6 Tips to Avoid and Treat Traveler’s Diarrhea

One item no traveler wants to pick up on their trip is an uncomfortable illness. It’s never, ever fun and traveler’s diarrhea is one of the most common (and one of the least pleasant) traveler’s diseases. The Centers for Disease Control and Prevention (CDC) reports that as high as 50 percent of international travelers suffer some form of traveler’s diarrhea and diarrheal diseases account for 1 in 9 child deaths worldwide, making diarrhea the second leading cause of death for children under the age of five.

Nearly all diarrhea-associated deaths worldwide are attributed to unsafe water, inadequate sanitation, and insufficient hygiene. Other causes of traveler’s diarrhea include changes in diet, dehydration from flying, changes in climate, traveler’s stress and even lack of sleep.

The most common cause of traveler’s diarrhea is exposure to bacteria – particularly E. coli and while an E. coli vaccine has been in the works for some years now, there’s no sign it will be available any time soon.

While most diarrheal germs are spread from the stool of an infected person to the mouth of another, these germs are passed via a wide-ranging number of items including glassware, utensils, doorknobs, faucet handles, and tools, as well as through food and water.

1. Avoid High-Risk Areas for Traveler’s Diarrhea

According to the CDC, the highest-risk destinations for traveler’s diarrhea break down like this:

• Low risk – The U.S., Canada, Northern and Western Europe, New Zealand, Australia and some Caribbean islands.
• Medium risk – Eastern Europe, South Africa, Argentina, Chile and some Caribbean islands.
• Highest risk – Most developing countries in Latin America, including Mexico, Central and South America, the Middle East, Africa, and Asia.

While in some high-risk areas it may be all but impossible to avoid some exposure to traveler’s diarrhea there are measures that every traveler can implement to reduce their personal risk.

2. Prevent Traveler’s Diarrhea with these Simple Practices

The best step to avoiding traveler’s diarrhea is putting into place practices that help you avoid it entirely. The CDC and the World Health Organization (WHO) have strong recommendations that help travelers avoid their exposure to germs. These include the following:

• Consume foods that are fully cooked and served hot (avoid items that have been sitting in a buffet line, for example)
• Eat raw fruits and vegetables only if you have washed them carefully in clean water or peeled them
• Drink only beverages in factory-sealed containers and if you can’t pour it into a clean glass, clean the container carefully around the rim where you will drink.
• Avoid ice unless you know that it was made from clean water.
• Wash your hands often with soap and water. If soap and water are not available, use a hand sanitizer with alcohol.
• Keep your hands away from your mouth (keeping your hands away from your eyes and nose will help prevent the transmission of cold and flu viruses as well)
• Drink plenty of clean water every day

Even if a traveler implements these steps and regularly practices good hygiene, they may contract traveler’s diarrhea. Let’s look at how to recognize it.

3. Recognize Traveler’s Diarrhea

The symptoms of traveler’s diarrhea are familiar to many, and include stomach cramps, nausea and vomiting and of course, diarrhea. In otherwise healthy travelers, diarrhea is rarely serious or life-threatening, but dangerous complications can develop that go far beyond the unpleasant physical discomfort and screwed up travel plans.

In the worst cases, diarrhea can be a cause of severe dehydration, an emergency medical situation that can put you into the hospital. It can also cause malnutrition if it lasts for more than a day or two. In either situation, you might need medical care.

4. Be Prepared for Traveler’s Diarrhea

Ensure that you have access to plenty of clean water if you get traveler’s diarrhea. This is especially important for young children or adults with chronic illnesses. Pack oral rehydration salts in your travel medical kit – these aid in fluid replacement.

Several antimotility medications, such as Pepto Bismol or Imodium, can be purchased and used to treat the symptoms of traveler’s diarrhea. These drugs relieve the need for the traveler to stay close to a bathroom and make it easier for a traveler suffering from diarrhea to use transportation like buses, airplanes and trains while the antibiotic takes effect. They do not, however, constitute a complete cure.

Antibiotics are a principal method of treating traveler’s diarrhea. Many travelers carry a dose of antibiotics to treat illnesses. Ask your doctor for a prescription and understand when they should be taken before you leave.

5. Treat Traveler’s Diarrhea

The symptoms of traveler’s diarrhea usually clear up in a day or two, but to speed recovery, you’ll need to make some changes in your diet and avoid caffeinated drinks as well as alcohol.

There are essentially three components to treating traveler’s diarrhea:

1. Fluid replacement (consider including the oral rehydration solution)
2. Over the counter antimotility drugs (the most common are Pepto Bismol and Imodium)
3. Antibiotics (two common antibiotics are Ciproflaxacin and Norfloxacin)

Once a traveler identifies their symptoms as diarrhea, it’s important to realize that significant fluid and electrolytes are lost when diarrhea strikes. Regular replenishment is critical to staying healthy while treating the diarrhea illness itself. Taking the antimotility agents (per the instructions on the bottle) can help with the need to visit the restroom often, but those also exacerbate the feelings of dehydration so plenty of clean fresh water is key to treating traveler’s diarrhea.

Take the antibiotics per the doctor’s instructions, keep drinking plenty of water, and washing your hands thoroughly and you should be feeling better soon.

6. When to Seek Medical Help

It’s important to note that antibiotic treatment is useful in cases of bacterial diarrhea but not for amebic dysentery, viruses, or food toxins – in fact, antibiotics can make these infections worse.

If the traveler’s condition is accompanied by a fever or lethargy or the diarrhea persists for more than a day or two, consider seeking medical attention. The following are signs that you should seek medical help:

• Blood or mucus in the stool
• Fever
• Persistent symptoms for more than 48 hours
• Inability to keep down light foods or liquids (vomiting)

See Finding Medical Care on the Road and In a Hurry for details on seeking medical treatment.