{"id":35368,"date":"2025-02-26T14:42:49","date_gmt":"2025-02-26T22:42:49","guid":{"rendered":"https:\/\/community.nrs.com\/duct-tape\/?p=35368"},"modified":"2025-02-19T17:09:15","modified_gmt":"2025-02-20T01:09:15","slug":"toilet-paper-diaries-lesson-two","status":"publish","type":"post","link":"https:\/\/community.nrs.com\/duct-tape\/2025\/02\/26\/toilet-paper-diaries-lesson-two\/","title":{"rendered":"The Toilet Paper Diaries, Lesson Two: Don&#8217;t Drink That! Gastrointestinal Care for Paddlers"},"content":{"rendered":"<h2><b><span data-contrast=\"none\">Welcome to the\u202f<\/span><\/b><b><i><span data-contrast=\"none\">Toilet Paper Diaries<\/span><\/i><\/b><b><span data-contrast=\"none\">, a series of lessons about&#8230; poop.<\/span><\/b><span data-contrast=\"none\">\u202f<\/span><\/h2>\n<p>Your professors are paddlers and their lectures combine their education, experiences, and professional insights, providing practical advice for whitewater enthusiasts.<\/p>\n<p>These lessons cover three essential feces-focused skills: minimizing environmental impact (water management), connecting with nature (identifying wildlife through scat), and staying safe and healthy (understanding water treatment). All foster a better understanding of aquatic ecosystems where paddlers play, strategies to stay healthy on the water, and mitigating negative impacts on nature.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-large wp-image-35224\" src=\"https:\/\/d2kl15j267vxtq.cloudfront.net\/duct-tape\/wp-content\/uploads\/2025\/01\/30151523\/NRS-ToiletPaperDiaries_3x2-1000x667.png\" alt=\"\" width=\"970\" height=\"647\" srcset=\"https:\/\/d2kl15j267vxtq.cloudfront.net\/duct-tape\/wp-content\/uploads\/2025\/01\/30151523\/NRS-ToiletPaperDiaries_3x2-1000x667.png 1000w, https:\/\/d2kl15j267vxtq.cloudfront.net\/duct-tape\/wp-content\/uploads\/2025\/01\/30151523\/NRS-ToiletPaperDiaries_3x2-300x200.png 300w, https:\/\/d2kl15j267vxtq.cloudfront.net\/duct-tape\/wp-content\/uploads\/2025\/01\/30151523\/NRS-ToiletPaperDiaries_3x2-768x512.png 768w, https:\/\/d2kl15j267vxtq.cloudfront.net\/duct-tape\/wp-content\/uploads\/2025\/01\/30151523\/NRS-ToiletPaperDiaries_3x2-1536x1024.png 1536w, https:\/\/d2kl15j267vxtq.cloudfront.net\/duct-tape\/wp-content\/uploads\/2025\/01\/30151523\/NRS-ToiletPaperDiaries_3x2-2048x1366.png 2048w\" sizes=\"auto, (max-width: 970px) 100vw, 970px\" \/><\/p>\n<p><span data-contrast=\"auto\">When navigating whitewater, water naturally gets in your mouth, nose and eyes\u2014it\u2019s unavoidable. On multiday missions, having to drink the element we play in becomes a sort of paradox. Understanding the basics of what\u2019s in the water can help mitigate fecal fiascos. Professor Kyle\u2019s <\/span>lesson will include details about common waterborne illness and a rundown on how to prevent, diagnose and treat\u2026 the runs.<\/p>\n<h2><b><span data-contrast=\"none\">Meet the Professor <\/span><\/b><b><span data-contrast=\"auto\">|<\/span><\/b> <b><span data-contrast=\"auto\">Kyle Smith<\/span><\/b><\/h2>\n<p><span data-contrast=\"auto\">Meet Kyle Smith, aka &#8220;Smitty&#8221; to his friends. He\u2019s a trauma nurse with a background in big water and expedition paddling. \u201cI\u2019m an adventure enthusiast with potatoes and sagebrush in my veins,\u201d says Kyle. Nurse, kayaker, DIY\u2019er and new dad, Kyle fell in love with moving water on the Middle Fork of the Salmon at the tender age of 16. But it wasn\u2019t until he started guiding on California\u2019s Kern River that he really<\/span> <span data-contrast=\"auto\">learned to kayak.<\/span><\/p>\n<p><span data-contrast=\"auto\">Guiding sparked an interest in wilderness medicine and, eventually, nursing. His work as a trauma nurse<\/span><span data-contrast=\"auto\"> accommodates a \u201cpaddling wanderlust\u201d that has taken him all over the world, paddling (and drinking) whitewater from Chile to Nepal, India to Ecuador, East Coast USA and home to Idaho. Like most international paddlers, Kyle has plenty of gut health-related stories as souvenirs from his travels. Paired with his medical training, he\u2019s the man to teach <\/span><span data-contrast=\"auto\">paddlers how to stay healthy in order to, in his words, \u201crun the sh*t, as opposed to having to take\u2026 well, you get it.