Traveler's diarrhea

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at June 21, 2016
StartTraveler's diarrhea

Traveler's diarrhea is a type of gastrointestinal illness that a traveler acquires. It is usually not serious, and the unpleasant symptoms will often go away on their own. Travelers should still be wary of the possibility of having traveler's diarrhea in order to take commonsense precautions that will help prevent it from occurring.

Contents

Definition & Facts

Traveler's diarrhea is an illness in the digestive tract that can result in bowel discomfort, cramps, and loose stools or diarrhea. The main cause of the illness is a variety of microorganisms that are present in different types of contaminated food and contaminated water.

Traveler's diarrhea is often called different names depending on where it occurs proving that it can happen in any destination. A traveler is more likely to get the illness when they are traveling to a developing part of the world, but it can occur in any area where the climate, sanitary conditions, or food and water are different than what the traveler is used to. 

The people most likely to get traveler's diarrhea are young adults, those with immune deficiencies, and people who travel to certain destinations during certain times. High risk areas for this illness are Central and South America, Mexico, Africa, the Middle East and a large portion of Asia. 

Symptoms & Complaints

The symptoms of traveler's diarrhea usually occur shortly after the digestion of the contaminated food or water, and they will last for a couple of days without treatment. The major symptoms include:

Most of these symptoms are not severe and require no treatment to get better; however, medical supervision may be required if the contamination occurred by an unusual or more severe organism.  If any of these symptoms occur, a doctor should be consulted:

  • Persistent vomiting
  • Bloody stools, particularly if the blood is dark
  • A high grade fever over 102 degrees Fahrenheit (39 degrees Celsius)
  • A child who cries without tears or has a dry mouth
  • Unusual drowsiness or unresponsiveness
  • Dehydration may occur with traveler's diarrhea. People with this illness or any diarrhea illness should make sure to drink plenty of fluids to replenish those lost through diarrhea.

Causes

Occasionally the major change in diet because of traveling is to blame for the onset of traveler's diarrhea, but most occurrences of the illness are a result of some type of infection caused by an organism. These are usually organisms that people who live in the area have already become accustomed to and they are immune to the organism's effect. Those who have never been exposed to the bacteria, like travelers, very quickly start to be affected by them.

These organisms can attach to the walls of the intestine and release the symptom-causing toxins. The most common organisms that cause traveler's diarrhea are enterotoxigenic Escherichia coli (ETEC), Campylobacter, norovirus, or protozoa like Giardia (Giardia infection). Most of these bacteria and organisms will only affect the traveler for a short amount of time, but some can take as much as two weeks to work their way out of a person's system.

Diagnosis & Tests

Most of the people who get traveler's diarrhea won't need to visit a doctor, but if the diarrhea lasts more than a few days, the patient becomes dehydrated, or a severe fever arises then it is a good idea to have a doctor's visit. 

Traveler's diarrhea is mainly diagnosed based on the patient's symptoms. The doctor will ask a patient what their symptoms are. Most people affected with this illness will be easy to diagnose because they will be recent travelers. If there is anything beyond the normal symptoms then the doctor can explore other illnesses and causes for the patient's symptoms. 

Treatment & Therapy

Even though most people will have their symptoms go away on their own after a few days, there are a few treatment options to ease the symptoms or control them if they are not going away. Antimotility agents such as loperamide and diphenoxylate will provide relief to those who are suffering severe diarrhea. They work by reducing the spasms in the colon and slowing down processes therein, allowing more fluid to be absorbed. Since the fluid is absorbed in the digestive tract, there is less fluid in the stool. These medications work quickly, but they should only be used for a short amount of time. They should not be taken if the diarrhea or other symptoms last for more than 48 hours.

Another treatment is bismuth subsalicylate. It comes in liquid format and is usually pinkish in color. This over-the-counter medication can soothe the stomach and decrease the frequency of stools thus soothing the condition. Read the instructions on the bottles of these medicines as they are not recommended for everyone.

If the doctor does need to become involved, or the illness is not stopping on its own, the traveler's diarrhea patient may be prescribed a course of antibiotics. These medications will kill the organisms that are causing the symptoms. Doctors usually only prescribe these medications when the symptoms are severe, there is a very high fever, or there is blood, pus, or mucus in the stool.

One of the major treatments for traveler's diarrhea will involve preventing dehydration. Because so much water is lost through the stool, it is imperative that patients are drinking enough fluid to replenish those that are lost. Oral rehydration salts are available in most countries and they are a safe way to replenish fluids and prevent dehydration in diarrhea patients.

Prevention & Prophylaxis

The best approach towards dealing with traveler's diarrhea is to prevent it in the first place. Potential travelers should always ask a doctor and do some research about ways to prevent common illnesses when traveling. 

When traveling to high risk areas, never drink unsterilized water. The easiest way to do this is to drink bottled water. Also, tourists should avoid food from street vendors, and only eat food that has been cooked thoroughly. By heeding these warnings, travelers can make sure that traveler's diarrhea doesn't interrupt their journey.