Montezuma’s Revenge: Traveler’s Guide on How to Stay Healthy in Mexico

You planned your trip to the pyramids, and then it happens: Montezuma’s revenge, also called traveler’s diarrhea, hits you and ruins your vacation. This is probably one of the most common fears that travelers are facing in Mexico. But no worries! With a good understanding of what to watch out for you’re well prepared to avoid complications.

One thing upfront: Even Mexicans get Montezuma’s revenge from time to time, especially when they travel to another region within Mexico. So it’s not just you! Most of the time, the sickness lasts only for 1-3 days with mild symptoms. Still, here are some guidelines that will hopefully help you avoid it. So you can make the most of your vacation and enjoy Mexico’s pyramids, beaches, and delicious cuisine!

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Understanding the Causes of Traveler’s Diarrhea

Diarrhea is normally caused by microbes and parasites that are ingested due to a lack of hygienic measures. Especially in a hot and humid climate, microbes strive and multiply in no time. Remember that your body has to handle the many challenges it faces when traveling: Unfamiliar food and spices, maybe a lack of sleep and more alcohol than usual, a different climate, and much more. All this can cause even strong and healthy guts to be more vulnerable than usual.

Some of the main culprits behind traveler’s diarrhea in Mexico are the following:

• Bacteria: E. coli, Salmonella, and Shigella are the most common cause of digestive issues. These bacteria can lurk in unwashed fruits and vegetables, undercooked meat, and contaminated water.
• Viruses: Rotavirus and norovirus can also cause similar symptoms. These are often spread through contact with contaminated surfaces or infected individuals.
• Parasites: Giardia is a common parasite found in untreated water.

But no worries: With the following tips you can protect yourself from the main causes of traveler’s diarrhea.

At a Glance: 13 Tips on How to Stay Healthy in Mexico

Here are some general guidelines on how to prevent getting traveler’s diarrhea. Especially if you have a sensitive digestive system, you might want to stick to it more thoroughly.

1. Avoid Tap Water: The first rule is to avoid tap water. Don’t use it to rinse your mouth after brushing your teeth. Also, don’t use it for making tea or coffee, nor for boiling pasta or rice. Always use bottled water instead.
2. Peel It: Bacteria can survive on surfaces for a long time. Especially on the skin of fruits and veggies, they can multiply. The best option is to peel your fruit to avoid any issues and wash and boil your vegetables. Be careful with already peeled and sliced-up fruit you can buy on the street or at the beach: You don’t know if the person who prepared it followed hygiene rules, nor do you know how long it’s been since they prepared the fruit.
3. Disinfect It: If you can’t peel it, wash your fruits and veggies with bottled water and soak them in vinegar water for 10-15 minutes. Some also use baking soda, as it’s said to get rid of some pesticides that might still linger on the produce. One doctor even told me that she washes her fruits and veggies with soap. Anything to kill the bugs, I guess😉
4. Order Only Bottled Water: At restaurants, order a bottle of water („una botella de agua”) instead of a glass of water (“un vaso de agua”). You’d expect that the glass of water has been filled with purified drinking water from the garrafón (20 l jugs), but you can’t know for sure. You better order a bottle of water and check that the lid is still sealed before opening it. In general, sticking to bottled or canned drinks can prevent many issues.
5. No Ice, Baby! I usually order my beverages without ice cubes („sin hielo“). Again, you don’t know if they used purified drinking water from the garrafón to make the ice, or if they’ve stored it in a clean environment.
6. Wash Your Hands Regularly: Tacos, Burritos, Botanas, Nachos – many Mexican foods or snacks are eaten with your hands. Make sure to wash your hands thoroughly before eating. Carry hand sanitizer for situations when soap and water aren’t available.
7. Be Careful Eating at Market Stalls: I love the experience of visiting the local markets, and I’m always curious about what kind of food the street vendors offer at their stalls. However, be aware that these stalls or stands often don’t have running water. No opportunity for the cook to wash their hands in between handling the food and the money, nor for cleaning up. Often, you get served your food on a plastic dish wrapped in plastic (again, for the lack of running water to wash the dishes). Now, you might not want to miss out on all the food experiences, so my general guideline is this: Eat where the queue is the longest – that means that the food is relatively fresh and hasn’t been lying around for long, and the locals also know where you can eat safely.
8. Prefer Cooked Food: The heat of the cooking process kills already many bacteria, so it should generally be safer to eat than raw food.
9. Be Careful Eating Raw Fish: Some Mexican dishes are made of raw fish (ceviche, fish cocktails). If you have a sensitive stomach, you should be careful with these. The preparation of ceviche, for example, should prevent bacteria, as the acidity of the lime it’s prepared with doesn’t allow it to grow. However, that’s just true for the outside of the fish; if the fish has bacteria or parasites on the inside already, this won’t change much about it. Also, I would avoid fish buffets and rather order a freshly prepared plate.
10. Dairy Products: Unpasteurized dairy products can carry a risk of contamination. When you have a sensitive gut, it’s probably wise to stick to commercially bottled milk, cheese, and yogurt.
11. Up your Medication: Although you get the standard off-the-shelf medication in any pharmacy, I suggest bringing some emergency medication as you never know when Montezuma strikes. I’m not a big fan of taking Imodium (loperamide) at the slightest hint of diarrhea, but I think it can be vital when you need to get your bus to your accommodation or your flight back home on time.
12. Get Help at the Local Pharmacies: Many pharmacies in Mexico have a consulting room next to them where a doctor can examine you and prescribe the required medications. This is a very economical way of getting medicinal help. The consultation usually costs around 50 pesos (3 USD) or is completely free. And no worries about language barriers: In tourist areas, the doctors speak English; else use your translation app. If you have travel insurance, contact them first for information on how to proceed.
13. If in Doubt, Deworm: For recurring digestive issues, taking an antiparasitic medication might be helpful. This type of medication has normally no harmful side effects unlike antibiotics, and for people living in Mexico, Mexican doctors recommend taking them once a year to be on the safe side. However, check with your doctor first instead of self-medicating yourself.