\u201d<\/span><\/p>\n<div id='gallery-1' class='gallery galleryid-35368 gallery-columns-3 gallery-size-thumbnail'><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon portrait'>\n\t\t\t\t<a href='https:\/\/community.nrs.com\/duct-tape\/2025\/02\/26\/toilet-paper-diaries-lesson-two\/tpd_kylesmith_2x3_6\/'><img loading=\"lazy\" decoding=\"async\" width=\"100\" height=\"100\" src=\"https:\/\/d2kl15j267vxtq.cloudfront.net\/duct-tape\/wp-content\/uploads\/2025\/02\/13090444\/TPD_KyleSmith_2x3_6-100x100.jpg\" class=\"attachment-thumbnail size-thumbnail\" alt=\"\" \/><\/a>\n\t\t\t<\/div><\/figure><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/community.nrs.com\/duct-tape\/2025\/02\/26\/toilet-paper-diaries-lesson-two\/tpd_kylesmith_3x2_4\/'><img loading=\"lazy\" decoding=\"async\" width=\"100\" height=\"100\" src=\"https:\/\/d2kl15j267vxtq.cloudfront.net\/duct-tape\/wp-content\/uploads\/2025\/02\/13090526\/TPD_KyleSmith_3x2_4-100x100.jpg\" class=\"attachment-thumbnail size-thumbnail\" alt=\"\" \/><\/a>\n\t\t\t<\/div><\/figure>\n\t\t<\/div>\n\n<h2><span data-contrast=\"auto\">\u200b<\/span><span aria-label=\"Rich text content control\"><span data-contrast=\"auto\">\u200b<\/span><\/span><b><span data-contrast=\"none\">LESSON 1 | The Skill: <\/span><\/b><b><span data-contrast=\"auto\">Building the Best Backcountry Water Purification System<\/span><\/b><\/h2>\n<p><span data-contrast=\"auto\">Sometimes something as small as not washing your hands can result in being evacuated from the wilderness due to dehydration. Others, it\u2019s an ill-advised sip from what seems like a clean stream. <\/span><span data-contrast=\"none\">\u201cHiking out of Lolo Creek after a team member\u2019s boat got pinned, I didn\u2019t have proper water treatment options, and grew extremely dehydrated,\u201d says Kyle. \u201cAt one point, I knelt for a long drink from the top water column of a muddy puddle before projectile vomiting everything back up.\u201d In hindsight, this may have been the start of Kyle\u2019s journey to GI professor.<\/span><\/p>\n<p><span data-contrast=\"auto\">Whether it requires an evac or rest day, or just a lot of emergency stops, the good news is: Most GI-related issues are easily avoidable with a little knowledge and a few basic tools.<\/span><\/p>\n<div id='gallery-2' class='gallery galleryid-35368 gallery-columns-3 gallery-size-thumbnail'><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/community.nrs.com\/duct-tape\/2025\/02\/26\/toilet-paper-diaries-lesson-two\/tpd_kylesmith_3x2_9\/'><img loading=\"lazy\" decoding=\"async\" width=\"100\" height=\"100\" src=\"https:\/\/d2kl15j267vxtq.cloudfront.net\/duct-tape\/wp-content\/uploads\/2025\/02\/13092947\/TPD_KyleSmith_3x2_9-100x100.jpg\" class=\"attachment-thumbnail size-thumbnail\" alt=\"\" \/><\/a>\n\t\t\t<\/div><\/figure><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/community.nrs.com\/duct-tape\/2025\/02\/26\/toilet-paper-diaries-lesson-two\/blog-bkitching_owyhee_packraft_20240926-52_rgb\/'><img loading=\"lazy\" decoding=\"async\" width=\"100\" height=\"100\" src=\"https:\/\/d2kl15j267vxtq.cloudfront.net\/duct-tape\/wp-content\/uploads\/2025\/02\/17143713\/Blog-BKitching_Owyhee_Packraft_20240926-52_RGB-100x100.jpg\" class=\"attachment-thumbnail size-thumbnail\" alt=\"\" \/><\/a>\n\t\t\t<\/div><\/figure><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/community.nrs.com\/duct-tape\/2025\/02\/26\/toilet-paper-diaries-lesson-two\/tpd_kylesmith_3x2_5\/'><img loading=\"lazy\" decoding=\"async\" width=\"100\" height=\"100\" src=\"https:\/\/d2kl15j267vxtq.cloudfront.net\/duct-tape\/wp-content\/uploads\/2025\/02\/13092920\/TPD_KyleSmith_3x2_5-100x100.jpg\" class=\"attachment-thumbnail size-thumbnail\" alt=\"\" \/><\/a>\n\t\t\t<\/div><\/figure>\n\t\t<\/div>\n\n<h2><b><span data-contrast=\"none\">LESSON 2 | Skill Application: Gastrointestinal Care for Paddlers\u00a0<\/span><\/b><\/h2>\n<p><span data-contrast=\"auto\">Understanding potential contaminants found in water helps make appropriate decisions on water treatment and consumption. <\/span><span aria-label=\"Rich text content control\">\u200b<\/span>Through practice and the application of knowledge, paddlers will understand why and how to mitigate and manage waterborne illness on multiday trips and expeditions<span data-contrast=\"auto\">\u00a0and build the best backcountry water purification system for their needs. <\/span><\/p>\n<h3><b><span data-contrast=\"auto\">Microbiology and Bacteriology Basics<\/span><\/b><\/h3>\n<p><span data-contrast=\"auto\">Microbiology is the study of tiny, living things and how they affect the world. Microbes are everywhere and are responsible for both good (<\/span><a href=\"https:\/\/www.mdpi.com\/2227-9717\/9\/11\/2049\" target=\"_blank\" rel=\"noopener\"><span data-contrast=\"none\">that perfect dry-aged steak<\/span><\/a><span data-contrast=\"auto\">) and bad (gut rot from hummus left in a hot van). For our purposes, we\u2019ll break waterborne illness into three general classifications of disease-causing microorganisms. These are\u2014from largest to smallest\u2014protozoa, bacteria and viruses. <\/span><span data-contrast=\"auto\">Very few of these microorganisms occur naturally in outdoor water and are usually introduced into the water system by human or animal feces.