Doctor's Notes on Traveler's Diarrhea
Traveler’s diarrhea is a type of food poisoning that can often occur when people travel to foreign countries. Eating or drinking contaminated food or water, particularly in developing countries, can result in traveler’s diarrhea, which can be defined as three or more unformed stools in a 24-hour period. Food and water may become contaminated when handled by people with fecal content on their hands. High-risk areas for developing traveler’s diarrhea include Mexico, Latin America, Africa, the Middle East, and Asia.
Symptoms of traveler's diarrhea often start two to three days into a trip or even after a person returns home and may include
- loose or watery stools,
- abdominal cramping,
- bloating,
- nausea,
- urgency to have a bowel movement,
- fever,
- vomiting,
- headache,
- painful bowel movements, or
- bloody stools.
What Is the Treatment for Traveler's Diarrhea?
Most cases of traveler’s diarrhea are mild and do not require specific treatment. For years it was thought that antibiotics (especially fluoroquinolones) should be used to prevent and treat traveler’s diarrhea. The Centers for Disease Control (CDC) has recently updated the guidance for use of antibiotics in cases of traveler’s diarrhea, and the current recommendation is to only use antibiotics in severe cases when patients are at risk for severe complications. Also, fluoroquinolones (such as ciprofloxacin or levofloxacin) are no longer recommended due to antibiotic resistance and potential side effects of those drugs. Recommended antibiotics, depending on the bacterial cause of traveler’s diarrhea include:
Keeping hydrated is the most important treatment for traveler’s diarrhea. Adults with mild diarrhea can drink lots of fluids with water, salt, and sugar. Soups and water mixed with juice are good choices. Urine will appear light yellow or almost clear if you are well-hydrated.
Mild cases of traveler’s diarrhea can also respond to medicines that ease diarrhea, such as:
- Loperamide (Imodium)
- Diphenoxylate-atropine (Lomotil)
- Bismuth subsalicylate (Pepto-Bismol, Kaopectate)
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Immunizations and Antibiotics for Overseas Travel
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REFERENCE:
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.