What to do if you have traveler’s diarrhea

Traveler’s diarrhea is a common travel-related illness. Vacationers usually become infected with it through contaminated water or food. Bacteria are to blame in 80-90% of cases, but viruses, parasites and food poisoning (an illness caused by toxins produced by bacteria in food) can also cause the disease.

Bacteria and viruses cause symptoms within 6 to 72 hours. If the infection is caused by a parasite, the incubation period can be one to two weeks. Food poisoning from toxins produced by bacteria can occur within a few hours of ingestion and resolve within 12 to 24 hours.

Treatment options can range from drinking clear liquids to taking over-the-counter medications or antibiotics.

Symptoms of traveler’s diarrhea

Traveler’s diarrhea can mean different things at different times, depending on the cause. In general, you can expect to experience the following symptoms, which may be quite urgent:

• Abdominal cramps (mild to severe)
• Bloody stool
• High temperature
• Vomit
• Watery stool

If you have diarrhea Caused by a virus, it usually lasts only two to three days. If it is a bacterial disease, it usually lasts three to seven days without treatment. Severe cases of bacterial diarrhea can last for weeks. If protozoa (single-celled parasites) are to blame, the condition can last for months without treatment.

When to Contact Your Health Care Provider

In some cases, traveler’s diarrhea goes away and resolves on its own. But if you experience any of the following, don’t hesitate to contact your doctor:

• Bloody stool
• Showing signs of dehydration, such as a fast heart rate or rapid breathing, extreme thirst, dizziness, or sunken eyes or cheeks.
• High fever, vomiting, dizziness and severe pain.
• Prolonged, severe diarrhea that lasts more than two days.

Treatment with antibiotics

Antibiotics are not recommended for mild traveler’s diarrhea. Mild diarrhea is defined as tolerable and not interfering with planned activities. Taking antibiotics is generally avoided due to the risk of promoting the spread of antibiotic-resistant bacteria (those against which the drugs intended to kill them no longer work) and the development of Clostridia difficult (C. diff) infection.

Antibiotics may be considered for severe diarrhea (such as those accompanied by shock, low blood pressure, or persistent fever) or in people at high risk, such as people over 70, people with weakened immune systems, or people with chronic diseases. conditions.

Pregnant women, those with inflammatory bowel disease, and those whose diarrhea does not go away within one week can get tested to determine the organism responsible and determine the best antibiotic for treatment.

Possible antibiotics include:

• Fluoroquinolones such as Cipro (ciprofloxacin) and levofloxacin are usually prescribed first. In South and Southeast Asia, different antibiotics may be prescribed because Campylobacter is usually responsible for the condition in these areas, and some resistance to fluoroquinolones has been found.
• Rifamycins used to treat non-invasive strains Escherichia coli (E.coli)associated diarrhea in travelers. These include Xifaxan (rifaximin) and the new drug Aemcolo (rifamycin SV). But you may also want to keep azithromycin on hand in case the illness is caused by an invasive pathogen.
• Zithromax, Z-Pak or Zmax (azithromycin) may no longer be the most effective drug in some countries where antibiotic resistance is on the rise, but it can be prescribed in other countries. It is often given as a single dose of 1000 mcg, but can be divided into two doses on the same day to avoid nausea.

Can over-the-counter medicine help?

You can find over the counter (Over-the-counter) remedies for mild traveler’s diarrhea at your local pharmacy.

Imodium (loperamide) not recommended unless needed to relieve some of the symptoms of urge and reduce the number of trips to the toilet. It should not be used if you have a fever or blood in your stool. For cases of moderate to severe diarrhea, you can also take it while you wait for the antibiotics to take effect.

Pepto-Bismol (Bismuth Subsalicylate) may soothe and coat the stomach, and also has some antibacterial and antacid activity. You can use it for mild traveler’s diarrhea.

