Introduction
Traveler’s diarrhea (TD) is a common illness that affects people traveling to areas with poor sanitation and hygiene. It is typically caused by consuming food or water contaminated with bacteria, viruses, or parasites. While TD is usually mild and self-limiting, it can disrupt travel plans and cause significant discomfort.
Causes
Traveler’s diarrhea is most often caused by bacteria, with Escherichia coli (E. coli) being the most common culprit. Other potential causes include viruses (such as norovirus and rotavirus) and parasites (such as Giardia and Cryptosporidium). The risk of TD is highest in regions with poor sanitation, including parts of Asia, Africa, Latin America, and the Middle East.
Symptoms
Symptoms of traveler’s diarrhea typically develop within a few days of arriving in a high-risk area and can include:
- Frequent, loose, or watery stools
- Abdominal cramps and pain
- Nausea and vomiting
- Fever
- Bloating
- Urgency to have a bowel movement
Most cases are mild and resolve within a few days, but some can be more severe and prolonged.
Diagnosis
Diagnosis of traveler’s diarrhea is usually based on symptoms and a history of recent travel to a high-risk area. In most cases, specific testing is not required. However, if symptoms are severe or prolonged, a healthcare provider may request stool tests to identify the causative organism.
Treatment Options
Most cases of traveler’s diarrhea can be managed with self-care:
- Drink plenty of fluids to prevent dehydration.
- Oral rehydration solutions (ORS) are particularly helpful for replacing lost electrolytes.
- Eat easily digestible foods, such as bananas, rice, applesauce, and toast (BRAT diet).
- Over-the-counter medications such as loperamide (Imodium) can help reduce diarrhea, but should be used with caution and avoided if there is a fever or blood in the stool.
- Bismuth subsalicylate (Pepto-Bismol) can also help relieve symptoms.
In severe cases, antibiotics may be prescribed, especially if there is a fever, blood in the stool, or persistent symptoms.
Prevention
Preventing traveler’s diarrhea involves following safe food and water practices:
- Drink only bottled, boiled, or treated water.
- Avoid ice cubes, as they may be made with contaminated water.
- Eat food that is thoroughly cooked and served hot.
- Avoid raw or undercooked meats, seafood, and eggs.
- Wash fruits and vegetables thoroughly or peel them yourself.
- Avoid salads and buffet-style meals.
- Wash hands frequently with soap and water, especially before eating.
- Consider taking bismuth subsalicylate (Pepto-Bismol) preventively, but consult with a healthcare provider first.
When to Seek Medical Care
Seek medical attention if you experience:
- High fever
- Blood in the stool
- Severe abdominal pain
- Signs of dehydration (such as dry mouth, decreased urination, or dizziness)
- Symptoms that last longer than a few days or worsen
Takeaway
Traveler’s diarrhea is a common illness that can affect anyone traveling to areas with poor sanitation. Following safe food and water practices and seeking medical care when needed can help prevent and manage this condition.