Traveller's Diarrhea

Traveller's diarrhea is the most common health problem for people traveling to tropical or developing countries. Unfortunately, up to one-half of travelers may be affected. The diarrhea usually begins suddenly, is short-lived and may be associated with other symptoms such as stomach cramps, bloating, nausea, and vomiting. Contaminated food and water are the usual culprits.

Food which is well cooked and served hot immediately after preparation is generally considered safe. Ensure that all meat is well cooked and that dairy foods are pasteurized. Fruits and vegetables which have just been peeled are usually safe. Best avoided are salad bars, raw vegetables, fruits which cannot be easily cleaned (for example, grapes and strawberries), custards, mousses, potato salads, hollandaise sauce, mayonnaise, and seafood. Foods sold by street vendors may also carry an increased risk of contamination.

Water should be treated before drinking. Purification may involve boiling, filtration, or treatment with iodine or chlorine. Bottled water with an unbroken seal, carbonated beverages, bottled juices, alcoholic beverages, coffee, and tea are safe. Ice cubes are to be avoided. Used bottled water for brushing teeth.

If traveller's diarrhea develops, lost fluids, salts, and sugars need to be replaced in order to prevent dehydration. Commercial or homemade oral rehydration solutions (i.e., 1/2 tsp baking soda & 1/3 tsp salt & 1/2 tsp honey all in 1 cup fruit juice OR 8 tsp sugar & 1 tsp salt in 1 litre water), canned juices, purified water, or clear salty soups may be used for rehydration. Bland foods (bananas, salted crackers, rice) may be started after 1 or 2 days when the person is starting to feel better.

A physician must be consulted if one of the following should occur:

• diarrhea does not improve after 2 or 3 days;
• other symptoms such as high fever or blood or pus in the stools develops;
• dehydration (dry mouth, rapid pulse, reduced urination) sets in;
• Diarrhea is more than mild in children less than 2 years of age.

Medications such as bismuth subsalicylate (Pepto Bismol) or loperamide (Imodium) may be used to treat the symptoms of diarrhea in adults and children over the age of 12 years. Certain antibiotics, such as siprofloxacin, are used to treat traveller's diarrhea. Travelers to certain countries may be prescribed a short course of antibiotics to be taken as soon as diarrhea occurs. Certain travelers may even need to take antibiotics as a preventative measure throughout their stay.

Before embarking on your travels, be sure to speak to your health care provider about traveller's diarrhea. Depending on your destination, you may be advised to visit a travel clinic.