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Traveler's Diarrhea

Traveler's Diarrhea

What is travelers' diarrhea? — Travelers' diarrhea is runny or watery bowel movements in people who are traveling. It is usually caused by bacteria but can also be caused by a virus or parasite.
You are more likely to get travelers' diarrhea if you travel in:
Asia (except Singapore and Japan)
South America, Central America, and Mexico
Countries around the Mediterranean Sea, including Israel
Caribbean islands
What are the symptoms of travelers' diarrhea? — The main symptom is runny or watery bowel movements. These usually start about 4 to 14 days after arriving. Other symptoms can include:
Feeling sick
Loss of appetite
Cramps in the lower belly
Nausea and vomiting
Gas and bloating – Feeling like the belly is full, with pain in the middle or top of the belly.
Blood in the bowel movements
Feeling as though you need have a bowel movement even if you just did, or like you need to get to the toilet in a hurry
Travelers' diarrhea usually lasts 1 to 5 days, but some people are sick for a week or longer.
Should I see a doctor or nurse? — If your doctor or nurse gave you antibiotics to take in case you got diarrhea, you can take them instead of going to a doctor or nurse in another country. But you might need to see a doctor or nurse if:
You are sick for 10 to 14 days or longer
You have a fever of 102ºF (40ºC) or higher
You have severe belly pain
You have bloody diarrhea
The antibiotics you took did not help
Will I need tests? — Probably not. If you see a doctor or nurse, he or she will ask where you traveled and what you did. If the doctor thinks a certain type of bacteria or parasite might be causing the diarrhea, he or she might ask for a bowel movement sample. Testing the sample can sometimes show the cause of the diarrhea. But this is not usually needed.
How is travelers' diarrhea treated? — The most important treatment is getting enough fluid. That's because diarrhea can cause the body to lose fluid. Adults with mild diarrhea can drink lots of fluids with water, salt, and sugar. Soup broth and water mixed with juice are good choices. If you are drinking enough, your urine will look light yellow or almost clear.
If you have very frequent diarrhea, you can drink an "oral rehydration solution." You can buy this in a packet at the pharmacy. Mix it with bottled or boiled drinking water.
Other treatments are not necessary for everyone. They might include:
Antibiotics – These medicines fight infections.
Medicines that ease diarrhea – These medicines include loperamide (brand name: Imodium), diphenoxylate-atropine (sample brand name: Lomotil), and bismuth subsalicylate (sample brand names: Pepto-Bismol, Kaopectate). They can help, but they can also cause other health problems. Bismuth salicylate might not be safe for pregnant women or people who take aspirin for another condition. You can take loperamide or diphenoxylate if you have mild diarrhea. If you have very bad diarrhea, you should only take loperamide or diphenoxylate if you are also taking antibiotics. You should stop loperamide or diphenoxylate if your symptoms get worse when you take them.
Can travelers' diarrhea be prevented? — You can reduce your chances of getting travelers' diarrhea by being careful about what and how you eat and drink. While you are traveling:
Do not drink tap water. Drink bottled carbonated drinks, beer, wine, or hot tea or coffee instead. Brush your teeth with bottled water.
Do not use ice in drinks. Ice is usually made from tap water.
Do not eat food from carts or stands in the street.
Do not eat sauces set out on restaurant tables. These include salsa and ketchup.
Do not eat fresh foods at room temperature. These include guacamole, fruit or chicken salads, and buffet food on a steam table.
Do not eat foods or drinks made with unpasteurized milk.
Ask for drinks in the bottle, without ice. If you drink from a glass, use a straw.
Do not eat fruits unless they have a peel and you have peeled them yourself.
Make sure meat and seafood are well done and eggs have a firm yolk.
If you can't find bottled water or soft drinks, you can make your drinking water safe by doing one of the following:
Boiling it for 3 minutes (let it cool before drinking)
Adding 5 drops of tincture of iodine to 4 cups of water and waiting 30 minutes – Tincture of iodine is a liquid you can buy at most pharmacies or camping goods stores.
Using a water treatment filter from a camping or sports store
Wash your hands after going to the bathroom, changing diapers, blowing your nose, touching animals, or taking out the trash.
If you have a serious health condition, travelers' diarrhea could cause you to lose too much water. This can be dangerous and even cause death. If you are going on a trip, talk to your doctor or nurse ahead of time. He or she might give you antibiotics to take while you are traveling.
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 83761 Version 7.0
Release: 28.2.2 - C28.105
© 2020 UpToDate, Inc. and/or its affiliates. All rights reserved.

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