Maintaining Hydration

When you have diarrhea, your body loses a lot of water and dehydration becomes a risk. To prevent this from happening, it is important to stay hydrated. Here are some ways to do this:

• Drink eight to 10 glasses of clear liquid every day, preferably water or oral rehydration solutions like Pedialyte
• Replenish fluids every time you have loose stools by drinking 1 glass of liquid.
• Food foods high in potassium such as bananas or drinking bottled fruit juice
• Consuming salty foods, sports drinks, or oral rehydration solutions to help replenish lost electrolytes (charged minerals such as sodium and potassium)

Risks of long-term diarrhea

In most cases, traveler’s diarrhea goes away within a few days to a few weeks. But if it lasts, you risk serious complications such as anemia (low number of healthy red blood cells), kidney problems, infections and electrolyte imbalance.

In the case of chronic diarrhea, a healthcare professional can run tests to understand what is going on and make sure the condition is not causing such complications.

Unfortunately, having traveler’s diarrhea once will not protect you from getting it again, even during the same trip. After recovery, you do not become immune to microorganisms. You must continue to be vigilant and avoid sources of contamination.

One study of foreigners living in Kathmandu, Nepal, found an average of 3.2 cases of diarrhea in travelers during their first year there.

How to avoid sources of pollution

Traveler’s diarrhea is associated with contaminated food or drink. You can prevent this by avoiding the following potential sources:

• Raw vegetables, fruits and other foods (only eat them after they have been washed with clean water, peeled or cooked)
• Buffet food
• Food sold by street vendors
• Unpasteurized milk
• Shellfish
• Hand contamination
• Tap water (including ice made from tap water)

Wash your hands after using the toilet and before and after eating. If soap and water are not available, use alcohol-based cleaners or wipes. Also, always keep your hands away from your mouth.

Drinking from the tap, brushing your teeth with tap water, or adding ice cubes made from tap water to soda or other liquids can expose you to waterborne pathogens.

Bowel treatment after diarrhea

When you have diarrhea, it is best to avoid foods and drinks that may make it worse. These include:

• Alcohol
• Caffeine
• Dairy products
• Fatty foods
• Fruits, foods and drinks containing fructose
• Spicy food
• Sugar-free products containing sugar alcohols such as sorbitol, mannitol and xylitol.

A restricted or bland diet is no longer recommended for diarrhea. You should return to your normal diet after the diarrhea goes away.

After traveler’s diarrhea goes away, you may feel uncomfortable and not understand why, especially if you took antibiotics to get the condition under control.

Community of microorganisms (ie. gut microbiome) colonizes the intestines and promotes digestion and absorption of nutrients. Taking antibiotics to control a condition like traveler’s diarrhea causes changes in the organisms that live there, sometimes killing off the good bacteria from the bad bacteria.

You can try consuming probiotics every day or two to correct this situation. Probiotics contain some beneficial microbes commonly found in the gut. This can help reintroduce healthy bacteria into your gut and replenish your supply.

Future Travel Prevention

You may want to take some Pepto-Bismol with you when traveling. Taking two of these tablets four times a day may help prevent diarrhea. But remember that you should not continue this regimen for more than three weeks.

Most people are not recommended to take antibiotics to prevent traveler’s diarrhea because the risks outweigh the benefits. However, it may be recommended for people with diseases such as cancer, human immunodeficiency virus (HIV), diabetes, or chronic bowel or kidney disease. In such cases, the doctor may prescribe an antibiotic.

Summary

Traveler’s diarrhea is caused by drinking contaminated water or food. This is usually a bacterial disease, but it can also be caused by a virus or parasite.

Hydration is critical in treating traveler’s diarrhea. In mild cases, you can take Imodium or Pepto-Bismol to relieve symptoms. For moderate to severe diarrhea, your doctor may prescribe antibiotics, although it may go away on its own.

You can take precautions to prevent traveler’s diarrhea by avoiding tap water and eating foods that have been properly washed or prepared. It is recommended to take Pepto-Bismol to prevent traveler’s diarrhea. For most people, prophylactic antibiotics are not recommended.