Hopefully, sticking to these guidelines will help you prevent getting sick in the first place.

What to Do When Montezuma’s Revenge Hits You

Here are some tips on what to do if you get traveler’s diarrhea nevertheless. Please note that I‘m not a doctor and this isn’t medical advice.

• Stay Hydrated: When you have traveler’s diarrhea, you’ll lose a lot of water. Make sure to drink enough water to stay hydrated. Remember to choose bottled water.
• Take Electrolytes: Recharge your batteries that get drained due to the sickness. At Mexican pharmacies, you can buy “Electrolitos Orales”, for example. These are little packs of electrolyte powder you can dissolve in drinking water.
• Take a Rest: Slow down your activities to give your body the chance to recover.
• Take Medication: Normally, traveler’s diarrhea doesn’t last longer than 1-3 days. Still, some medications can help you get through this time. The best is to bring the medication you know from home with you.
• Consult a Doctor: If diarrhea takes longer than 1-3 days, or you feel really bad or notice symptoms not normal for regular diarrhea, I suggest consulting a doctor. Contact your travel insurance about how to proceed. As mentioned before, most pharmacies have a consulting room next door, where a doctor can examine you and prescribe any medication required. In tourist areas, Mexican doctors speak English; else use your translation app.
• Stick to a Diet: While being sick, it’s recommended to watch what you eat. Take a break from spicy food or anything that irritates your bowels. I was once recommended the BRAT diet by a doctor when having diarrhea: Bananas, rice, apples, and toast.

Hopefully, you’ll feel better soon when your body has the time and chance to recover.

A Little Preparation Goes a Long Way

If you’re prepared with an emergency medication kit, and know how to stay safe in the country, you’ll likely avoid Montezuma’s revenge. And even if you get it, remember that most infections are mild and pass after a couple of days. So don’t let the fear of catching traveler’s diarrhea ruin the joy and fun of exploring Mexico and its cuisine!

I hope you find this guide helpful. Have a safe and healthy vacation in Mexico!

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