<\/span><\/p>\n<p><span data-contrast=\"auto\">Diagnosing which infection is plaguing you can be a challenge without laboratory testing, so in the backcountry we focus on prevention and treatment, which means paying attention to your surroundings and de-dirtying your water. \u201cMost strains of infection result in the same treatment: supportive therapy,\u201d says Smitty. \u201cHydrate, eat what\/when you can, rest, and let your body do the work. I<\/span><span data-contrast=\"none\">\u2019m always hesitant to turn to meds because, without a stool sample analysis, you can\u2019t be sure what bacteria\/virus\/fungus you\u2019re trying to treat.\u201d<\/span><\/p>\n<div id='gallery-3' class='gallery galleryid-35368 gallery-columns-3 gallery-size-thumbnail'><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/community.nrs.com\/duct-tape\/2025\/02\/26\/toilet-paper-diaries-lesson-two\/blog-mbestard_grandcanyon_rafting_20241001-368_rgb\/'><img loading=\"lazy\" decoding=\"async\" width=\"100\" height=\"100\" src=\"https:\/\/d2kl15j267vxtq.cloudfront.net\/duct-tape\/wp-content\/uploads\/2025\/02\/17143722\/Blog-MBestard_GrandCanyon_Rafting_20241001-368_RGB-100x100.jpg\" class=\"attachment-thumbnail size-thumbnail\" alt=\"\" \/><\/a>\n\t\t\t<\/div><\/figure><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon portrait'>\n\t\t\t\t<a href='https:\/\/community.nrs.com\/duct-tape\/2025\/02\/26\/toilet-paper-diaries-lesson-two\/tpd_kylesmith_2x3_14\/'><img loading=\"lazy\" decoding=\"async\" width=\"100\" height=\"100\" src=\"https:\/\/d2kl15j267vxtq.cloudfront.net\/duct-tape\/wp-content\/uploads\/2025\/02\/13092800\/TPD_KyleSmith_2x3_14-100x100.jpg\" class=\"attachment-thumbnail size-thumbnail\" alt=\"\" \/><\/a>\n\t\t\t<\/div><\/figure>\n\t\t<\/div>\n\n<h3><b><span data-contrast=\"auto\">Protozoa<\/span><\/b><\/h3>\n<p><span data-contrast=\"auto\">Protozoa are the most common disease-causing microorganism in backcountry water. They are also the largest and easiest to remove from water through microfiltration, and the toughest to kill using chemical means. Protozoan infections typically have a long incubation period, meaning you become ill from a week to a month after drinking contaminated water. Though protozoan infections like <\/span><a href=\"https:\/\/www.cdc.gov\/parasites\/giardia\/general-info.html\" target=\"_blank\" rel=\"noopener\"><span data-contrast=\"none\">giardia<\/span><\/a><span data-contrast=\"auto\"> and <\/span><a href=\"https:\/\/www.cdc.gov\/parasites\/crypto\/\" target=\"_blank\" rel=\"noopener\"><span data-contrast=\"none\">cryptosporidium<\/span><\/a><span data-contrast=\"auto\"> are relatively common worldwide, they can be tricky to diagnose and symptoms can be quite severe, especially if left untreated.<\/span><\/p>\n<h3><b><span data-contrast=\"auto\">Bacteria<\/span><\/b><\/h3>\n<p><span data-contrast=\"auto\">Bacteria present in fresh water results from the same contamination as protozoa: animal or human fecal contamination. If you are consuming water downstream from where wild or domestic animals are \u201cdoing their business,\u201d you are at risk. Bacteria can cause diarrhea and fever, with some strains causing more severe symptoms like vomiting, nausea and cramps. This includes <\/span><a href=\"https:\/\/www.cdc.gov\/campylobacter\/technical.html\" target=\"_blank\" rel=\"noopener\"><span data-contrast=\"none\">Campylobacter jejuni<\/span><\/a><span data-contrast=\"auto\">, a bacterium commonly associated with traveler\u2019s diarrhea, <\/span><a href=\"https:\/\/www.cdc.gov\/shigella\/general-information.html\" target=\"_blank\" rel=\"noopener\"><span data-contrast=\"none\">shigella<\/span><\/a> <i><span data-contrast=\"auto\">(<\/span><\/i><span data-contrast=\"auto\">bacillary dysentery), <\/span><a href=\"https:\/\/www.cdc.gov\/ecoli\/general\/\" target=\"_blank\" rel=\"noopener\"><span data-contrast=\"none\">E. coli,<\/span><\/a> <a href=\"https:\/\/www.cdc.gov\/salmonella\/general\/index.html\" target=\"_blank\" rel=\"noopener\"><span data-contrast=\"none\">salmonella,<\/span><\/a> <a href=\"https:\/\/www.cdc.gov\/cholera\/\" target=\"_blank\" rel=\"noopener\"><span data-contrast=\"none\">cholera<\/span><\/a><span data-contrast=\"auto\"> and other scaries. As with protozoa, the primary concern when in the backcountry is fluid loss due to diarrhea.<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<h3><b><span data-contrast=\"auto\">Viruses<\/span><\/b><\/h3>\n<p><span data-contrast=\"auto\">The two most common waterborne viruses in North America are <\/span><a href=\"https:\/\/www.cdc.gov\/rotavirus\/\" target=\"_blank\" rel=\"noopener\"><span data-contrast=\"none\">rotavirus<\/span><\/a><span data-contrast=\"auto\"> and <\/span><span data-contrast=\"none\">norovirus<\/span><span data-contrast=\"auto\">. These types of viruses are responsible for what we call \u201cfood sickness\u201d and occur on rivers contaminated with feces or raw sewage, including your own.