Medical Edge Newspaper Column

Traveler's Diarrhea

April 17, 2009
Readers:
If you're planning on traveling to a developing country, there is a 20 to 50 percent chance that you'll experience something you hadn't planned for: a bout of traveler's diarrhea.

Traveler's diarrhea is usually caused by food or water that contains bacteria, viruses or parasites that your body isn't accustomed to dealing with. It generally lasts about three to five days. Signs and symptoms include the fairly abrupt onset of loose stools and cramping abdominal pain, possibly accompanied by fever or vomiting. Fortunately, traveler's diarrhea usually isn't a serious health threat, but it can cause you to feel miserable and weak, even after the diarrhea stops.

However, about 5 to 10 percent of these cases are more serious and include bloody stools, persistent vomiting, severe abdominal pain or a temperature greater than 102 degrees.

In countries where traveler's diarrhea is a risk, be careful about what you drink and eat. With drinking, don't consume untreated water from the local supply. This may involve avoiding ice cubes in drinks; keeping your mouth closed in the shower; using bottled water to brush your teeth; and drinking only factory-bottled beverages.

Local water sources can be purified by boiling the water for about three to five minutes or by using water purification products, such as chlorine- or iodine-based drops or tablets.

When eating, stick to foods that are packaged or freshly cooked and served steaming hot. In addition, wash your hands with soap and water before eating or preparing food. If clean water and soap aren't available, use a hand sanitizer.

Avoid food from street vendors; raw vegetables and fruits without a peel; moist food at room temperature, such as sauces, salads and buffet offerings; raw or undercooked meats; and nonpasteurized dairy products or fruit juices.

Before you travel, talk to your doctor about drugs that you can pack that may help significantly shorten the course of traveler's diarrhea. Key anti-diarrhea medications include loperamide (Imodium) and bismuth subsalicylate (Pepto-Bismol). If you only have mild to moderate diarrhea, either of these may be enough. However, neither should be taken if diarrhea is accompanied by high fever, severe abdominal pain or blood in your stool.

Rehydrating yourself is important to recovery. Try pasteurized juices, broths, soups or soft drinks. You may also want to look for hydrating solutions labeled "WHOORS," for World Health Organization oral rehydration salt solution. These are widely available in most developing countries.

— Adapted from Mayo Clinic Health Letter