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:
- Abrupt onset of passage of three or more loose stools a day
- An urgent need to defecate
- Abdominal cramps
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.
When 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:
- Persistent vomiting
- Bloody stools or severe diarrhea
- A fever of 102 F (39 C) or more
- Dry mouth or crying without tears
- Signs of being unusually sleepy, drowsy or unresponsive
- Decreased volume of urine, including fewer wet diapers in infants
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:
- Young adults. The condition is slightly more common in young adult tourists. Though the reasons why aren't clear, it's possible that young adults lack acquired immunity. They may also be more adventurous than older people in their travels and dietary choices, or they may be less vigilant in avoiding contaminated foods.
- People with weakened immune systems. A weakened immune system increases vulnerability to infections.
- People with diabetes, inflammatory bowel disease or cirrhosis of the liver. These conditions can leave you more prone to infection or increase your risk of a more-severe infection.
- People who take acid blockers or antacids. Acid in the stomach tends to destroy organisms, so a reduction in stomach acid may leave more opportunity for bacterial survival.
- People who travel during certain seasons. The risk of traveler's diarrhea varies by season in certain parts of the world. For example, risk is highest in South Asia during the hot months just before the monsoons.
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.