Carl R. Darnall Army Medical Center - Health Library

Traveler’s Diarrhea

Pronounced: Traveler’s die-ah-ree-ah

Definition

Traveler's diarrhea is diarrhea in people who travel to international destinations. It often happens in less developed countries.

Causes ^

The primary cause of traveler’s diarrhea is ingesting contaminated food or water. The pathogen that is ingested causes the diarrhea. Examples of pathogens that can cause the diarrhea include:

  • Bacteria such as—
    • Escherichia coli (E. coli)
    • Campylobacter jejuni
    • Shigella
    • Salmonella
  • Viruses
    • Rotavirus
    • Norovirus
  • Parasites such as
    • Protozoa
    • Giardia

Virus Attacking Cell
Virus

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The pathogen that causes the infection will partly depend on the area of travel.

Risk Factors ^

The most important risk factor for getting traveler’s diarrhea is the destination. Underdeveloped countries with unsafe water supplies or sanitation pose the highest risk. The following factors increase your chance of getting traveler’s diarrhea. If you have any of these risk factors and plan to travel internationally, tell your doctor:

Inflammatory Bowel Disease
Crohn's Disease

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Symptoms ^

Symptoms can include:

  • Increased frequency and volume of stool
  • Frequent loose stools—4 to 5 watery bowel movements a day
  • Abdominal cramping
  • Nausea
  • Vomiting
  • Fever
  • Bloating

Diagnosis ^

You will be asked about your symptoms and medical history. A physical exam will be done.

A stool sample may be taken. This will allow your doctor to identify the pathogen.

Treatment ^

Talk with your doctor about the best treatment plan for you. Your doctor may direct you to self-treat if you are traveling to certain countries and have sudden moderate to severe diarrhea. People who get traveler's diarrhea usually get better within 3-5 days even without treatment. Treatment options include the following:

Hydration

It is important for people who have diarrhea to make sure they are drinking plenty of clear fluids. This will replace the fluids lost in the diarrhea. Some people may need to use an oral rehydration solution such as children and older adults who are more likely to become dehydrated.

Antibiotics

Antibiotics may reduce how long symptoms last by 1-2 days. These antibiotics are only helpful for treating infections caused by bacteria.

Antimotility Agents

Antimotility agents may help relieve symptoms of diarrhea. Examples of these medications include:

  • Loperamide—Should not be used in children less than 2 years old, people with fever over 101.3°F (38.5°C), and people with bloody diarrhea.
  • Bismuth subsalicylate—Should not be used in children, pregnant women, and people with allergies to aspirin or salicylates.

Prevention ^

To help reduce your chances of traveler’s diarrhea:

  • Avoid eating foods from street vendors or unsanitary eating establishments.
  • Avoid raw or undercooked meat or seafood.
  • Eat foods that are fully cooked and served hot.
  • Avoid salads or unpeeled fruits. Have only fruits and vegetables that you peel yourself, such as bananas or oranges.
  • Do not drink tap water, or use it to brush your teeth or make ice cubes.
  • Drink only bottled water with a sealed cap or, if necessary, local water that you have boiled for 10 minutes or treated with iodine or chlorine.
  • Sealed bottled carbonated beverages, steaming hot tea or coffee, wine, and beer are all okay to drink.
RESOURCES:

American Gastroenterological Association
http://www.gastro.org

Centers for Disease Control and Prevention
https://www.cdc.gov

CANADIAN RESOURCES:

Be Food Safe—Canadian Partnership for Consumer Food Safety Education
http://befoodsafe.ca

Health Canada
https://www.canada.ca

REFERENCES:

Acute diarrhea in adults. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T900062/Acute-diarrhea-in-adults. Updated April 27, 2017. Accessed December 15, 2017.

Acute diarrhea in children. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T116662/Acute-diarrhea-in-children. Updated March 9, 2017. Accessed December 15, 2017.

Travelers' diarrhea. Centers for Disease Control and Prevention website. Available at: https://wwwnc.cdc.gov/travel/page/travelers-diarrhea. Updated October 23, 2017. Accessed December 15, 2017.

Traveler's diarrhea. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T116545/Travelers-diarrhea. Updated September 28, 2017. Accessed December 15, 2017.

Traveler’s diarrhea. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/gastrointestinal-disorders/gastroenteritis/traveler%E2%80%99s-diarrhea. Updated May 2017. Accessed December 15, 2017.

Last reviewed December 2017 by EBSCO Medical Review Board Marcie L. Sidman, MD  Last Updated: 12/15/2017