Some time ago, the Thai Ministry of Health published a list of nine Thai dishes that can easily cause diarrhea.

Food poisoning and traveller's diarrhoea

Traveler diarrhea affects more than 40 percent of travelers. In most cases, nothing serious is going on and the illness lasts one to five days. Nevertheless, digestive problems cause a change in time use in 40 percent of cases, and a few days of rest are required in 20 to 30 percent of cases.

Food poisoning is caused by toxins in food. These toxins are produced by bacteria or fungi. Abdominal cramps, nausea, diarrhea or vomiting are signs of food poisoning. The complaints usually arise within 8 hours after infection. According to a British study, it is especially important to be careful when traveling to high-risk countries. “In addition to the destination itself, the level of hygiene also plays a role and the restaurants you visit,” the researchers emphasize.

Thailand risk country

Thailand is in the top 5 of countries where you are most at risk of traveler's diarrhoea. According to a British study, the 'Land of Smiles' is even number 3. Only in Egypt and India are you more likely to get traveller's diarrhoea.

The Thai Ministry of Health warns

Between January 1 and March 10 this year, there were over 191.515 cases of severe diarrhea, likely caused by food poisoning, according to Thailand's health department. The ministry therefore asks restaurants in Thailand to pay more attention to hygiene in the kitchen and calls on Thais to wash their hands before every meal.

Below is the list of Thai dishes that you should keep an eye out for in hot weather. They can quickly breed bacteria and fungi, potentially posing health risks.

1. Larb/Koi a spicy Isan meat dish. This dish is a combination of meat seasoned with fish sauce, lime juice, chili and herbs. Especially Koi is dangerous because raw meat is used for it.

2. Yum Goong Dten or 'spicy shrimp salad': The literal Thai name is 'Dancing shrimp salad', which suggests that live shrimps are used in the dish.

3. Yum Hoy Krang or "spicy cockle salad." This dish can only be eaten when the clams are well cooked.

4. Fried rice with crab meat

5. All dishes with coconut milk: Phanaeng curry, Massaman curry, chicken with green curry, coconut custard, Bualoy, Saku Biak, you name it.

6. Kanom Jeen Kanom: This dish is made from rice that has been fermented. As a result, it spoils quickly.

7. Khao Mangai 'chicken with rice'

8. Som Tam (with palaa – fermented fish) 'spicy green papaya salad'

9. Leaf salad

The ministry also warns against desserts with ice cream. In addition, be careful when buying food in the early morning. Sometimes it's about food left over from the previous day.

Sources: www.coconutsbangkok.com/ en www.thailandblog.nl/toerisme/reisigersdiarrhoea/

31 responses to “Tourists Beware: Nine Thai Dishes That Guarantee Serious Diarrhoea!”

  1. J. Jordan. says up

    It is also mainly about food from those mobile stalls on the street. Often looks good, especially after a drink after a night out. Something sweet just before going to sleep. You mustn't forget that those guys already took to the street with that cart in the morning and walked around with it with about 32 bones.
    Of course many of those people are also busy making everything fresh in the afternoon.
    When I came here on holiday (a long time ago) I sometimes had stomach problems. Now that I've lived here for years, almost no more.
    I think I've become a bit of a Thai. You become immune to certain bacteria. I always tell my wife. A cow can drink from the ditch, but we can go straight to the hospital.
    My advice. Just go try everything. I used to have a few days of diarrhea when I was on holiday in Spain. Also often caused by drinking too much cold in that heat.
    J. Jordan.

    • Ann says up

      There is a golden rule for stalls: buy from one that is busy, high turnover is important.
      something that has been waiting all day is a bad thing.

  2. Simon Slototter says up

    My experience is that food in Thailand is really safe. In Isaan I ate raw meat and one of my favorite meals is “Kung Cha nam plaa”. That's a raw shrimp dish.

    My advice to friends is to drastically change the way they are used to eating when they are in Thailand. (Or any other country for that matter.)
    But my experience, however, is that even many expats cannot afford this. "Because they're so used to it." (Let alone a brand new Tourist.) Breakfast, lunch and dinner. Often in the same amount as they are used to. And because it's so delicious, something more.
    They do not realize that the climate can have an influence or vice versa.
    .
    First of all, drink plenty of (bottle) water. This somewhat dampens the feeling of hunger and is also necessary to eliminate the loss of moisture. In addition, there is really no shortage of dining options in Thailand. Because wherever you look, you will see a stall everywhere and in an emergency you can always find a snack at 7eleven.