<\/span><\/p>\n<h2><strong><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-35385 aligncenter\" src=\"https:\/\/d2kl15j267vxtq.cloudfront.net\/duct-tape\/wp-content\/uploads\/2025\/02\/13090520\/TPD_KyleSmith_3x2_3.jpg\" alt=\"\" width=\"1800\" height=\"1200\" srcset=\"https:\/\/d2kl15j267vxtq.cloudfront.net\/duct-tape\/wp-content\/uploads\/2025\/02\/13090520\/TPD_KyleSmith_3x2_3.jpg 1800w, https:\/\/d2kl15j267vxtq.cloudfront.net\/duct-tape\/wp-content\/uploads\/2025\/02\/13090520\/TPD_KyleSmith_3x2_3-300x200.jpg 300w, https:\/\/d2kl15j267vxtq.cloudfront.net\/duct-tape\/wp-content\/uploads\/2025\/02\/13090520\/TPD_KyleSmith_3x2_3-1000x667.jpg 1000w, https:\/\/d2kl15j267vxtq.cloudfront.net\/duct-tape\/wp-content\/uploads\/2025\/02\/13090520\/TPD_KyleSmith_3x2_3-768x512.jpg 768w, https:\/\/d2kl15j267vxtq.cloudfront.net\/duct-tape\/wp-content\/uploads\/2025\/02\/13090520\/TPD_KyleSmith_3x2_3-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1800px) 100vw, 1800px\" \/><\/strong><\/h2>\n<h3><b><span data-contrast=\"auto\">Other Water Contaminants<\/span><\/b><\/h3>\n<p><span data-contrast=\"auto\">Other human-sourced contaminants in water can give you trouble, especially when paddling in countries with less developed sewage infrastructure. <\/span><b><span data-contrast=\"auto\">Chemical contamination<\/span><\/b><span data-contrast=\"auto\"> should be considered if you are downstream from agricultural or industrial areas. Activated charcoal, present in many backcountry water filters, will remove organic chemicals from water, but does not remove most metals, salts, or carbonates.<\/span><\/p>\n<p><span data-contrast=\"auto\">Avoiding<\/span><b><span data-contrast=\"auto\"> mineral contamination<\/span><\/b><span data-contrast=\"auto\"> is simple. Don\u2019t drink water from a hot spring and don\u2019t use water from pools that lack vegetation around them, have unnatural color, or strong mineral, metal or salty odors or tastes. <\/span><a href=\"https:\/\/www.cdc.gov\/habs\/illness-symptoms-freshwater.html\" target=\"_blank\" rel=\"noopener\"><span data-contrast=\"none\">Cyanobacteria<\/span><\/a><span data-contrast=\"auto\">, aka blue-green algae, and the toxins it produces are very harmful if consumed. Cyanobacteria blooms generally occur in late summer or early fall in warm, slow-moving or stagnant water rich in nutrients from fertilizers or septic systems. The water will smell bad and usually (but not always) presents a bloom that can look like foam, scum or mats in any range of colors from brown to bright green, blue or red.<\/span><\/p>\n<h2><b><span data-contrast=\"auto\">Tried &amp; True Mitigation Techniques<\/span><\/b><\/h2>\n<p><span data-contrast=\"auto\">Eliminating the chance of contracting something waterborne is impossible; whitewater paddlers can\u2019t avoid getting splashed in the face. So, let\u2019s mitigate. To prep river water for drinking, there are four primary options: purify it, filter it, zap it or boil it.<\/span><\/p>\n<p><b><span data-contrast=\"auto\">Purify<\/span><\/b><span data-contrast=\"auto\"> &#8211; Water purification tablets like Aquatabs are lightweight and inexpensive. They rely on chemicals such as chlorine dioxide or iodine to kill or neutralize microorganisms. Some brands, like Katadyn&#8217;s Micropur tablets, also combat the cryptosporidium parasite. Others don\u2019t. Purifiers also combat viruses, which are too tiny for most water filters to effectively catch<\/span><span data-contrast=\"auto\">, but the tablets often leave an<\/span><span data-contrast=\"auto\"> unpleasant odor or taste in the water and they require 30 minutes to a few hours for disinfection to take place.<\/span><\/p>\n<p><b><span data-contrast=\"auto\">Filter <\/span><\/b><span data-contrast=\"auto\">&#8211; Hand pumps and gravity filters draw water through a series of filters to remove bacteria, protozoa and visible impurities. For large groups, a gravity filter is more efficient, but patience\/planning is needed. <\/span><span data-contrast=\"auto\">If you&#8217;re paddling in less-developed regions, using water tablets in addition to a filter can be a good second line of defense against viruses, which are often too small to filter effectively.<\/span><\/p>\n<p><b><span data-contrast=\"auto\">Zap <\/span><\/b><span data-contrast=\"auto\">&#8211;<\/span> <span data-contrast=\"auto\">\u201cA SteriPEN that uses UV light to kill waterborne bacteria and protozoa can be an awesome addition to the kit,\u201d says Kyle. \u201cBut remember, you need batteries and fairly clean\/clear water for it to be effective.\u201d<\/span><\/p>\n<p><b><span data-contrast=\"auto\">Boil <\/span><\/b><span data-contrast=\"auto\">&#8211;<\/span> <span data-contrast=\"auto\">Some swear by this method; others use it as a last resort. \u201cIf you have the fuel, time and patience, then have at it,\u201d says Kyle. Boiling water deactivates viruses, bacteria, protozoa and other pathogens by scrambling their DNA. <\/span><span data-contrast=\"auto\">But sediment and contaminants, such as <\/span><span data-contrast=\"auto\">heavy metals or chemicals, will remain. Water needs to boil for around 2 minutes to be good to go. For large groups or when fuel is precious, it\u2019s not the most effective method.