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Traveler’s Diarrhea: 5 Questions and Answers

July 17, 2018
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:

  • Making 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)
  • Drinking bottled water, even for brushing your teeth
  • Avoiding coffee and tea, usually brewed with water that hasn’t been boiled.
  • Avoiding swallowing water when showering or swimming
  • Not using ice cubes and avoiding fruit juices mixed with water
  • Limiting fruit consumption to those fruits that you can wash and peel
  • Washing hands before eating
  • Cleaning 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.


Sources:

CDC: Travelers Diarrhea

Mayo Clinic: Traveler’s Diarrhea

NPR: Can you protect your tummy from traveler’s diarrhea

MedicineNet.com: Travelers’ Diarrhea

CDC: Norovirus

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.

  • Reply
    Kemkem
    July 18, 2018 at 4:08 am

    Great post. Informative. I’ve been lucky in my travels and knowing my body, I know what sort of foods to eat when l travel. I never eat street food either, no matter how cheap they are, I know they won’t agree with me. My husband always gets diarrhea no matter what he eats till his body adjusts, so l carry Imodium and a course of antibiotics. Luckily, my pharmacy background helps :-).

    • Irene S. Levine
      Reply
      Irene S. Levine
      July 18, 2018 at 8:32 pm

      My trick is to always drink bottled water! Great to have a pharmacist along on the trip:-)

  • Reply
    Janice and George (SandInMySuitcase)
    July 18, 2018 at 1:55 pm

    A helpful article!
    We’ve been pretty lucky — but in Myanmar we did get sick. We hear everyone gets sick in India, no matter where you stay! We’ve taken Dukoral sometimes when traveling to “iffy” places.

    • Irene S. Levine
      Reply
      Irene S. Levine
      July 18, 2018 at 8:31 pm

      And getting sick when you’re far away from home really get be frightening.

  • Reply
    Suzanne Fluhr
    July 18, 2018 at 5:16 pm

    Almost TMI, but important “news you can use”. I’m adding to my Travel Tips Pinterest board. I’ve been too lucky gastrointestinally on our last several trips, I hate to attract the evil eye by even mentioning that.

  • Reply
    Debra BORCHERT
    July 19, 2018 at 12:10 pm

    Just suffered this, and I was still in America only 150 miles from home! And I felt bloated for a week after the attack. My DR said that it takes a week for the digestive system to recover fully and during that time, it has to work really hard to digest the simplest of foods. She recommended pro-biotics, so those are in my travel first-aid kit right next to the Imodium.

    • Irene S. Levine
      Reply
      Irene S. Levine
      July 19, 2018 at 12:26 pm

      Sorry you succumbed, Deborah. Sometimes, it can even be a change in water.

  • Reply
    Doreen Pendgracs
    July 19, 2018 at 8:44 pm

    Very helpful article, Irene. Gratefully, I have not suffered from TD for a very long time. I think that adopting the simple suggestions you have provided will help most travellers stay well and out of the bathroom.

    • Irene S. Levine
      Reply
      Irene S. Levine
      July 19, 2018 at 10:07 pm

      Not always preventable but we certainly can reduce the risk!

  • Reply
    Lauren M
    July 20, 2018 at 1:21 am

    Excellent information! Travel agents don’t always tend to provide this info, ( no “glam factor” here!) so it’s good to be knowledgeable and well aware of what can happen, and in the event it does, how to deal properly with this condition. Knowledge is power. Great post!

    • Irene S. Levine
      Reply
      Irene S. Levine
      July 20, 2018 at 2:36 pm

      Thanks, Lauren. Not very inspiring but helpful I hope!

  • Reply
    Cathy Sweeney
    July 20, 2018 at 12:55 pm

    When I see articles on this and related subjects, my mind instantly goes back to Cancun 1984. I won’t share the details. Thanks for the helpful information that even us seasoned travelers can forget sometimes.

    • Irene S. Levine
      Reply
      Irene S. Levine
      July 20, 2018 at 2:35 pm

      Seems like everyone has an un-sharable memory if you travel enough:-)

  • Reply
    Debbra Dunning Brouillette
    July 21, 2018 at 11:07 am

    I’ve been fortunate to not have had a bad case of TD in my travels. I always pack Imodium, just in case. I always drink bottled water, unless I’m sure the water is safe to drink, and am careful about hand washing. It’s no fun to be sick on vacation!

  • Reply
    Lyn aka The Travelling Lindfields
    July 22, 2018 at 6:29 pm

    I am tucking this away for our visit to Egypt later this year. Hubby got very sick last time we were there and I am sure it was because he drank tea – probably made from Nile river water.

    • Irene S. Levine
      Reply
      Irene S. Levine
      July 22, 2018 at 6:51 pm

      It’s easy to forget you are drinking water when it’s buried in tea or coffee!

  • Reply
    May
    October 13, 2018 at 9:32 pm

    We are a group of 7 from France. 3 members got the TD one after the other, within a gap of 48 hours between those infected while travelling in Canada. We all ate the same food and drank the same beverages. India and Sri Lanka have been infinitely kinder.

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