Diarrhea is the body's way of flushing out noxious bugs, and is always a risk when traveling in the tropics. Even if you take great care to eat and drink sensibly, the simple fact that your normal diet and way of life has changed is often enough to bring on the 'runs'. Rest, relaxation and a little abstinence is the best way to combat diarrhea. When you feel hungry, opt for bland foods such as bread, rice and plantains. Most importantly, drink plenty of fluids to avoid dehydration, the most serious complication of diarrhea and a particular danger in hot countries. In addition to the fluid streaming from your bottom end, you will also be sweating constantly in the heat and humidity of Hispaniola. Try to drink after each bowel movement: two glasses of water with a four-finger scoop of sugar and a three-finger pinch of salt added to each glass (to one liter of safe water, add eight level teaspoons of sugar and one level teaspoon of salt). If the diarrhea is particularly bad and accompanied by a fever, blood and slime, you will probably need antibiotics in addition to fluid replacement. A three-day course of Ciprofloxacin 500mg, Norfloxacin or Nalidixic Acid taken twice daily is appropriate treatment for bad diarrhea and dysentery. Diarrhea tablets or 'blockers', such as Imodium and Lomotil, keep the poisons in the body, causing the diarrhea to last longer than it would if left to run its natural course. Only use them if you have to - on a long gua-gua journey or during an activity, for example.
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Prevention is best. Given that the majority of travelers succumb to diarrhea after eating contaminated food or drinking dirty water, and because the Dominican Republic is a developing country competing with a climate in which bacteria love to breed, you should take sensible precautions when choosing what to eat and drink. Ironically, street food served fresh and hot is safer than the reheated buffet food found in many of the more expensive restaurants and all-inclusive hotels. Other things to avoid - or at least be wary of - are salads, unpeeled fruit, ice and ice-cream, all of which are potential carriers of bacteria. The only way to be sure that water is completely clean is to bring it to the boil, something which is not always very practical. Since bottled water is so readily available in the Dominican Republic, it might be wise not to take your chances with the tap water. If you do, purify it first. Iodine is the favored method, although slightly less effective chlorine-based water purification tablets are also popular.
A bout of diarrhea, unpleasant as it is, should not last more than about 36 hours. If it persists, see a doctor.