In this article: Travellers' diarrhea Over-the counter help Avoid stomachaches from overeating

Stop that queasy feeling

Upset stomach? USA WEEKEND's health expert shares his prescription.

Nothing is more unpleasant than a good case of intestinal cramps, nausea and diarrhea. Usually, the sudden onset of these symptoms is caused by an infection. Fortunately, most of these infections are triggered by viruses that are resolved in about three days. But those days can be miserable! Knowing what to expect, how to take care of yourself and when to call the doctor can help get you through.

Symptoms of gastrointestinal infections include fever, chills, loss of energy and loss of appetite. The greatest health risk is dehydration -- loss of fluid -- so it's important to drink lots of clear liquids (such as water, broth, non-caffeinated beverages and even electrolyte solutions like Gatorade). Remember: You can go for days without food, but you cannot go without water!

Wait until your appetite returns to slowly put small amounts of food back into your life. Start with clear soups, crackers, dry toast and low-fat desserts such as sherbet. Avoid caffeine, alcohol, dairy products and highly seasoned foods.

Children, older adults and anyone with a chronic illness or immune problems may need to see a doctor early for help in fighting dehydration and infection. But most of us can give it a few days and see how it plays out. It's time to call it quits and see a doctor if the fever persists for more than three days, the abdominal pain and cramping is extreme, the diarrhea or vomiting involves bleeding, or fluids and over-the-counter medications do not help. You may have more than a simple infection.

Traveler's diarrhea

A special situation is traveler's diarrhea, typically caused by bugs our American intestines aren't used to. We're lucky to live in a country where we can safely drink a glass of water in almost any restaurant, hotel or house.

Typical traveler's diarrhea begins three to seven days after exposure to a foreign bug. Often, you're back home by the time it hits. Antibiotics are often needed; you probably should go immediately to your physician.

To avoid traveler's diarrhea, watch every bite you eat and every drop you drink. Avoid uncooked or undercooked foods (particularly seafood or meat). Avoid buffet meals that have been left exposed. Absolutely avoid food sold by street vendors. My wife, also a physician, grew up in Mexico City, where one of her favorite treats was a meat-and-pineapple dish sold by street vendors. Now that she's been living in the United States for 20 years, she knows better than to try to eat that snack when we visit Mexico.

Also avoid salads (which may be sprayed with contaminated water), ice cubes and tap water. Drink only bottled beverages.

And that means bottled water for brushing your teeth!

Over-the-counter help for 4 types of stomachache

Have heartburn? For quick action, try chewable or liquid antacids that contain aluminum salts and calcium salts that neutralize acid already in the stomach; products include Rolaids, Tums, Alka-Mints and Maalox. For slower but longer- lasting relief, acid reducers (H2 receptor antagonists) reduce the production of acid in the stomach. Products include Pepcid AC, Tagamet HB, Zantac AR, Axid AR. If symptoms persist, see a physician to rule out an ulcer or even heart disease.

Have gas? Try medicines containing simethicone, taken alone or with antacids. Products include Gas-X chewable tablets, Maalox anti-gas tablets, Mylanta gas relief, Mylicon and Alka-Seltzer gas relief.

Have diarrhea? To slow the movement of the intestine and change how water and salt move in the bowel, try products such as Imodium A-D, Mitrolan chewable tablets, Di-Gel, Donnagel liquid and Pepto-Bismol, the only over-the-counter remedy shown to be effective for upper and lower intestinal symptoms. If there's also a fever over 101 degrees, or if blood or mucus is in the stool, see a physician.

Have nausea or vomiting? Try antihistamines to decrease the sensation of nausea in mild cases; products include Bonine and Dramamine. Or use a topical medication: Pepto-Bismol is believed to work by coating the stomach lining.

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Avoid a stomachache from holiday overeating

Use the "belt technique." Most of us eat until we are stuffed, then loosen our belts an extra notch. This season, avoid overeating by doing the opposite: Before a big meal, tighten your belt one extra notch. When eating has made you uncomfortable, stop. Many of my patients have tried this with success!

Before a meal, snack on low-fat, high-volume foods such as carrots, celery, cucumbers and pickles. This takes the edge off your appetite.

Drink lots of water before and during meals to hasten a sense of fullness.

Emphasize high-fiber foods. Vegetables and whole grains move through the digestive system faster than high-fat foods such as meats, sauces and gravies. If you do overeat them, at least you'll be uncomfortable for less time.

Get the jump on heartburn. If you have a history of heartburn, use H2 blockers (see box at right) before meals to limit symptoms. If you forget, take antacid and anti-gas medicines soon after meals.