What to Do If You Get Travelers' Diarrhea

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Travelers' diarrhea (TD) can turn a trip into a nightmare; luckily, treatment options are available. Here is an overview of the symptoms of travelers' diarrhea, with an in-depth discussion of available treatment options, so that you can know what you need to do to take care of yourself.

Travelers' diarrhea is generally caused by pathogens found in food and water. Bacteria is the most likely culprit, along with viruses and parasites. Your greatest defense against travelers' diarrhea is prevention, so be sure to observe strict adherence to food and drink safety practices.

Symptoms of travelers' diarrhea usually show up several days into one's trip, although in some cases it may take two weeks for the disease to manifest itself. Symptoms will vary depending on the nature of the causative microorganism. Here are the more common symptoms of travelers' diarrhea:

  • Sudden, explosive and watery diarrhea
  • Abdominal cramps
  • Nausea and vomiting
  • Belching
  • Bloating

In more severe cases, a person could experience fever and blood in the stool. If you are experiencing these symptoms, or if your symptoms last for longer than 48 to 72 hours, it is essential that you be seen by a physician.

Most cases of travelers' diarrhea last from one to five days. In a small number of cases, symptoms may linger for a month after the initial infection.

Treatment of Travelers' Diarrhea

Getting sick while far from home is more than just inconvenient; the sudden onset and severity of symptoms can be frightening. At times like this, information is essential. Here are the main treatment options for travelers' diarrhea:

Fluid replacement: Your first line of defense is hydration. For mild cases of travelers' diarrhea, any safe fluids will do, such as boiled water, broth, or prepackaged (non-citrus) fruit juice. Sports drinks like Gatorade are good, too, but for severe dehydration an oral rehydration solution is the preferred option. You can obtain oral rehydration products at most drugstores - just be sure to mix them with safe, clean water. For children, Pedialyte is a good option.

Antibiotics So as to provide you with top-notch advice as to the use of antibiotics as a treatment for travelers' diarrhea, I turned to UpToDate -- a trusted electronic reference used by doctors and patients. Here is what I found out:

"When antibiotics are indicated, therapy with a quinolone antibiotic can be initiated after the diarrhea begins. Most commonly, ciprofloxacin (500 mg twice daily) is given for one or two days, although any of the newer, once a day quinolones should be effective. Quinolones are not approved for use in pregnant women or children.

"Azithromycin may have a particular role in the treatment of travelers' diarrhea in southeast Asia where...quinolone-resistant Campylobacter jejuni is a common cause.

"Rifaximin (200 mg three times daily for three days) is a nonabsorbed rifamycin that has been demonstrated to be effective in the treatment of TD caused by noninvasive strains of E. coli. It is attracting increasing interest because of concerns about quinolone resistance."

Also, according to UpToDate bismuth subsalicylate (found in products such as Pepto-Bismol) is another option. However, to be effective, high doses must be taken, thus running the risk of a health condition called salicylate toxicity. As this can cause serious symptoms affecting the respiratory, gastrointestinal, cardiovascular and nervous systems, as well as the ears, nose and throat, only choose this option on the advice of a physician who is informed as to what other medications you are taking. (For more on salicylate toxicity, see Sodium Salicylate overdose).

Antidiarrheal agents: It might seem logical to reach for an antidiarrheal product such as loperamide (Imodium) or diphenoxylate (Lomotil). However, these products should not be used if the cause of your symptoms is dysentery or if you are see any signs of blood in your stools. An antidiarrheal agent should only be taken if you have been prescribed an antibiotic. When using an antidiarrheal for travelers' diarrhea, it is especially important to keep yourself well-hydrated. Discontinue the product if your symptoms worsen or if you are still experiencing diarrhea after two days.

Want to learn more about travelers' diarrhea? See UpToDate's topic, "Travelers' Diarrhea" for additional in-depth, current and unbiased medical information, including expert physician recommendations.

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