Drinking water is not cause of diarrhea

DEAR DR. ROACH » While reading one of your recent columns, I learned that all water, except distilled, contains electrolytes. I wondered if there are differences in the amount of each electrolyte in drinking water in different places in Canada, and if so, whether that might explain why I experience cramping and diarrhea when I am visiting another place? Through experience, I have been able to avoid the problem by drinking only bottled mineral or distilled water when I am away from my home. In cases where I have been on lengthier holidays, after I lived through the initial distress, eventually, my gastric system calmed down and seemed to accommodate the new source of water. I felt that my malady might be some sort of domestic version of Montezuma’s Revenge, but the analogy is inapt because the water I have consumed away from my home was not contaminated.

— M.T.

DEAR READER » “Montezuma’s Revenge” is an (insulting) term for traveler’s diarrhea, specifically in reference to Mexico, where drinking water may be contaminated with bacteria, especially a type of E. coli that has a toxin. I don’t think the answer to your diarrhea while traveling is in the water.

The quality of drinking water in nearly all of Canada and the United States is outstanding, and bacterial contamination is exceedingly rare, as you say.

Similarly, electrolytes are kept at very low levels in most parts of North America, although some water softeners do put a fair bit of sodium into the water in exchange for other ions, such as magnesium and calcium. Still, none of these trace minerals are likely to cause diarrhea.

Some people develop diarrhea with stress. You don’t have to be diagnosed with irritable bowel syndrome to have stressrelated diarrhea, and travel is a stressful time for many.

Other people are more likely to drink alcohol while traveling, and excess alcohol can cause diarrhea.

I can’t explain why drinking bottled or distilled water seems to prevent the problem.