Pronounced: Traveler’s die-ah-ree-ah
In persons traveling to international destinations, particularly in less developed countries, watery, loose stools ( diarrhea ) are most often caused by bacterial or viral infection. Most cases of traveler’s diarrhea resolve within 1 to 2 days without treatment and 90% resolve within one week. To ease symptoms, over-the-counter medications may be taken. If traveler’s diarrhea doesn’t resolve on its own in about a week, you may want to see your physician.
The primary cause of traveler’s diarrhea is ingestion of fecally-contaminated food or water. The offending substance carries a bacteria or virus that causes the diarrhea. The common pathogens include:
The most important risk factor for contracting traveler’s diarrhea is destination. Underdeveloped countries with contaminated water supplies pose the highest risk. The following factors increase your chance of developing traveler’s diarrhea. If you have any of these risk factors and plan to travel internationally, tell your doctor:
If you experience any of these symptoms do not assume it is due to traveler’s diarrhea. These symptoms may be caused by other health conditions:
Your doctor will ask about your symptoms and medical history, and perform a physical exam. A stool sample will be taken.
Tests may include the following:
Talk with your doctor about the best treatment plan for you. Treatment options include the following:
Loperamide (Imodium), diphenoxylate (Lomotil), and opiates reduce muscle spasms in the gastrointestinal tract, slowing transit time, thus increasing absorption. Infants and those with bloody diarrhea cannot use them. Bismuth subsalicylate (Pepto-Bismol) is an over-the-counter medication that decreases the frequency of stools. Note : This medication should not be used by children or pregnant women. It should not be used by people who have allergies to aspirin or salicylates. In addition, it should not be used by persons currently taking aspirin or similar type drugs (salicylates).
Ciprofloxacin , norfloxacin , ofloxacin , doxycycline , or trimethoprim-sulfamethoxazole are the most common antibiotics for treating traveler’s diarrhea. These antibiotics are only effective for treating a bacterial infection.
If you are diagnosed with traveler's diarrhea, follow your doctor's instructions.
To help reduce your chances of getting traveler’s diarrhea, take the following steps:
RESOURCES:
American Academy of Family Physicians
http://www.aafp.org
American Gastroenterological Association
http://www.gastro.org
Centers for Disease Control and Prevention
http://www.cdc.gov
CANADIAN RESOURCES:
Canadian Partnership for Consumer Food Safety Education
http://www.canfightbac.org
Health Canada
http://www.hc-sc.gc.ca/index_e.html
References:
Guerrant RL, et al. Practice guidelines for the management of infectious diarrhea. Clinical Infectious Diseases . 2001:32:331-50.
Juckett G. Prevention and treatment of traveler’s diarrhea. Am Fam Physician . 1999;60:119-36.
Yates J. Traveler’s diarrhea. Am Fam Physician . 2005;71:2095-100, 2107-8.
Last reviewed November 2008 by David L. Horn, MD, FACP
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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