Diarrhea from viruses and parasites is less common. Food and water can be infected by people:. You are at risk for this condition if you travel to a country that has poor public sanitation and hygiene. Poor hygiene in local restaurants is also a risk factor. Places that have the highest risk are often in developing countries in:. If you travel to a developing country, you are more likely to get this illness if you eat food or have drinks:. The main symptom is loose stool that occurs suddenly.
The stool may be watery. Other symptoms may include:. The loss of body fluid from diarrhea and vomiting can lead to dehydration. This can be serious. Contact your healthcare provider if you are not urinating as much as usual.
A small number of people can develop post-infectious irritable bowel syndrome. This can cause symptoms such as:. Health Home Conditions and Diseases. Diarrhea is the term for bowel movements that are loose or watery.
Traveler's diarrhea occurs within 10 days of travel to an area with poor public hygiene. What causes traveler's diarrhea? Dehydration is especially dangerous for children, older adults and people with weakened immune systems.
Dehydration caused by diarrhea can cause serious complications, including organ damage, shock or coma. Signs and symptoms of dehydration include a very dry mouth, intense thirst, little or no urination, dizziness, or extreme weakness. The general rule of thumb when traveling to another country is this: Boil it, cook it, peel it or forget it. But, it's still possible to get sick even if you follow these rules.
If it's not possible to buy bottled water or boil your water, bring some means to purify water. Consider a water-filter pump with a microstrainer filter that can filter out small microorganisms.
You can also chemically disinfect water with iodine or chlorine. Iodine tends to be more effective, but is best reserved for short trips, as too much iodine can be harmful to your system. You can purchase water-disinfecting tablets containing chlorine, iodine tablets or crystals, or other disinfecting agents at camping stores and pharmacies.
Be sure to follow the directions on the package. Public health experts generally don't recommend taking antibiotics to prevent traveler's diarrhea, because doing so can contribute to the development of antibiotic-resistant bacteria.
Antibiotics provide no protection against viruses and parasites, but they can give travelers a false sense of security about the risks of consuming local foods and beverages. They can also cause unpleasant side effects, such as skin rashes, skin reactions to the sun and vaginal yeast infections. As a preventive measure, some doctors suggest taking bismuth subsalicylate, which has been shown to decrease the likelihood of diarrhea.
However, don't take this medication for longer than three weeks, and don't take it at all if you're pregnant or allergic to aspirin. Talk to your doctor before taking bismuth subsalicylate if you're taking certain medications, such as anticoagulants.
Common harmless side effects of bismuth subsalicylate include a black-colored tongue and dark stools. In some cases, it can cause constipation, nausea and, rarely, ringing in your ears tinnitus. Traveler's diarrhea may get better without any treatment. But while you're waiting, it's important to try to stay hydrated with safe liquids, such as bottled water or water with electrolytes such as an oral rehydration solution see below. If you don't seem to be improving quickly, several medications are available to help relieve symptoms.
Anti-motility agents. These medications — which include loperamide and drugs containing diphenoxylate — provide prompt but temporary relief by reducing muscle spasms in your gastrointestinal tract, slowing the transit time through your digestive system and allowing more time for absorption. Anti-motility medications aren't recommended for infants or people with a fever or bloody diarrhea, as they can delay clearance of the infectious organisms and make the illness worse.
Also, stop using anti-motility agents after 48 hours if you have abdominal pain or if your signs or symptoms worsen and your diarrhea continues. In such cases, see a doctor. You may need blood or stool tests and treatment with an antibiotic.
Before you leave for your trip, talk to your doctor about taking a prescription with you in case you get a serious bout of traveler's diarrhea. Dehydration is the most likely complication of traveler's diarrhea, so it's important to try to stay well hydrated. An oral rehydration salts ORS solution is the best way to replace lost fluids. These solutions contain water and salts in specific proportions to replenish both fluids and electrolytes. They also contain glucose to enhance absorption in the intestinal tract.
Bottled oral rehydration products are available in drugstores in developed areas, and many pharmacies carry their own brands. Reconstitute the powder in bottled or boiled water according to the directions on the package.
If these products are unavailable, you can prepare your own rehydrating solution in an emergency by mixing together:. You or your child can drink the solution in small amounts throughout the day as a supplement to solid foods or formula, as long as dehydration persists. Small amounts reduce the likelihood of vomiting. Breastfed infants also can drink the solution but should continue nursing on demand. If dehydration symptoms — such as dry mouth, intense thirst, little or no urination, dizziness, or extreme weakness — don't improve, seek medical care right away.
Oral rehydration solutions are intended only for urgent short-term use. If you do get traveler's diarrhea, avoid caffeine, alcohol and dairy products, which may worsen symptoms or increase fluid loss.
But keep drinking fluids. Drink canned fruit juices, weak tea, clear soup, decaffeinated soda or sports drinks to replace lost fluids and minerals. Later, as your diarrhea improves, try a diet of easy-to-eat complex carbohydrates, such as salted crackers, bland cereals, bananas, applesauce, dry toast or bread, rice, potatoes, and plain noodles. You may return to your normal diet as you feel you can tolerate it.
Add dairy products, caffeinated beverages and high-fiber foods cautiously. Call a doctor if you have diarrhea that is severe, lasts more than a few days or is bloody. If you are traveling, call an embassy or consulate for help locating a doctor. Other signs that you should seek medical attention include:. If you have diarrhea and you've just returned home from a trip abroad, share that trip information with your doctor when you call to make an appointment. In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions as they occur to you during your appointment.
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over points you want to talk about in-depth. Your doctor may ask:. Clair can be found here.
Clair Medical Group Search for: Search. The most common signs and symptoms of traveler's diarrhea are: Abrupt onset of passage of three or more looser watery stools a day An urgent need to defecate Abdominal cramps Nausea Vomiting Fever Sometimes, people experience moderate to severe dehydration, persistent vomiting, a high fever, bloody stools, or severe pain in the abdomen or rectum.
When to see a doctor Traveler's diarrhea usually goes away on its own within several days. Subsequently, other studies to visualize both the upper and lower gastrointestinal tracts, with biopsies, may be indicated. Dietary modifications may help those with malabsorption. Probiotic medications have been shown to reduce the duration of persistent diarrhea among children in some settings. Antimicrobial medications may be useful in treating persistent diarrhea caused by parasites.
Nonabsorbable antibiotics may help if small intestinal bacterial overgrowth accompanies the symptom complex. Note: Javascript is disabled or is not supported by your browser.
For this reason, some items on this page will be unavailable. For more information about this message, please visit this page: About CDC. Travelers' Health. Chapter 11 Posttravel Evaluation. Bradley A. Clin Infect Dis. Connor BA. Chronic diarrhea in travelers. Curr Infect Dis Rep. J Trav Med. Review: chronic and persistent diarrhea with a focus in the returning traveler.
Trop Dis Travel Med Vaccines. Development of functional gastrointestinal disorders after Giardia lamblia infection. BMC Gastroenterol Apr. Detection of pathogenic protozoa in the diagnostic laboratory: result reproducibility, specimen pooling, and competency assessment. J Clin Microbiol.
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