Stomach upsets, food poisoning and what Antinal actually is

It is usually not food poisoning

Almost everyone calls it food poisoning and almost nobody has it. The common case is ordinary travellers’ diarrhoea — unfamiliar bacteria arriving via water, ice, washed salad or a hand that touched something, in a gut that has never met them. True toxin food poisoning from a specific bad dish exists, but it is a minority of what happens on this coast, and blaming last night’s fish is usually wrong about both the cause and the fix.

If half the hotel has it, it is probably not the kitchen

Sudden violent vomiting sweeping through a resort over two or three days is the signature of norovirus, which spreads person to person and by surfaces — lift buttons, buffet tongs, pool handrails — not by food. It is ferociously contagious and passes in a day or two. The response that works is handwashing with soap (alcohol gel is poor against norovirus), staying out of the pool and off the buffet while ill, and rehydrating hard.

The heat is what makes this serious here

At home, a day of diarrhoea is miserable and self-limiting. At 38°C with a sea breeze hiding how much you are sweating, the same illness dehydrates you far faster, and dehydration is what actually puts visitors in a clinic. This is the single reason to take a stomach upset more seriously on this coast than you would at home — and the reason rehydration, not medication, is the priority.

How pharmacies work here

Egyptian pharmacies are excellent, everywhere, open late, and function as the first line of care rather than the last — a pharmacist is genuinely knowledgeable and consulting one is normal, not a fallback. They will also sell you almost anything without a prescription. Both halves of that are true at once: use them, and understand that a recommendation across a counter is not a diagnosis.

Eating again

Start when you are hungry rather than to a schedule, with plain starch — bread, rice, potato, plain pasta. Skip the dairy for a day or two, since the enzyme that handles it is often the last thing to come back. Alcohol and a big buffet are the two things most likely to restart it. And keep drinking after the symptoms stop, because the deficit takes longer to refill than it did to create.

Oral rehydration salts

Glucose and electrolyte powder (ORS)

What it is

Sachets of glucose and salts dissolved in clean water. Every pharmacy on the coast has them, they cost almost nothing, and they are the only item on this page that treats the thing that actually harms people.

The honest verdict

The one to buy, and the one nobody asks for. The glucose is not a sweetener — it is what lets the gut absorb the sodium and the water with it, which plain water and cola do not do. In a climate where you are already losing fluid before you are ill, this matters more here than it would at home.

Watch out for: Mix with bottled or boiled water, at the dilution on the packet — stronger is not better. Sip continuously rather than drinking a lot at once. If you cannot keep fluids down at all, that is a doctor, not a stronger sachet.

Antinal

Nifuroxazide

What it is

The default. An intestinal antiseptic of the nitrofuran class that stays in the gut rather than being absorbed into the body, sold over the counter here in capsules and as a children’s suspension, and handed out for essentially any diarrhoea.

The honest verdict

Widely used in Egypt, and not authorised at all in most of northern Europe — you cannot buy it in the UK, Germany or the US, because it has never been approved there. The evidence that it shortens ordinary travellers’ diarrhoea is thin. In 2019 the French medicines regulator restricted nifuroxazide to adults and pulled the paediatric forms from the market, citing the risk of serious hypersensitivity reactions and no demonstrated benefit in children.

Watch out for: The gap that matters: the children’s syrup an Egyptian pharmacy will cheerfully sell for a toddler is a formulation France withdrew. If it is for a child, ask a doctor rather than a pharmacy counter. Stop immediately and get help for any rash, swelling or breathing difficulty.

Imodium and its generics

Loperamide

What it is

Slows the gut down. It treats the symptom and nothing else, and it is the reason people get through a flight home or a four-hour bus to Luxor.

The honest verdict

Genuinely useful for an adult who needs to travel, and honest about what it is: a pause button, not a cure. It does not shorten the illness and may slightly prolong it, which is a fair trade for a specific journey and a poor one as a default.

Watch out for: Not with a high fever, and not with blood or mucus in the stool — in an invasive infection, slowing everything down keeps the problem in. Not for young children. If you need it for more than a day or two, the answer is a doctor rather than another box.

Smecta and similar

Diosmectite

What it is

A clay-based powder that binds fluid in the gut. Common on Egyptian and French shelves, mixed into water, chalky to drink.

The honest verdict

Mild and largely benign. It firms things up somewhat and is not doing much beyond that. Harmless as an adjunct to rehydration; not a substitute for it.

Watch out for: Take it well apart from any other medicine — it binds those too, and will reduce the absorption of anything swallowed alongside it, including antibiotics and the contraceptive pill.

Antibiotics over the counter

Azithromycin, ciprofloxacin and others

What it is

Egyptian pharmacies will sell antibiotics without a prescription, and will often suggest them. This is a convenience and a trap in the same transaction.

The honest verdict

There is a real place for antibiotics in severe or dysenteric travellers’ diarrhoea — prescribed, for the right case. There is no place for taking them because a counter suggested it for two days of ordinary looseness, which is most cases, which resolve on their own.

Watch out for: Self-prescribing here has three costs: side effects, a course that may be wrong for the organism, and a contribution to the resistance that already makes some of these drugs less useful in this region than they were. Ask a doctor. Clinics on this coast are quick and used to exactly this.