<\/span><\/p>\n<div id='gallery-4' class='gallery galleryid-35368 gallery-columns-3 gallery-size-thumbnail'><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/community.nrs.com\/duct-tape\/2025\/02\/26\/toilet-paper-diaries-lesson-two\/blog-bkitching_owyhee_packraft_20240926-35_rgb\/'><img loading=\"lazy\" decoding=\"async\" width=\"100\" height=\"100\" src=\"https:\/\/community.nrs.com\/duct-tape\/wp-content\/uploads\/2025\/02\/Blog-BKitching_Owyhee_Packraft_20240926-35_RGB-100x100.jpg\" class=\"attachment-thumbnail size-thumbnail\" alt=\"\" \/><\/a>\n\t\t\t<\/div><\/figure><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/community.nrs.com\/duct-tape\/2025\/02\/26\/toilet-paper-diaries-lesson-two\/gptempdownload-5\/'><img loading=\"lazy\" decoding=\"async\" width=\"100\" height=\"100\" src=\"https:\/\/d2kl15j267vxtq.cloudfront.net\/duct-tape\/wp-content\/uploads\/2025\/02\/13101038\/GPTempDownload-5-100x100.jpg\" class=\"attachment-thumbnail size-thumbnail\" alt=\"\" \/><\/a>\n\t\t\t<\/div><\/figure><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon portrait'>\n\t\t\t\t<a href='https:\/\/community.nrs.com\/duct-tape\/2025\/02\/26\/toilet-paper-diaries-lesson-two\/tpd_kylesmith_2x3_13\/'><img loading=\"lazy\" decoding=\"async\" width=\"100\" height=\"100\" src=\"https:\/\/d2kl15j267vxtq.cloudfront.net\/duct-tape\/wp-content\/uploads\/2025\/02\/13092751\/TPD_KyleSmith_2x3_13-100x100.jpg\" class=\"attachment-thumbnail size-thumbnail\" alt=\"\" \/><\/a>\n\t\t\t<\/div><\/figure><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/community.nrs.com\/duct-tape\/2025\/02\/26\/toilet-paper-diaries-lesson-two\/blog-bherndon_priestlake_sup_20230706-920_rgb\/'><img loading=\"lazy\" decoding=\"async\" width=\"100\" height=\"100\" src=\"https:\/\/d2kl15j267vxtq.cloudfront.net\/duct-tape\/wp-content\/uploads\/2025\/02\/17145841\/Blog-BHerndon_PriestLake_SUP_20230706-920_RGB-100x100.jpg\" class=\"attachment-thumbnail size-thumbnail\" alt=\"\" \/><\/a>\n\t\t\t<\/div><\/figure>\n\t\t<\/div>\n\n<p><span data-contrast=\"auto\">Do some research beforehand, carry the tools (and know how to use them), plan ahead and be patient. The <\/span><a href=\"https:\/\/www.cdc.gov\/healthywater\/pdf\/drinking\/Backcountry_Water_Treatment-508.pdf\" target=\"_blank\" rel=\"noopener\"><span data-contrast=\"none\">CDC has a cheat sheet<\/span><\/a><span data-contrast=\"auto\"> that can help determine what your water purification kit should include. As a bonus, Professor Kyle has shared his tried-and-true system and encourages adaptation for your needs.<\/span><\/p>\n<h2><strong>Professor Kyle\u2019s <\/strong><b><span data-contrast=\"none\">Quick &amp; Dirty Backcountry Water Filtration<\/span><\/b><\/h2>\n<p><span data-contrast=\"auto\">The \u201cMad Scientist Smitty Setup\u201d takes a little time, but Kyle says it\u2019s well worth it. <\/span><span data-contrast=\"auto\">Tools needed: cord, handkerchief or cloth, gravity filter with bag, water storage and water purification tablets.<\/span><\/p>\n<ol>\n<li><span data-contrast=\"auto\">Find a tree with good branches or rig up a station using paddles or a kayak standing on its stern.<\/span><\/li>\n<li><span data-contrast=\"auto\">Hold a handkerchief over the top of gravity filter bag 1, then have your buddy pour river water from a pot or drybag through the fabric and into the filter bag. This will grab the big particulates and help prevent your filters from clogging.<\/span><\/li>\n<li><span data-contrast=\"auto\">Hang bag 1, now full of cloudy water, high above a second empty gravity filter bag, (bag 2). Use cord to pull the first gravity filter higher up into a tree after filling it, if necessary. <\/span><\/li>\n<li><span data-contrast=\"auto\">Start filtering bag 1 into <\/span><span aria-label=\"Rich text content control\"><span data-contrast=\"auto\">\u200b<\/span><span data-contrast=\"auto\">\u200b<\/span><\/span><span data-contrast=\"auto\">bag 2, hanging below. If you\u2019re really fancy, you can run bag 2 directly into a large dromedary bag (collapsible water bag with wide mouth and lid). \u201cI like to use a six-liter dromedary,\u201d says Kyle.<\/span><\/li>\n<li><span data-contrast=\"auto\">To be on the super-safe side, add some Aquatabs to the filtered water. One tab per two liters (three tabs for a six-liter dromedary).