    Taste and snack small amounts throughout the day. Especially if you are at a Thai party, it is not necessary that you fill your plate. Because before you can blink your eyes, there are new dishes on the table. My experience is that most Westerners say thank you after half an hour. But then the feast has yet to begin. So feel free to skip a hallway if you haven't finished your plate yet. Because there is no time limit.

    I would also avoid large hotels or restaurants or hawkers with food, where you cannot see how and when the food has been prepared or stored, for the first few weeks. Yes, I know tourists understandably opt for convenience. But maybe it helps if I tell you that at best you pay double what you would pay at a food stall.

    After a week you will notice that you have adjusted reasonably well. And at the end of the holiday, that you are 5 kg heavier. 🙂

    Enjoy your meal.

    • RonnyLadPhrao says up

      All well and good, and what you write is good nutritional advice, but that has no effect on the risk of getting diarrhea from food poisoning.
      You may experience a more difficult digestion due to the heat, or because your body is not used to the food and you will notice that in your bowel movements, but that is not the result of food poisoning.

      The amount of food a person consumes is not important, but the ingredients and how they are prepared or stored, as well as the general hygiene of the eatery, environment and staff.
      Once food is inside it can't get bad anymore, the stomach acid will take care of that.

      I think you increase the chance of getting diarrhea if you eat small amounts all day instead of 3 meals, because then you only have three times the chance of eating something spoiled.
      On the other hand, it is healthier to eat several small meals in a day instead of three large ones.
      By the way, I think most people here already eat less, just because it's warm. At least I do, even if it's nice I'm satisfied faster here.

      I have also had some bad experiences with food in Thailand and it is now much less. It will be true that you become more resistant to certain bacteria. Yet I also see in my Thai family that occasionally one is passed out due to food poisoning.
      One of the ways I use to limit the risk is to either pick up food from well-known stalls or one where a lot of people come. Many people mean a high turnover and the chance that it is freshly made daily increases.

      You can of course make all the preparations you want, but you can't rule anything out and if you're unlucky then it's sick. Just then it is also very important to drink a lot of water.

      Still tasty.

    • theos says up

      Those street stalls and moving creatures are the worst culprits. Have you ever seen how or where they clean their dinner plates and cutlery? If there is a klong nearby, it is done with klong water. Or a tub is filled with water in the morning and the dishes are washed in the same water all day long. Ugh! No water? Plate is then wiped clean using a roll of toilet paper. Ice cubes in your drink? I have and still see how they get that ice cream. Is ordered and then placed in the back of a pick-up or the sidecar of a motor cycle, covered with a jute bag.
      The block of ice is tipped to the ground and dragged with tow hooks to the stall or food house. this one makes cubes of it with a pick hammer or otherwise and in your drink. Bon appetit and get enough pills at home.

  3. Mathias says up

    What are we supposed to do with this again? The example som tam beats everything. Fermented fish. I think fermented products are very good for digestion because they replenish good bacteria. They say that it can cause diarrhea. Nice contradiction. Perhaps this site will help the ministry, for example.

    http://www.optimalegezondheid.com/gefermenteerde-voeding-voor-extra-goede-bacterien/

    Actually it is an easy story and this applies to all food stalls or famous restaurants: If the hygiene is not good or products are not treated properly, we can get sick all over the world, this has nothing to do with these dishes. If the chicken is no longer good, we will really get sick and also from chicken dishes that are not mentioned here.

  4. m.mali says up

    “Yum Goong Dten or 'spicy shrimp salad': The literal Thai name is 'Dancing shrimp salad', which suggests that live shrimps are used in the dish.”

    Not only does it suggest, but it is also true…
    When it is prepared in the “Clock” (stone bowl where the herbs are steeped) the very small shrimps indeed jump out….

    Ate it once, but also raw shrimp cut into strips, topped with a sweet and sour sauce….

    Oh everything is so delicious here…

    A good tip if you do not trust the food you have eaten, then immediately drink 1 or 2 strong drinks straight ... (kill all germs I thought and so in the 7 years that I have been here now, I have only had a diarrhea attack once in the beginning, so I always keep the drink at hand…haha)

    • Eric Donkaew says up

      “Yum Goong Dten or 'spicy shrimp salad': The literal Thai name is 'Dancing shrimp salad', which suggests that live shrimps are used in the dish.”

