Digestive Diseases: Traveler's Diarrhea

Traveler's diarrhea is a stomach and intestinal infection that occurs as a result of unsanitary handling of food. Food handlers who do not wash their hands after they use the bathroom can transmit the infection to people who consume the contaminated food.

Areas where there is the highest risk of contracting traveler's diarrhea include the developing countries of Africa, the Middle East and Latin America. The risk of infection varies depending on the type of eating establishment visited -- from fairly low risk in private homes to high risk in food from street vendors.

The most common culprit is a bacteria called E.coli.

What Are the Symptoms of Traveler's Diarrhea?

The typical symptoms of traveler's diarrhea include:

• Abrupt onset of diarrhea
• Nausea and vomiting
• Bloating
• Urgent need to have a bowel movement
• Malaise (weakness or discomfort)
• Explosive and painful gas
• Cramps
• Loss of appetite

Traveler's diarrhea usually lasts from 3 to 7 days and is very rarely life threatening.

How Do I Treat Traveler's Diarrhea?

As with all diseases, it is best to consult a doctor rather than attempting to self-medicate. This is especially relevant for pregnant women and children.

Pepto-Bismol (2 ounces four times daily or two tablets four times daily) decreases the diarrhea and shortens the duration of the illness. This medication also appears to be effective in preventing traveler's diarrhea, but it should not be taken for more than three weeks at a time.

Side effects of Pepto-Bismol can include temporary blackening of tongue and stools, occasional nausea and constipation, and rarely, ringing in the ears. Do not take Pepto-Bismol if you have an aspirin allergy, renal insufficiency, gout, or if you are taking anticoagulants, probenecid (Benemid, Probalan) or methotrexate (Rheumatrex).

Treatment also requires the replacement of fluids and salts lost from diarrhea. This is best achieved by use of an oral rehydration solution such as the World Health Organization oral rehydration salts (ORS) solution. ORS packets are available at stores or pharmacies in almost all developing countries.

ORS is prepared by adding one packet to boiled or treated water. Packet instructions should be followed carefully to ensure that the salts are added to the correct volume of water. ORS solution should be consumed or discarded within 12 hours if stored at room temperature or within 24 hours if refrigerated.

An antidiarrheal medication, such as Lomotil or Imodium, can decrease the number of diarrheal stools but can also cause complications for people with serious infections. These drugs should not be used by anyone with a high fever or blood in their stools.

Antibiotics such as doxycycline, Bactrim, Septra and Cipro or norfloxacin may shorten the length of illness. The CDC does not recommend the use of antibiotics to prevent traveler's diarrhea because they can sometimes cause additional problems. Consult your doctor about taking these medications.