Traveler’s Diarrhea: 5 Questions and Answers

Traveler's diarrhea (Credit: Pixabay)

Put quite simply, traveler’s diarrhea is nothing more than having one or more unformed stools while traveling.

It’s considered the most common of all travel ailments, affecting 10-60 percent of travelers depending on the travel destination. Western travelers often tend to worry about contracting traveler’s diarrhea (TD) when they travel to Mexico (Montezuma’s Revenge) and India (Delhi Belly) but the ailment can occur anywhere.

1) What are the signs and symptoms of traveler’s diarrhea?

Traveler’s diarrhea is a gastrointestinal illness characterized by an abrupt onset of loose stools with abdominal cramps, gas and/or bloating—sometimes accompanied by nausea, fever, and vomiting.

2) What factors produce this ailment?

While traveler’s diarrhea is often associated with changes in climate; changes in diet (both food and water); and unsanitary conditions associated with food preparation and serving—the ailment is more likely to be caused by infectious agent entering the digestive tract. Most commonly, this is a bacteria (usually E-coli) and less often, viruses or parasites.

Diarrhea is often a symptom of norovirus, a highly contagious foodborne illness. Although cruise ships only account for less than 1% of norovirus outbreaks, it is the most common cause of diarrhea on cruise ships.

3) What are the risk factors for traveler’s diarrhea? 

  • Travel to certain destinations (e.g. Central and South America, Mexico, Asia, Africa and the Middle East are considered higher risk);
  • Travel during certain seasons (e.g. very hot weather);
  • Having a weakened immune system or prior history of inflammatory bowel disease or diabetes;
  • Use of antacids or acid-reducing medications (e.g., Pepcid, Nexium, Prilosec, Tagamet) that make the stomach more vulnerable to certain infectious agents.

4) How can traveler’s diarrhea be prevented? 

According to the Mayo Clinic, prevention largely involves being very cautious (and conscious) about foods and water consumption when traveling. (The same foods and water that transmit the pathogens associated with TD usually have no adverse effects on locals who have developed immunity.

Here are some prevention tips:

  • Make sure foods are thoroughly cooked and served hot. Staying clear of raw foods or foods sitting around at room temperature, even if they’ve previously been cooked (e.g. street food and restaurant buffets)
  • Drink bottled water, even for brushing your teeth
  • Avoid coffee and tea, usually brewed with water that hasn’t been boiled.
  • Avoid swallowing water when showering or swimming
  • Don’t use ice cubes and avoid fruit juices mixed with water
  • Limit fruit consumption to those fruits that you can wash and peel
  • Wash hands before eating
  • Clean tops of cans and bottles before drinking or pouring

Some studies suggest that prescribed regimens of Pepto-Bismol can help prevent TD

5) What can a traveler do to “treat” the ailment?

Although the symptoms of TD can be a real nuisance when traveling, most cases are self-limiting, resolving on their own within three or four days. (Although symptoms can be similar, the condition needs to be differentiated outbreaks of foodborne illnesses, which can be quite serious.)

If a traveler is experiencing mild and transient diarrhea, it’s important, however, to stay well hydrated in order to replace lost body fluids. (Older people are more subject to dehydration)

Over-the-counter Lomotil or Imodium can help reduce mobility in the intestine but shouldn’t be taken for more than two days.

If symptoms of diarrhea are severe, don’t improve or worsen, a physician should be consulted. He/she may take cultures and recommend a course of antibiotics. Although antibiotics may shorten the course and severity of diarrhea, therapeutic effects must be weighed in relation to possible adverse side effects.


Severe traveler’s diarrhea can be life-threatening. This post is provided for general information and shouldn’t be construed as medical advice, which should be obtained from a physician.

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