      Those are also included. See for yourself: http://www.youtube.com/watch?v=KuCmiAOxnYA

  5. RonnyLadPhrao says up

    I have also eaten all those dishes or still eat them regularly.
    You have to have some luck, but in general I think it's not too bad.
    However, no matter how delicious it may be, eating raw food in Thailand is always a bad idea. Always go for fried or boiled food, but then of course you still have no influence on the baking or cooking process, or you don't know in what conditions or how long the food has been stored. So nothing can be ruled out.
    Another cause is often overlooked and that is tap water. Always be careful with this, even when brushing your teeth

    Tourists are also quick to assume that they have food poisoning, but often it's just the change of food and drink, or the use of lots of ice cubes, that shocks the digestive system for the first few days.
    Usually this is limited to some practical inconveniences.

    What is worse is the well-known tummy or traveler's diarrhoea. Name speaks for itself.
    You can read all the details about this here http://www.ingelicht.be/reizigersdiarree-of-turista

  6. Tino Kuis says up

    Traveler's diarrhea has beautiful names such as Dehli belly, Rangoon runs, Montezuma's revenge, Aden gut and Tokyo pride.
    More than 95 percent of travelers' diarrhea occurs in the first week of the journey. 45 and 18 percent.
    In the Netherlands, 4 million people per year have a period of acute diarrhea comparable to traveller's diarrhoea.
    Bacteria and viruses are the culprits, a new strain of E.Coli (a common intestinal bacteria) the most common. Bacterial poisons a close second.
    Traveler's diarrhea has more to do with getting acquainted with new organisms against which we have not yet built up resistance (immunity) than with unhygienic conditions or 'different type of food', although that also plays a role. This also explains why (older) people and those who have lived in a country for a longer period of time have less diarrhea even though they eat the same food. I now have diarrhea as often as I used to in the Netherlands, about once every few years. That is the paradox: the more contaminated food you consume, the more immunity you build up and the less often you end up with acute diarrhea. So if you get diarrhea, remember that it is good for building up your immune system!
    I wouldn't use Motilium, there are nasty stories about that. Only loperamide (Imodium) if it is really necessary (bus and air travel), it always goes away after 2-3 days. Consult a doctor in case of fever, blood and/or mucus in the stool or severe abdominal cramps. A separate diet does not help much. Drink extra.
    I think it's completely nonsense to remove the above nine dishes, that's just guesswork, no research has been done. So tame dangerous? I do not believe it.

  7. Ruud Vorster says up

    Food poisoning gives you diarrhea , but diarrhea does not automatically mean food poisoning .
    The biggest culprit for diarrhea is not in the list of 9, which is WATER
    Never drink unbottled water or use ice that you are not sure is kosher!
    .

  8. Harry says up

    Our poor bellies, always overprotected, no natural resistance anymore, so… we go flat with every new bacteria.
    Singaporeans talked to me about it back in 1995: one step outside the super-hygienic city-state and we fall over. Or as a Dr in food science and NL QC manager summed it up, after seeing everything in TH: I am paid to keep EU food safety laws up, NOT to prevent half the population from being killed in the event of a 6-month power cut. dies of food poisoning.
    Own experience: eaten at a Thai. My wife fell over after 1 hour and almost threw her diaphragm out. After 4 hours of very rickety, the mend was already started. I... felt mediocre. Next morning on a company visit,. She... mediocre, me lousy. At 12:00 I literally fell over, and was taken to the hospital. A week of medication and in bed because.., I was semi-immune, so everything could have passed on in my stomach. My wife had zero tolerance, so everything out and all right the next day. Thai: zero burden.
    So every year on a new business trip, I update my immune system with a small infection, two days of tummy time and .. I can eat anywhere in TH again.
    With thanks to the EU Inspection Service of Waren and the legislation.

  9. adje says up

    If you have to believe the above list, you can no longer eat anything. Even rice with chicken wouldn't be good. When I'm in Thailand I just eat everything. The only thing I take into account is that the water I drink comes from bottles. When you go to a foreign country you have to deal with a different kind of food. And a lot of people can't handle that well with the result that you get diarrhea. It doesn't matter if you are in Greece, Spain, Thailand or any other hot country. I would say to holidaymakers, take along medicines against diarrhea and constipation and something to supplement any moisture deficiency.

