Beat the Bug: Your Guide to Conquering Traveler’s Diarrhea on Vacation

What causes traveler’s diarrhea?

Traveler’s diarrhea is a common problem for people who travel to developing countries. It is caused by eating or drinking food or water that is contaminated with bacteria, viruses, or parasites. The symptoms of traveler’s diarrhea include loose stools, abdominal cramps, nausea, and vomiting.

What can you do to treat traveler’s diarrhea while on vacation?.

• Drink plenty of fluids to stay hydrated.

• Take over-the-counter medications such as Imodium (loperamide) or Pepto-Bismol (bismuth subsalicylate) to help control the diarrhea. Use Imodium short-term to get you through your plane, train, or bus ride, and don’t take it if you have bloody diarrhea or fever.

• Eat bland foods such as toast, crackers, and bananas.

• Avoid dairy products, caffeine, and alcohol.

• Get plenty of rest.

When should you use an antibiotic?

If your symptoms are severe or do not improve after a few days, you may need an antibiotic. While Cipro used to be the drug of choice to treat traveler’s diarrhea, it is no longer first-line treatment due to increasing resistance to it and the potential for severe adverse reactions, including tendonitis and tendon rupture. It has been replaced by Zithromax (azithromycin), which is taken as a one-time dose. If you have a sensitive stomach or are prone to vomiting after taking antibiotics, the dose of azithromycin can be divided in half and taken once in the morning and once at night for one day only.

How long does traveler’s diarrhea usually last?

If left untreated, bacterial diarrhea typically continues for 3 to 7 days, while viral diarrhea often resolves within 2 to 3 days. On the other hand, protozoal diarrhea can last from weeks to months if not addressed. A single acute episode of traveler’s diarrhea may result in ongoing intestinal symptoms, even when the infection has resolved. This condition is frequently known as postinfectious irritable bowel syndrome.

When should you seek medical attention?

Mild diarrhea does not interfere with your planned activities. It’s tolerable and does not cause distress. This can be treated symptomatically with Imodium or Pepto-Bismol.

Moderate diarrhea is distressing and does interfere with your planned activities. An antibiotic plus or minus Imodium would be appropriate to treat moderate diarrhea.

Severe diarrhea is incapacitating and prevents you from participating in any activities. You should take an antibiotic AND consider Imodium (if your diarrhea is not bloody, and you don’t have a fever). At this stage, oral rehydration packets (which contain electrolytes) mixed with clean water should be used for hydration.  Also, consider visiting a doctor if your diarrhea is so frequent that you cannot keep up with your fluid intake, especially in children, older adults, and those with chronic illness.

Additionally, you should seek medical attention for traveler’s diarrhea in the following situations:

1. Severe Dehydration: Symptoms include very dry mouth, excessive thirst, little or no urination, severe weakness, dizziness, or lightheadedness. Dehydration is particularly concerning in young children and the elderly.
2. High Fever: A temperature of 38.5°C (101.3°F) or higher can indicate a more serious infection or complication.
3. Bloody Stools: The presence of blood in your diarrhea or black, tarry stools suggests a more severe infection that requires medical intervention.
4. Persistent Symptoms: If diarrhea lasts more than a few days without any signs of improvement, it’s important to consult a healthcare physician. For adults, seek help if diarrhea lasts longer than 3 days without signs of improvement. For children, seek immediate medical advice, as they can become dehydrated quickly.
5. Severe Pain: Intense abdominal or rectal pain can indicate complications or severe infections that need medical attention.
6. Signs of Serious Illness: Symptoms such as persistent vomiting, signs of dehydration, jaundice (yellowing of the skin or eyes), or if you’re unable to keep any fluids down, necessitate medical care.
7. If You Have a Pre-existing Condition: Individuals with weakened immune systems, chronic diseases like diabetes, kidney disease, or heart conditions, and those who are pregnant should seek medical advice early if they experience symptoms of traveler’s diarrhea.
8. Medication Not Working: If over-the-counter treatments are not alleviating the symptoms, or if symptoms worsen despite treatment with an antibiotic, medical evaluation is necessary.

In these situations, a healthcare professional can offer appropriate treatments, which may include prescription medications like antibiotics, rehydration solutions, or other therapies tailored to the cause and severity of your symptoms.

How can I prevent traveler’s diarrhea while on vacation?

Remember, while it’s good to have treatment options, prevention is the best treatment. To prevent traveler’s diarrhea, consider adopting the following measures, especially when visiting areas where the condition is more common:

1. Consume Safe Beverages:
   – Drink only bottled water that is sealed or water that has been boiled.
   – Avoid ice in drinks unless you’re sure it’s made from purified water.
   – Choose canned or bottled carbonated beverages over non-carbonated.
2. Eat Safely:
   – Eat foods that are cooked and still hot.
   – Avoid raw fruits and vegetables unless you can peel them yourself.
   – Steer clear of raw or undercooked meat and seafood.
   – Be cautious with dairy products from small independent vendors.
3. Practice Good Hygiene:
   – Wash your hands frequently with soap and water, especially before eating or preparing food and after using the bathroom.
   – Use an alcohol-based hand sanitizer (at least 60% alcohol) when soap and water are not available.
4. Be Cautious with Street Food:
   – While street food is a significant part of many cultures, it can sometimes be risky. Eat from places that are busy and appear to maintain high hygiene standards.
5. Water Treatment:
   – If bottled water is not available, treat water by boiling, filtering, or using a chemical disinfectant.
6. Consider Prophylactic Measures:
   – In some cases, your doctor might recommend taking antibiotics or bismuth subsalicylate (Pepto-Bismol) as a preventive measure, especially if you’re at high risk for traveler’s diarrhea or are traveling to a very high-risk area. Keep in mind that bismuth can cause black tongue and stool as well as constipation, nausea, and rarely tinnitus (ringing of the ears).
7. Consult a Healthcare Physician:
   – Before traveling, especially to high-risk areas, discuss preventive measures with a healthcare physician. They may recommend vaccines or other specific precautions based on your destination.
8. Understand Your Risks:
   – Recognize that certain destinations are higher risk, and take extra precautions when traveling to these areas.

By adhering to these guidelines, you can significantly reduce your risk of developing traveler’s diarrhea and ensure a more enjoyable trip. For more in depth information regarding traveler’s diarrhea, check out the CDC (Centers for Disease Control) website.

And don’t forget to visit TravelMeds2Go for your pre-travel prescription meds.