Bali, so Smartraveller urges care with alcohol. Prevention is easier than any Bali belly treatment, and a consult with a GP before you go can cover what to pack.

Treating Traveller's Diarrhoea With Fluids and Rest

Fluids and rest are the main Bali belly treatment, because the real danger of diarrhoea is losing more water and salt than you take in. Sip small amounts often, even with nausea, and use oral rehydration salts from a pharmacy, made up exactly as the packet says with bottled or boiled water. Sports drinks and soft drinks hold too much sugar to replace salts well. Once you can eat, start with plain food, and add fruits such as bananas as your stomach settles.

An anti-diarrhoea medicine from the pharmacy can ease the trips to the toilet for a short time, such as on a flight, but it should not be used if there is blood in your poo or a high fever. A travel doctor may suggest packing an antibiotic for a severe bout; it is only available on prescription in Australia, and the doctor decides whether it suits you. Dizziness, confusion or passing very little urine are signs of dehydration that need medical care straight away.

Preparing for Bali Before You Fly

Preparing well starts six to eight weeks before you fly, with a visit to a travel doctor or clinic in person: vaccines such as hepatitis A and typhoid, both spread through food and water in Indonesia, are given face to face, and a phone appointment cannot replace that visit. Pack a small kit of hand sanitiser, sachets of electrolyte salts, simple pain relief and a thermometer, and check that your travel insurance covers medical care and evacuation.

If you have a digestive condition such as inflammatory bowel disease, ask your own doctor for a plan for traveller's diarrhoea before you go. It also helps to plan for the chance of a bout. How long does Bali belly last for most people? One to three days, so a flexible first week and a room with its own bathroom make it easier to ride out, along with good hygiene from the day you land.

Travellers Most at Risk of a Severe Bout

Some people become much sicker from the same infection: older travellers, pregnant women, and people with diabetes, kidney or heart disease, inflammatory bowel disease or a weakened immune system. For them, losing fluid can upset blood sugar, blood pressure and kidney function quickly, so a consult with their own GP before travel about which regular medicines to pause during a bout, and when to seek care, is worth the time. People taking medicines that lower stomach acid may also be more prone, since stomach acid kills some germs.

So is Bali belly contagious within a travelling group? It can be, especially when norovirus is the cause, so a sick person should keep their own towel, the bathroom should be cleaned often, and they should not prepare food for others until two days after it stops. Drinking bottled water and keeping up hygiene protect everyone else.

Summary

This guide has covered how to avoid Bali belly with clean hands, safe water and well cooked food, the symptoms to watch for, treating a bout and who needs extra care. Before you go, a Medio GP can talk through how to avoid Bali belly by phone consult, while vaccines need an in-person travel clinic, and if diarrhoea lingers once you are home, the doctor can arrange a stool test where they think it right.

Frequently asked questions

Is Bali belly contagious?

Yes, it can spread from person to person, mostly on hands that pick up germs in a shared bathroom, and norovirus spreads especially easily. Washing hands with soap after the toilet, cleaning shared bathrooms often, and not preparing food for others until two days after it settles all help protect the people you are travelling with.

What to eat after Bali belly?

Start with plain, easy food such as rice, toast, crackers, bananas and clear soup, in small meals, once you can keep fluids down. Add your usual food back over a day or two, and leave alcohol, spicy and fatty food, and large amounts of dairy until your stomach feels settled again.

Can I drink the water in Bali?

No, the tap water in Bali is not safe to drink, so drink sealed bottled water or water that has been boiled or properly treated. Don't drink tap water even in a smart hotel unless the hotel tells you it is treated, use the same water to brush your teeth, and keep your mouth closed in the shower.

What food should I avoid?

Avoid salads and herbs washed in untreated water, raw or undercooked seafood and meat, food left sitting warm on buffets, unpasteurised milk, and fruit someone else has cut. Fruits you peel yourself, and dishes prepared fresh and served steaming hot, are the safer choices on most menus.

How to Avoid Bali Belly?

The tips for how to avoid Bali belly are simple: clean hands, sealed water, hot freshly made food and fruit you peel, with caution around ice, salads, buffets and unlicensed spirits. None of these makes you immune, but together they lower the risk, and most bouts that do happen pass within a few days.