  10. michiel says up

    Been to Thailand 7 times for a month and only 2 times have been seriously ill.

    1st time of a club sandwich in an empty restaurant on Samui.

    2nd time mayonnaise (salmonella poisoning) in Kanchanaburi .

    Never got sick from local food, not even in Vietnam last November and there
    are some wild stories about . When I travel, I eat just about anything and almost everywhere.

    Always apply the rule "no row then shit".

    Digestion always sputters a bit during the holidays, but that is normal due to the heat, alcohol consumption and spicy food that we are not used to at home.

    I did find out that especially in Thailand and Cambodia often (too) many flavor enhancers are used. These often contain MSG (E620 to E625) if you are sensitive to it. Your dinner can also quickly turn into a run to the toilet.

    • brabant man says up

      Michael,
      You write that in Thailand, for example, flavor enhancers are often used. I can reassure you, these are always used. Stacks of KG bags are at the TESCO'S, Big C's EN 7/11. This is not often MSG, this is always MSG (monosonoglutomate). Thais find it extremely tasty, gives flavor to the food (cheaper than real herbs). But it can give you gout, a swollen face or stomach cancer. Then an extra walk to the toilet is not too bad.
      If it is present in a Dutch restaurant, the case will be closed. Many farangs say, I've never been bothered by it and I've been eating Thai food everywhere for years. If I then see their swollen legs, they say it is always due to the heat.
      When I eat Thai, I do this at home, homemade. Without ajinomoto or Vstin (Turot). Prevention is better than cure in my opinion.

  11. roswita says up

    My tip is to eat somewhere where many customers come, especially the Thai themselves. I once made the mistake of eating somewhere where I was the only guest. And that around dinner time. I subsequently contracted salmonella poisoning from the chicken I ate there. With 3 days of severe abdominal pain and diarrhea. As for the small roadside shacks in Bangkok, you can generally eat well there, but I always check to see if they have the meat in cool boxes with ice.

  12. rudolf says up

    i have been coming here for 10 years and only eat thai dishes…never been sick…but i only go to restaurants that are well stocked with thai…not enough customers then i move on

  13. harm says up

    Yes yes, one thing is certain if a commodity law starts to control the kitchens here, 90% of the restaurants can close, and what was said above you can sometimes just have bad luck, good food because wherever you are in the world, it can happen to you anywhere.
    Greetings.H.

  14. john says up

    Think NL is too sterile and too hygienic. Just look at what happened to our marines in Cambodia (1992). All with diarrhea. Not used to anything, of course there must be some control, but in Europe it goes too far.
    TGT, THT etc all invented by the industry to sell more.

  15. ruud says up

    If you go to a tropical country you will come into contact with bacteria that are different than in the Netherlands, because the Dutch bacteria are adapted to Dutch conditions. (A lot colder than Thailand for example)
    They are therefore unknown to the body and you suffer from them.
    If you go to – for example – Thailand more often, you will probably be infected later on and your body will know the bacteria and you will be less bothered by it.

  16. Dirkphan says up

    I've been coming to Thailand for 10 years now and really eat everything. Also Lao Food.
    Never been sick.
    In January I went to Vietnam for a week.
    After 1 day sick for the rest of the week.
    Diarrhea and vomiting.
    In other words, those rankings are null and void.
    And the article is pure gazette talk.

  17. joy says up

    Perhaps a nice addition because of conversation during the diarrhea.

    Diarrhea : Khie pen name
    Khie chak

    Regards Joy

  18. Jack S says up

    Since the article is more than ten years old, I looked it up again on Google and to my surprise, Thailand is still at the top of the top ten, approximately number 3.
    I didn't think so.
    I eat almost none of the dishes listed here. I can imagine that happening. But not just foreigners, I often hear that Thais themselves have become ill after eating certain dishes. In fact, I believe my wife has gotten sick from eating the wrong food more often than I have. The stupid thing is that many Thais don't see the connections between what they eat and why they get sick...