<\/span><\/li>\n<li><span data-contrast=\"auto\"><span data-contrast=\"auto\">Give the filter(s) and tabs time to do their thing. Make dinner, chill out in a hammock, drink a beer, scout the rapid downstream&#8230;<\/span><\/span><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<div id='gallery-5' class='gallery galleryid-35368 gallery-columns-3 gallery-size-thumbnail'><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon portrait'>\n\t\t\t\t<a href='https:\/\/community.nrs.com\/duct-tape\/2025\/02\/26\/toilet-paper-diaries-lesson-two\/tpd_kylesmith_2x3_8\/'><img loading=\"lazy\" decoding=\"async\" width=\"100\" height=\"100\" src=\"https:\/\/d2kl15j267vxtq.cloudfront.net\/duct-tape\/wp-content\/uploads\/2025\/02\/13090458\/TPD_KyleSmith_2x3_8-100x100.jpg\" class=\"attachment-thumbnail size-thumbnail\" alt=\"\" \/><\/a>\n\t\t\t<\/div><\/figure><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/community.nrs.com\/duct-tape\/2025\/02\/26\/toilet-paper-diaries-lesson-two\/tpd_kylesmith_3x2_1\/'><img loading=\"lazy\" decoding=\"async\" width=\"100\" height=\"100\" src=\"https:\/\/d2kl15j267vxtq.cloudfront.net\/duct-tape\/wp-content\/uploads\/2025\/02\/13090507\/TPD_KyleSmith_3x2_1-100x100.jpg\" class=\"attachment-thumbnail size-thumbnail\" alt=\"\" \/><\/a>\n\t\t\t<\/div><\/figure>\n\t\t<\/div>\n\n<h2><b><span data-contrast=\"auto\">First Aid Treatment<\/span><\/b><\/h2>\n<p><span data-contrast=\"auto\">GI illness in the backcountry can have myriad implications. \u201cSevere dehydration and nutrition will wreck any trip and might just be the difference between having enough energy to fight out of that next hole or swim a mile-long rapid,\u201d says Smitty.<\/span><\/p>\n<p><span data-contrast=\"auto\">While an IV with fluids can often help, drinking Pedialyte or similar fluids is a more efficient and effective way of rehydrating. Plus, they are way easier to pack! \u201cPowdered Pedialyte [aka rehydration salts] might be your tether to survival.\u201d Rehydration salts can be purchased over the counter and are formulated with a precise balance of electrolytes and glucose to rehydrate cells. The powdered form is best for backcountry use.<\/span><\/p>\n<p><span data-contrast=\"auto\">\u201cThe idea is to get more nutrition\/hydration in than out.\u201d This can be a slow game. \u201cIf you rush by chugging a bunch of fluids, your body might reject them,\u201d says Professor Smitty. \u201cSlow sips and slow pace. This might mean taking a couple of layover days.\u201d<\/span><\/p>\n<p><span data-contrast=\"auto\">Of course, there are medicines to treat most of these infections. But it\u2019s nearly impossible to get a proper diagnosis in the backcountry. Professor Smitty recommends always speaking with a physician BEFORE leaving the country or throwing any drugs in the first aid kit.<\/span><\/p>\n<div id='gallery-6' class='gallery galleryid-35368 gallery-columns-3 gallery-size-thumbnail'><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/community.nrs.com\/duct-tape\/2025\/02\/26\/toilet-paper-diaries-lesson-two\/tpd_kylesmith_3x2_2\/'><img loading=\"lazy\" decoding=\"async\" width=\"100\" height=\"100\" src=\"https:\/\/d2kl15j267vxtq.cloudfront.net\/duct-tape\/wp-content\/uploads\/2025\/02\/13090513\/TPD_KyleSmith_3x2_2-100x100.jpg\" class=\"attachment-thumbnail size-thumbnail\" alt=\"\" \/><\/a>\n\t\t\t<\/div><\/figure><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/community.nrs.com\/duct-tape\/2025\/02\/26\/toilet-paper-diaries-lesson-two\/tpd_kylesmith_3x2_8\/'><img loading=\"lazy\" decoding=\"async\" width=\"100\" height=\"100\" src=\"https:\/\/d2kl15j267vxtq.cloudfront.net\/duct-tape\/wp-content\/uploads\/2025\/02\/13092940\/TPD_KyleSmith_3x2_8-100x100.jpg\" class=\"attachment-thumbnail size-thumbnail\" alt=\"\" \/><\/a>\n\t\t\t<\/div><\/figure><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/community.nrs.com\/duct-tape\/2025\/02\/26\/toilet-paper-diaries-lesson-two\/tpd_kylesmith_3x2_7\/'><img loading=\"lazy\" decoding=\"async\" width=\"100\" height=\"100\" src=\"https:\/\/d2kl15j267vxtq.cloudfront.net\/duct-tape\/wp-content\/uploads\/2025\/02\/13092933\/TPD_KyleSmith_3x2_7-100x100.jpg\" class=\"attachment-thumbnail size-thumbnail\" alt=\"\" \/><\/a>\n\t\t\t<\/div><\/figure>\n\t\t<\/div>\n\n<p><span data-contrast=\"auto\">The irony of understanding how to prevent and treat dehydration while being surrounded by water isn\u2019t a joke. \u201cIt\u2019s best to just prevent it ahead of time if possible. And carry a Garmin InReach for when things go south. Deciding whether to hit the \u2018come-get-me button\u2019 is particular to each situation, but a simple set of questions can help: <\/span><\/p>\n<ul>\n<li><em>\u201cDoes this seem like something we can manage in the field? If not, do we have the time\/energy\/resources to get to definitive care, i.e. a hospital before this progresses too far?\u201d\u00a0<\/em><\/li>\n<li><em>\u201cDoes the issue seem to be correcting itself? Do we have the resources to let it run its course, i.e. food, shelter, etc.? Is continuing downstream the easier\/safer option?