What is traveler's diarrhea?
Traveler's diarrhea is a sudden intestinal infection that you may
get when you travel to another country. Other names for this
problem are gastroenteritis, Montezuma's revenge, turista, or the
GI trots.
Up to half of the people who travel internationally get traveler's
diarrhea. High-risk areas include some parts of Latin America,
Africa, the Middle East, and Asia. Problems with the water supply
and sanitation facilities are more likely in these areas.
How does it occur?
Traveler's diarrhea occurs when you have food, ice, water, or
other drinks that contain germs from human or animal bowel
movements. The germs may be in cooked or uncooked food. The germs
may be a virus, parasite, or bacteria.
Escherichia coli (E. coli) bacteria are often a cause of
traveler's diarrhea. E. coli bacteria are normally found in the
human intestine. There are many varieties of E. coli bacteria.
Usually your body becomes used to the E. coli in your environment
and the bacteria do not cause problems. However, exposure to new
varieties of E. coli in new places may cause diarrhea.
Sometimes diarrhea while you are traveling is caused by the stress
of traveling, jet lag, a different diet, or other things, like
stomach flu.
What are the symptoms?
You may have the following symptoms:
- loose stools, as many as 3 to 10 a day
- stomach cramps
- bloating and gas
- nausea and vomiting
- fever
- weakness
- headache (sometimes).
How is it diagnosed?
Your healthcare provider will ask about your symptoms, including:
- the amount of diarrhea
- if you also have blood or mucus in your stool,
- if you are having a lot of gas
- if you have had vomiting, nausea, high fever, or weight loss.
Your provider will also ask about your travels:
- where you have been
- if you drank well water or spring water
- what food or drinks you have had.
Your provider will also ask about any medicines you may have used.
Your provider will examine you. A sample of bowel movement may be
tested. You may also have blood tests. These tests help find what
is causing the diarrhea.
How is it treated?
You may become dehydrated by the diarrhea. Dehydration happens
when your body loses more fluids and salts than it takes in.
Dehydration can cause serious problems. It is very important to
try to prevent it.
To replace lost fluids and salts, you can make a drink with
packets of oral rehydration salts. You can buy the packets at a
drugstore. You can also make a rehydration solution by mixing:
- 1 quart or liter of clean water (boil the water 5 minutes if
you are not sure it is safe to drink)
- 2 tablespoons of sugar
- 1/4 teaspoon salt
- 1/4 teaspoon of baking soda.
Or you can buy a solution that is already made. One brand is
Pedialyte.
Drinking other nonalcoholic drinks made with clean water (boiled
or bottled) will also help prevent dehydration, but you may not
get all the salts you need. Avoid using ice, unless you know it's
made from boiled or bottled water. Try to drink at least 8 ounces
of fluid for each watery stool you have.
Taking bismuth subsalicylate (for example, Pepto-Bismol) 4 times a
day may help prevent or treat traveler's diarrhea. Do not take it
longer than 3 weeks. You do not need a prescription to get this
medicine, but it can have some serious interactions with other
medicines. Check with your healthcare provider before you leave on
your trip about using it. You should not use it if:
- You are taking other medicines that interact with it.
- You are allergic to aspirin.
- You are pregnant.
Be cautious about taking nonprescription antidiarrheal medicines
such as Kaopectate or Imodium or the prescription medicine
Lomotil. These medicines can actually make you sicker, especially
if you have diarrhea that is bloody. Do not use these medicines
every day to control diarrhea. Do not give antidiarrheal medicine
to small children.
See a healthcare provider as soon as possible if you have:
- a fever of 101.5°F (38.6°C) or higher
- blood in your diarrhea
- symptoms that last more than 48 hours.
Do not try to treat these serious symptoms on your own.
How long will the effects last?
Traveler's diarrhea usually does not last long. It often stops
without treatment in 1 to 5 days. Rarely, it lasts 2 to 3 weeks.
How can I take care of myself?
If you are traveling to a place where you think you might get
traveler's diarrhea:
- Talk to your healthcare provider about your plans.
- Take several packets of oral rehydration salts with you.
- Carry a few Kaopectate, Imodium, or Lomotil tablets with you
for emergencies (for example, to avoid toilet accidents while
you are on an airplane).
If you get diarrhea:
- You may want to let your bowel rest for a few hours by
drinking only clear liquids such as water, weak tea, broth,
apple juice, or sports drinks or other oral rehydrating
solutions. You may also drink soft drinks without caffeine
(such as 7 UP) after letting them lose some of their
carbonation (go flat). Make sure you drink often so that you
do not become dehydrated. Suck on ice chips or Popsicles if
you feel too nauseated to drink fluids.
- It is OK to keep eating as long as it does not seem to worsen
the diarrhea or stomach cramps. Foods that are easiest to
digest are soft starchy foods, such as bananas, cooked cereal,
rice, potatoes, plain noodles, plain gelatin, toast or bread,
and applesauce. Avoid milk products for a few days. Return to
your normal diet after 2 or 3 days, but for several days avoid
fresh fruit (other than bananas), alcohol, greasy or fatty
foods such as cheeseburgers or bacon, spicy foods, and most
fresh vegetables. Cooked carrots, potatoes, and squash are
fine. If the diarrhea seems to get worse after you eat, stop
eating for a few hours and drink just clear liquids. This will
give your bowel a rest.
How can I prevent traveler's diarrhea?
Follow these guidelines:
- Do not drink untreated water. This includes avoiding ice cubes
in drinks.
- If you are camping or won't be where you can buy bottled
water, bring a way to purify water, such as a filter or
purifier, chlorine or iodine tablets, or a pot and stove for
boiling water. If you need to buy a water filter or purifier,
buy one that can filter out organisms as small as the ones
that cause giardiasis, cholera, and amoebic diarrhea.
- Carry a liter of purified water.
- Avoid food and drinks from street vendors.
- Eat only foods that are cooked and still hot, or fruits and
vegetables that you peel yourself.
- Do not eat raw or partially cooked fish or shellfish,
including such dishes as seviche. Fully cooked fish and
shellfish are safe.
- Brushing your teeth with untreated water is usually safe. Most
toothpastes contain antibacterial substances. Do not swallow
the water.
- Carbonated soft drinks and water, bottled water, wine, and
beer are usually safe without ice. Do not add ice that has
been made from tap water.
- Avoid uncooked dairy products.
You may discuss with your healthcare provider the pros and cons of
taking antibiotics with you on your trip. Most current
recommendations are to start antibiotics only if you have
diarrhea. Doxycycline, Bactrim, Septra, and ciprofloxacin (Cipro)
have been used in the past. However, bacteria are becoming
resistant to these medicines. Your provider may prescribe other
medicines. The usual antibiotic prescription is for 3 days only.
The medicines may cause side effects, including an increased risk
of sunburn and allergic reactions. Ask your provider about side
effects.
This content is reviewed periodically and is subject to
change as new health information becomes available. The
information is intended to inform and educate and is not a
replacement for medical evaluation, advice, diagnosis or
treatment by a healthcare professional.
© 2009 RelayHealth and/or its affiliates. All Rights Reserved.