  19. Jan Scheys says up

    Has nothing to do with the food because I have been eating my spicy favorite dishes with coconut milk for years (I eat them as spicy as the Thais themselves) and I don't have any problems with it. In the early years in Thailand I also had diarrhea easily, but that is because you sometimes come into contact with polluted water. After years of visiting Thailand you get used to it. I even provide evidence to support this: at my parents-in-law's house in Isaan, there was a large pot of water outside under a canopy with a ladle made from a coconut shell in it and I drank from it! Extremely dangerous for people who are not used to it, but I had already built up such a strong resistance that it did not bother me. So it has nothing to do with the food “per se”, but because we live too hygienically and when we travel to countries like Thailand, we immediately have a “price”. I knew Thai ladies who, after living in Belgium for a few years, returned to Thailand and later told me that they were also suffering from diarrhea haha. They were also used to hygiene with us until they also experienced it during their visit.

  20. John van den Broek says up

    New Thailand travelers have in any case been warned by the above experiences.
    Personally, I always make sure that what I am going to eat is properly heated.
    The two times I got a bacteriological infection were: once after eating a salad at a renowned Italian restaurant (used the wrong water?) and once when eating spare ribs in a Western shopping mall.
    there you have it.
    I usually just eat Thai everywhere: Aroi Mak Mak

  21. René says up

    I have been to Thailand about 10 times now and met my wife there. Almost all the dishes mentioned in the story contain meat and because I eat vegetarian, especially in similar countries, I have not had any problems with annoying thin exhaust except once. That one time was indeed due to the aforementioned coconut milk from brother-in-law's tree. Never suspected that this could be the cause. I always looked for it in the flesh and dirty water. So no more coconut milk. As for the ice, look for a hole in the ice cube, this is factory produced ice and is known to be safe. No gap then be careful. Order your drink without added ice or inquire about it. I have often eaten from the street trade but never had any problems. Certainly a lot has been sold during the rest of the day and the flow of food reduces the chance that it is contaminated, but meatless food gives the least chance of diarrhea.

  22. Jan Scheys says up

    Just as you say: when eating a salad and probably washed in tap water. So it has nothing to do with the food because the Thais are very careful with hygiene in the kitchen. You see them everywhere with net caps on their heads and plastic gloves. Sometimes they also give rice, but put it by hand in a plastic bag. I have also seen that here in Belgium.
    When my ex was recently in Belgium, she was shocked when I ate “americain” on my sandwich!
    “Moo mei sook!!!”. Translated “meat not fried waaa”.
    You won’t find raw meat in Thailand (although they also eat raw shrimps) I once ate “americain” on a sea terrace in Hua HIn at a Frenchman’s but it didn’t taste good and watery. Probably from the freezer and defrosted…

  23. Lord Gerhard Smith says up

    There are too many individual experiences. I rely on the facts. Thailand is one of the three countries where you are most likely to contract an intestinal infection
    I received the advice from a friend and a friend: go to a restaurant where it is busy because there you run the least risk of diarrhea. I had my regular places where I ate my food and had a view of the kitchen and therefore how it was done. was prepared..
    Enjoy your meal

  24. Nicole says up

    In principle, you can get food poisoning anywhere. We eat almost exclusively European food. However, this does not mean that you cannot have problems. Indonesia in 5* hotel, kohn Kaen 5* hotel, KL same, Baden Baden Germany luxury hotel. These are just a few examples that it doesn't always have to be street food.

    • John Scheys says up

      100% right Nicole!!!
      Of course, the climate also plays a major role in those warm countries and there is therefore a greater chance that you will have problems there. I have been eating street food and in local restaurants for 30 years and in the early years I sometimes had problems, but nothing as a result of the food. Once I drank water from a thermos in the hallway of our hotel with my Thai wife and yes, I suffered from diarrhea for a week, including my wife.
      In Burma I once accepted tea from the window of the train that stopped and that was from local cups and of course the same but NEVER from the food. By the way, I eat as spicy as the Thai and that saves him another sip on a drink. It's strange that in all warm countries people eat spicy food! I think it has to do with the fact that those spicy things kill bacteria.

  25. Walter EJ Tips says up

    If you think/feel that something is wrong with your meal after the time that your digestion is properly going (varies from person to person, 1.5-2.5 hours) then there is a strong remedy.

    You eat an unripe pineapple – that is the one that is as white as possible – you will get from person to person severe/moderate stomach pain and/or hard noises. If you go to sleep when the digestion is not yet far advanced, a sprint to the toilet follows. That unripe pineapple is nowadays harder to find even in local markets.

    Usually you have everything out. The pineapple should not be white but with overly ripe fruits it does not work well. Of course no sugar on it.

    This involves changing the acidity. In older people, even without digestive problems, there is often too alkaline an environment to promote proper digestion.


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