What is traveler's diarrhea?

Traveler's diarrhea is a common medical problem for people traveling from developed, industrialized countries to developing areas of the world. Traveler's diarrhea is sometimes called by its more colorful names: Montezuma's revenge, Delhi belly, and Turkey trots.

High-risk areas for traveler's diarrhea include developing countries in Africa, Asia, the Middle East, and Latin America. Low-risk areas include the developed countries of North America, Central Europe, Australia, and Japan.

What causes traveler's diarrhea?

Traveler's diarrhea is usually caused by a bacterial infection. Bacteria such as Escherichia coli (E. coli), Campylobacter, Shigella, or Salmonella are the most common causes. These bacteria are in water contaminated by human or animal stools. Drinking water, water used to wash food, or irrigation water may be affected. When the traveler drinks this water or eats contaminated food, he or she is likely to get diarrhea.

Common sources of bacteria that cause diarrhea are undercooked or raw foods, contaminated food, or contaminated water (including ice cubes).

What are the symptoms of traveler's diarrhea?

Traveler's diarrhea can be mild to severe. Most people who develop traveler's diarrhea experience symptoms within the first two weeks, and often within 2 to 3 days, of arriving in a developing area. Symptoms include:

• Diarrhea.
• Abdominal cramps.
• Mild to severe dehydration.
• General lack of energy, nausea, and vomiting.
• Fever, vomiting, and stools with blood or mucus. These symptoms mean you have serious diarrhea, which is more likely to lead to problems with dehydration. Dehydration may alter the effect of any medicines being taken, such as oral contraceptives or antimalarials.

How is traveler's diarrhea treated?

Treatment for traveler's diarrhea includes drinking fluids to avoid dehydration, taking nonprescription medicines, and in some cases, antibiotics and intravenous (IV) fluids.

• Let your stomach rest. Do not eat for several hours or until you are feeling better.
• Take frequent, small sips of bottled or boiled water or a rehydration drink and small bites of salty crackers.
• If possible, drink a solution made with World Health Organization (WHO) oral rehydration salts. Packets of the salts are available at stores and pharmacies in most developing countries. Add one packet to boiled or treated water, making sure to read the instructions regarding the proper amounts of salts and water. Drink the solution within 12 hours if kept at room temperature, or within 24 hours if refrigerated.
• Begin eating a simple diet of bland foods, such as crackers, rice, bread, potatoes, or bananas, which usually will help slow diarrhea. After your diarrhea is gone, you may eat a regular diet again.

Children 2 years old or younger are at high risk of dehydration from diarrhea. If your child has diarrhea:

• Give your child a solution of WHO rehydration salts in addition to his or her regular food as long as diarrhea continues. If your baby has trouble keeping the liquids down, try giving frequent sips by spoon.
• Continue breast-feeding normally. Bottle-fed babies should drink lactose-free or reduced-lactose formulas.
• Feed your child starches, cereals, yogurt, fruits, and vegetables.
• Seek medical help immediately if you or your child has bloody diarrhea, fever, or persistent vomiting, and give rehydration fluids in the meantime.