\u201d<\/em><\/li>\n<\/ul>\n<p>If the answer is <strong>NO<\/strong> to any of these questions, Smitty strongly encourages considering evacuation options.<\/p>\n<div id='gallery-7' class='gallery galleryid-35368 gallery-columns-3 gallery-size-thumbnail'><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon portrait'>\n\t\t\t\t<a href='https:\/\/community.nrs.com\/duct-tape\/2025\/02\/26\/toilet-paper-diaries-lesson-two\/tpd_kylesmith_2x3_7\/'><img loading=\"lazy\" decoding=\"async\" width=\"100\" height=\"100\" src=\"https:\/\/d2kl15j267vxtq.cloudfront.net\/duct-tape\/wp-content\/uploads\/2025\/02\/13090450\/TPD_KyleSmith_2x3_7-100x100.jpg\" class=\"attachment-thumbnail size-thumbnail\" alt=\"\" \/><\/a>\n\t\t\t<\/div><\/figure><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon portrait'>\n\t\t\t\t<a href='https:\/\/community.nrs.com\/duct-tape\/2025\/02\/26\/toilet-paper-diaries-lesson-two\/tpd_kylesmith_2x3_12\/'><img loading=\"lazy\" decoding=\"async\" width=\"100\" height=\"100\" src=\"https:\/\/d2kl15j267vxtq.cloudfront.net\/duct-tape\/wp-content\/uploads\/2025\/02\/13092743\/TPD_KyleSmith_2x3_12-100x100.jpg\" class=\"attachment-thumbnail size-thumbnail\" alt=\"\" \/><\/a>\n\t\t\t<\/div><\/figure><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon portrait'>\n\t\t\t\t<a href='https:\/\/community.nrs.com\/duct-tape\/2025\/02\/26\/toilet-paper-diaries-lesson-two\/tpd_kylesmith_2x3_11\/'><img loading=\"lazy\" decoding=\"async\" width=\"100\" height=\"100\" src=\"https:\/\/d2kl15j267vxtq.cloudfront.net\/duct-tape\/wp-content\/uploads\/2025\/02\/13092735\/TPD_KyleSmith_2x3_11-100x100.jpg\" class=\"attachment-thumbnail size-thumbnail\" alt=\"\" \/><\/a>\n\t\t\t<\/div><\/figure><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon portrait'>\n\t\t\t\t<a href='https:\/\/community.nrs.com\/duct-tape\/2025\/02\/26\/toilet-paper-diaries-lesson-two\/tpd_kylesmith_2x3_16\/'><img loading=\"lazy\" decoding=\"async\" width=\"100\" height=\"100\" src=\"https:\/\/d2kl15j267vxtq.cloudfront.net\/duct-tape\/wp-content\/uploads\/2025\/02\/13092816\/TPD_KyleSmith_2x3_16-100x100.jpg\" class=\"attachment-thumbnail size-thumbnail\" alt=\"\" \/><\/a>\n\t\t\t<\/div><\/figure>\n\t\t<\/div>\n\n<h2><b style=\"font-family: var(--font-body, 'Roboto'); background-color: var(--background-color, #ffffff);\"><span data-contrast=\"none\">Lesson Homework<\/span><\/b><\/h2>\n<p><span data-contrast=\"auto\">Prep your backcountry filtration setup and stock your first aid kit to both prevent and treat GI-related illness. \u201cAt a minimum, Aquatabs,\u201d says Kyle. \u201cThey weigh nothing and are very good chemical treatment options. If all your filters clog, at least you still have this option.\u201d<\/span><\/p>\n<ul>\n<li><b><span data-contrast=\"auto\">Pack the tools <\/span><\/b><span data-contrast=\"auto\">&#8211;<\/span> <span data-contrast=\"auto\">Water filtration system, purification tablets, and any extras like spare parts, spare filters or paracord. \u201cCompanies like MSR, Katadyn, or Platypus are more or less the same,\u201d says Kyle. \u201cJust get a reputable one and clean or replace the filters as necessary.\u201d<\/span><\/li>\n<li><b><span data-contrast=\"auto\">Pack the backup <\/span><\/b><span data-contrast=\"auto\">&#8211; Distribute some extra purification tabs throughout your gear and group. Stash some in the kitchen, in the first aid kit and even in your PFD in case you get separated from your boat.<\/span><\/li>\n<li><b><span data-contrast=\"auto\">Pack the relief <\/span><\/b><span data-contrast=\"auto\">&#8211;<\/span> <span data-contrast=\"auto\">Stock up on rehydration salts and chat with your doctor about any drugs to have on hand. It\u2019s much nicer to have some sense of a plan instead of trying to figure out a complex situation in a language you may not speak.<\/span><\/li>\n<\/ul>\n<h2><b><span data-contrast=\"none\">Lesson Summary<\/span><\/b><\/h2>\n<p><span data-contrast=\"auto\">\u201cFor me, the saying \u2018You can\u2019t fill from an empty cup\u2019 comes to mind,\u201d says Smitty. \u201cIf you are zapped physically or mentally, you can\u2019t be the team-member your team deserves. They can\u2019t lean on you when times get hard if you aren\u2019t taking care of yourself. This is applicable on the water, during travel, and in the trauma bay.\u201d<\/span><\/p>\n<p><span data-contrast=\"auto\">Having the know-how to purify water and the tools to do so properly can eliminate problems before they begin. Carrying the tools to treat an ailing paddler can bring peace of mind. But always carry ample toilet paper too, just in case.