What to Do If You Get Travelers' Diarrhea

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.

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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

Symptoms of travelers' diarrhea usually show up several days into your 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:

More severe cases of travelers' diarrhea may involve fever and blood in the stool.

See a doctor if your symptoms are accompanied by fever or bloody stools, or last longer than 48 hours. Most cases of travelers' diarrhea last from one to five days, however, symptoms may linger for several weeks.

Treatment

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

Antibiotics may be used for travelers' diarrhea that is likely to have a bacterial cause, and they are reserved for only the most severe cases. A stool test should be done to identify which antibiotic might work best.

Quinolone antibiotics are often the ones given, especially Cipro (ciprofloxacin). A dose of 500 milligrams (mg) twice daily for one or two days may be prescribed. There are also newer quinolone antibiotics that only require a single dose daily. Quinolones are not approved for use in children or people who are pregnant.

Emerging resistance to quinolones, especially in Southeast Asia where quinolone-resistant Campylobacter jejuni is a common cause of travelers' diarrhea, is a concern. Azithromycin might be given in this case, although some strains are resistant to it as well.

Rifaximin is approved to treat noninvasive strains of E. coli, but the problem is that it is difficult to tell whether the diarrhea is invasive or noninvasive. The FDA also approved rifamycin SV in November 2018 for noninvasive E. coli.

Also, 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 well, it is not recommended for children 12 years old or under, or up to 18 years old due the risk of Reye syndrome.

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.

Antidiarrheal Agents

It might seem logical to reach for an anti-diarrheal product such as Imodium (loperamide) or Lomotil (diphenoxylate). However, these products should not be used if the cause of your symptoms is dysentery or if you 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.

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Article Sources
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  1. Centers for Disease Control and Prevention. Travelers' diarrhea. Updated October 8, 2019.

  2. LaRoque RL, et. al. Travelers' diarrhea. UpToDate. Updated August 12, 2018.

  3. Centers for Disease Control and Prevention. Chapter 2: Preparing international travelers. Yellow Book. Updated November 22, 2019.

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