A trek is not only about your legs. It is also about your stomach, your throat, your skin and your sleep. Most of the small health problems on the trail come from the same few things: water, food, dry air, sun and cold. And most of them can be avoided with simple habits.
I’m Rujan, a licensed trekking guide in Nepal since 2018. This guide shares what I tell every walker before we start. It is practical advice from the trail, not medical advice: for vaccinations and medicines, please speak to a doctor or travel clinic before you come.
Safe drinking water, without plastic
You will drink a lot on a trek: often three to four litres a day at altitude, where the air is dry and you breathe hard. Water must be safe, but it does not need to come in plastic bottles. Every bottle bought on the trail stays in the mountains as rubbish, and some regions limit single-use plastic for this reason.
Refill your own bottle, from teahouse taps, springs or refill stations, and treat the water with one of these:
| Method | Good to know |
|---|---|
| Purification tablets or drops | Light and simple. Wait the full time on the packet before drinking (often 30 minutes; longer in very cold water). |
| Water filter | Fast, with no taste. Check what it removes: many filters don’t stop viruses, so add tablets if you’re unsure. |
| UV pen | Works in clear water in about a minute. Needs batteries; less effective in cloudy water. |
| Boiled water | Many teahouses sell boiled water. It’s safe once it has boiled properly, even at altitude. Let it cool in your bottle overnight. |
A few more tips:
- Use a bottle, not a hydration bladder, above about 4,000 m. Tubes freeze at night and in the early morning.
- Fill up in the evening with treated or boiled water, so it’s ready for the morning.
- Don’t drink straight from streams, however clean they look. Animals and villages live upstream.
- Watch the colour of your urine: pale is good, dark means drink more.
Food that keeps you strong
Eat well, even when you’re not hungry. At altitude, appetite often drops, but your body needs energy to walk and to adjust. Eat a good breakfast, snacks during the day, and a full dinner.
Dal bhat is your friend. Rice, lentils and vegetables, freshly cooked, with a free second helping in most teahouses. It gives steady energy all day.
Simple rules for a happy stomach:
- Eat hot, freshly cooked food.
- Choose vegetarian higher up. Meat is carried up for days without a fridge.
- Be careful with raw salads and unpeeled fruit, unless they’re washed in treated water.
- Avoid ice unless you know it’s made from treated water.
- Bring a few snacks from home that you like: nuts, chocolate, energy bars.
Read more about food and lodges in my guide to teahouse life in Nepal.
Clean hands
This is the simplest habit, and the most important.
- Use hand sanitiser before every meal and snack, and after the toilet.
- Wash your hands with soap when you can.
- Don’t share water bottles or cups.
- Keep your nails short.
Many stomach upsets on the trail come from hands, not food.
If your stomach gets upset
It happens to many travellers, especially in the first days in Nepal. Usually it’s mild and passes in a day or two.
- Drink plenty of water, with rehydration salts (ORS) to replace what you lose. Bring a few sachets from home; they’re also sold in Nepal.
- Eat plain food: rice, soup, plain noodles, crackers, tea.
- Rest, and tell your guide. We can walk shorter, or wait a day.
- See a doctor if you have a high fever, blood in your stool, severe pain, or if it doesn’t improve after a couple of days. Higher up, the Himalayan Rescue Association aid posts on the main treks can help in the main seasons.
Speak to your doctor before you travel about which medicines to bring for traveller’s diarrhoea, and how to use them.
The dry-air cough
Many walkers above about 4,000 m develop a dry, tickling cough from breathing cold, dry air, often called the “Khumbu cough” in the Everest region.
- Cover your mouth and nose with a buff or scarf, especially in the morning and when it’s windy or dusty.
- Drink warm drinks: tea, hot water, ginger and lemon.
- Throat lozenges help.
If the cough becomes wet, with breathlessness at rest, it can be a sign of fluid in the lungs (HAPE), which is an emergency. Read my guides to altitude sickness in Nepal and emergencies and rescue.
Sun, cold and skin
- The sun is very strong at altitude, even on cold days. Use sunscreen (SPF 50) and lip balm with SPF, and wear sunglasses with full UV protection; dark ones for snow.
- Layer for the cold: warm in the evening and at night, light while walking. Change out of sweaty clothes when you arrive.
- Moisturise: the dry air cracks lips, hands and heels.
Feet and knees
- Blisters: stop at the first hot spot and put on a blister plaster before it becomes a blister. Keep your feet dry; change socks if they’re wet.
- Knees: use trekking poles on long descents, and walk down slowly with short steps.
- Rest your feet in the evening with camp shoes or sandals.
Sleep and rest
Sleep is often lighter at altitude, and that’s normal. Go to bed early, keep warm, use earplugs in teahouses, and don’t worry about a restless night. On rest days, rest truly: a short walk higher in the morning, then relax.
What to bring
- Water purification (tablets, drops, filter or UV pen) and two bottles
- Hand sanitiser and a small soap
- Rehydration salts
- Your own medicines, in their original packets, and anything your doctor advises
- Blister plasters and tape
- Sunscreen, lip balm and sunglasses
- A buff or scarf
- Throat lozenges
See my full Nepal trekking packing list.
Before you travel
- Visit a doctor or travel clinic a few weeks before your trip, for vaccinations and advice about medicines, including for altitude.
- Tell your guide about any health condition or medicine. It stays between us, and it helps me look after you.
- Check your travel insurance covers trekking at your altitude. See my guide to travel insurance for trekking in Nepal.
Frequently Asked Questions
Can I drink tap water on a trek in Nepal?
Not untreated. Refill your bottle from taps or springs, and treat the water with tablets, drops, a filter or a UV pen, or drink boiled water from the teahouse.
Should I buy bottled water on the trail?
Better not. Plastic bottles stay in the mountains as rubbish. Refilling and treating your own water is safe and cheaper.
How much water should I drink at altitude?
Usually three to four litres a day. Pale urine is a good sign you’re drinking enough.
What should I eat on a trek?
Hot, freshly cooked food. Dal bhat is the best, and vegetarian food is safest higher up.
What is the Khumbu cough?
A dry cough from breathing cold, dry air at altitude. Cover your mouth with a buff and drink warm drinks. A wet cough with breathlessness at rest is different, and needs attention at once.
Simple Habits, Happy Trail
Most of staying healthy in the mountains is simple: clean water, clean hands, hot food, warm layers and enough rest. Do these every day, walk slowly, and tell your guide how you feel. Then your body will be free to enjoy what you came for.
Have more questions? Read my trekking FAQ or browse all my Nepal travel guides.
Rules change. If something here is out of date, please tell me and I will correct it.Tell me