<\/span><\/p>\n<p style=\"text-align: center;\"><span data-contrast=\"auto\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-35467 aligncenter\" src=\"https:\/\/d2kl15j267vxtq.cloudfront.net\/duct-tape\/wp-content\/uploads\/2025\/02\/17143729\/Blog-MBestard_GrandCanyon_Rafting_20241001-471_RGB.jpg\" alt=\"\" width=\"2000\" height=\"1335\" srcset=\"https:\/\/d2kl15j267vxtq.cloudfront.net\/duct-tape\/wp-content\/uploads\/2025\/02\/17143729\/Blog-MBestard_GrandCanyon_Rafting_20241001-471_RGB.jpg 2000w, https:\/\/d2kl15j267vxtq.cloudfront.net\/duct-tape\/wp-content\/uploads\/2025\/02\/17143729\/Blog-MBestard_GrandCanyon_Rafting_20241001-471_RGB-300x200.jpg 300w, https:\/\/d2kl15j267vxtq.cloudfront.net\/duct-tape\/wp-content\/uploads\/2025\/02\/17143729\/Blog-MBestard_GrandCanyon_Rafting_20241001-471_RGB-1000x668.jpg 1000w, https:\/\/d2kl15j267vxtq.cloudfront.net\/duct-tape\/wp-content\/uploads\/2025\/02\/17143729\/Blog-MBestard_GrandCanyon_Rafting_20241001-471_RGB-768x513.jpg 768w, https:\/\/d2kl15j267vxtq.cloudfront.net\/duct-tape\/wp-content\/uploads\/2025\/02\/17143729\/Blog-MBestard_GrandCanyon_Rafting_20241001-471_RGB-1536x1025.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" \/>***<\/span><\/p>\n<p><span data-contrast=\"auto\">Additional Resources: <\/span><br \/>\n<a href=\"https:\/\/www.nrs.com\/learn\/treating-backcountry-water\"><span data-contrast=\"none\">https:\/\/www.nrs.com\/learn\/treating-backcountry-water<\/span><\/a><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<p><a href=\"https:\/\/www.cdc.gov\/parasites\/giardia\/general-info.html\"><span data-contrast=\"none\">https:\/\/www.cdc.gov\/parasites\/giardia\/general-info.html<\/span><\/a><br \/>\n<a href=\"https:\/\/www.msrgear.com\/blog\/water-filter-vs-water-purifier\/\"><span data-contrast=\"none\">https:\/\/www.msrgear.com\/blog\/water-filter-vs-water-purifier\/<\/span><\/a><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">\u00a0<\/span><span data-ccp-props=\"{&quot;335559739&quot;:240}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">\u00a0<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">\u00a0<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<p><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Welcome to the\u202fToilet Paper Diaries, a series of lessons about&#8230; poop.\u202f Your professors are paddlers and their lectures combine their education, experiences, and professional insights,&hellip;<\/p>\n","protected":false},"author":47958,"featured_media":35406,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[341],"tags":[371,682,38,390,13,316,676,685],"class_list":["post-35368","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-pro-tips","tag-adventure-travel","tag-backcountry","tag-camping","tag-health-fitness","tag-kayaking","tag-rafting","tag-toilet-paper-diaries","tag-water-management","post-grid"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>The Toilet Paper Diaries, Lesson Two: Don&#039;t Drink That! Gastrointestinal Care for Paddlers | Duct Tape Diaries | NRS<\/title>\n<meta name=\"description\" content=\"Trauma nurse and longtime paddler Kyle Smith shares tips and tricks for how to maintain proper GI health in the backcountry.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/community.nrs.com\/duct-tape\/2025\/02\/26\/toilet-paper-diaries-lesson-two\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"The Toilet Paper Diaries, Lesson Two: Gastrointestinal Care for Paddlers\" \/>\n<meta property=\"og:description\" content=\"Trauma nurse and longtime paddler Kyle Smith shares tips and tricks for how to maintain proper GI health in the backcountry.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/community.nrs.com\/duct-tape\/2025\/02\/26\/toilet-paper-diaries-lesson-two\/\" \/>\n<meta property=\"og:site_name\" content=\"Duct Tape Diaries\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/nrsweb\" \/>\n<meta property=\"article:published_time\" content=\"2025-02-26T22:42:49+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/d2kl15j267vxtq.cloudfront.net\/duct-tape\/wp-content\/uploads\/2025\/02\/13090520\/TPD_KyleSmith_3x2_3.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1800\" \/>\n\t<meta property=\"og:image:height\" content=\"1200\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Carmen Kuntz\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@nrsweb\" \/>\n<meta name=\"twitter:site\" content=\"@nrsweb\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Carmen Kuntz\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"11 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/community.nrs.com\\\/duct-tape\\\/2025\\\/02\\\/26\\\/toilet-paper-diaries-lesson-two\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/community.nrs.com\\\/duct-tape\\\/2025\\\/02\\\/26\\\/toilet-paper-diaries-lesson-two\\\/\"},\"author\":{\"name\":\"Carmen Kuntz\",\"@id\":\"https:\\\/\\\/community.nrs.com\\\/duct-tape\\\/#\\\/schema\\\/person\\\/3fb29b6e10b0ec7aa5e52790a8c53466\"},\"headline\":\"The Toilet Paper Diaries, Lesson Two: Don&#8217;t Drink That! 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