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Traveler’s diarrhea

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Your digestive tract stretches from your mouth to your anus. It includes the organs necessary to digest food and process waste.

Traveler’s diarrhea is a digestive tract disorder that commonly causes loose stools and abdominal cramps. It’s caused by eating contaminated food or drinking contaminated water. Fortunately, traveler’s diarrhea usually isn’t serious — it’s just unpleasant.

When you visit a place where the climate or sanitary practices are different from yours at home, you have an increased risk of developing traveler’s diarrhea.

To reduce your risk of traveler’s diarrhea, be careful about what you eat and drink while traveling. If you do develop traveler’s diarrhea, chances are it will resolve without treatment. However, it’s a good idea to have doctor-approved medications with you when you travel to high-risk areas in case diarrhea persists.

Traveler’s diarrhea usually begins abruptly during your trip or shortly after you return home. Most cases improve within one to two days without treatment and clear up completely within a week. However, you can have multiple episodes of traveler’s diarrhea during one trip.

The most common signs and symptoms of traveler’s diarrhea are:

Sometimes, people experience moderate to severe dehydration, persistent vomiting, a high fever, bloody stools, or severe pain in the abdomen or rectum. If you or your child experiences any of these signs or symptoms or if the diarrhea lasts longer than a few days, it’s time to see a doctor.

Traveler’s diarrhea usually goes away on its own within several days. Signs and symptoms may last longer and be more severe if the condition is caused by organisms other than common bacteria. In such cases, you may need prescription medications to help you get better.

If you have severe dehydration, persistent vomiting, bloody stools or a high fever, or if your symptoms last for more than a few days, seek medical help. The local embassy or consulate may be able to help you find a well-regarded medical professional who speaks your language.

Be especially cautious with children because traveler’s diarrhea can cause severe dehydration in a short time. Call a doctor if your child is sick and exhibits any of the following signs or symptoms:

It’s possible that traveler’s diarrhea may stem from the stress of traveling or a change in diet. But almost always an infectious agent is to blame.

You typically develop traveler’s diarrhea after ingesting food or water that’s contaminated with organisms from feces. These organisms are infectious agents — including various bacteria, viruses and parasites — that enter your digestive tract and overpower your defense mechanisms, resulting in signs and symptoms of traveler’s diarrhea.

The most common cause of traveler’s diarrhea is enterotoxigenic Escherichia coli (ETEC) bacteria. These bacteria attach themselves to the lining of your intestine and release a toxin that causes diarrhea and abdominal cramps.

So why aren’t natives of high-risk countries affected in the same way? Often their bodies have become accustomed to the bacteria and have developed immunity to them.

Each year millions of international travelers experience traveler’s diarrhea. High-risk destinations for traveler’s diarrhea include many areas of Central and South America, Mexico, Africa, the Middle East and most of Asia.

Traveling to Eastern Europe and a few Caribbean islands also poses some risk. However, your risk of traveler’s diarrhea is generally low in Northern and Western Europe, Japan, Canada, Australia, New Zealand and the United States.

Your chances of getting traveler’s diarrhea are mostly determined by your destination. But certain groups of people have a greater risk of developing the condition. These include:

Because you lose vital fluids, salts and minerals during a bout with traveler’s diarrhea, you may become dehydrated. Dehydration is especially dangerous for children, older adults and people with weakened immune systems.

Dehydration caused by diarrhea can cause serious complications, including organ damage, shock or coma. Signs and symptoms of dehydration include a very dry mouth, intense thirst, little or no urination, and extreme weakness.

The general rule of thumb when traveling to another country is this: Boil it, cook it, peel it or forget it. Studies show, however, that you can still get sick even if you follow these rules. Remember these tips to decrease your risk of getting sick:

When visiting high-risk countries, keep the following tips in mind:

If it’s not possible to buy bottled water or boil your water, bring some means to purify water. Consider a water-filter pump with a microstrainer filter that can filter out small microorganisms.

You can also chemically disinfect water with iodine or chlorine. Iodine tends to be more effective, but is best reserved for short trips, as too much iodine can be harmful to your system. You can purchase iodine tablets or crystals at camping stores and pharmacies. Be sure to follow the directions on the package.

Here are other ways to reduce your risk of traveler’s diarrhea:

Public health experts generally don’t recommend taking antibiotics to prevent traveler’s diarrhea, because doing so can contribute to the development of antibiotic-resistant bacteria.

Antibiotics provide no protection against viruses and parasites, but they can give travelers a false sense of security about the risks of consuming local foods and beverages. They can also cause unpleasant side effects, such as skin rashes, skin reactions to the sun and vaginal yeast infections.

As a preventive measure, some doctors suggest taking bismuth subsalicylate (Pepto-Bismol), which has been shown to decrease the likelihood of diarrhea. However, don’t take this medication for longer than three weeks, and don’t take it at all if you’re pregnant, allergic to aspirin, or taking certain medications, such as anticoagulants.

Common harmless side effects of bismuth subsalicylate include a black-colored tongue and dark stools. In some cases it can cause constipation, nausea and, rarely, ringing in your ears (tinnitus).

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Traveler’s diarrhea

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