Traveler's Diarrhea: Symptoms & How to Get Relief

14 Jun 2023
WEDNESDAY, June 14, 2023 -- A bout of traveler's diarrhea can really put a damper on your vacation.
Here, experts break down what traveler’s diarrhea is, including its causes, symptoms and treatment, so you can get back to enjoying your trip as quickly as possible.
What is traveler's diarrhea?
Put simply, traveler’s diarrhea is frequent, loose, watery stools that occur after travel to an area with poor public hygiene. Unfortunately, it is the most common illness among travelers, according to Johns Hopkins University.
Traveler's diarrhea causes and risk factors
Although traveler's diarrhea could be the result of stress from traveling or a change in diet, it is usually caused by bacteria, viruses or parasites. According to the Mayo Clinic, you typically contract traveler’s diarrhea after ingesting food or water contaminated with germs from feces. People that are local to the area have often developed an immunity to the bacteria and are unaffected.
Traveler’s diarrhea symptoms
The Mayo Clinic lists the following symptoms:
Abrupt onset of three or more loose watery stools in a day
Urgent need to defecate
Abdominal cramps
Nausea
Vomiting
Severe symptoms indicate you should see a doctor; these include:
Diarrhea lasting longer than two days
Dehydration
Severe abdominal or rectal pain
Black or bloody stools
Fever over 102 degrees Fahrenheit
In children, traveler’s diarrhea can cause severe dehydration in a relatively short time; call your child’s health care provider if the following symptoms are occurring:
Persistent vomiting
Fever over 102 degrees F
Dry mouth, crying without tears
Unusually sleepy, drowsy or unresponsive
Bloody stools or severe diarrhea
Decreased volume of urine, including fewer wet diapers in infants
How to lower the risk of traveler’s diarrhea
The U.S. Centers for Disease Control and Prevention lists the following high-risk destinations for traveler’s diarrhea:
Asia (except Japan and South Korea)
Middle East
Africa
Mexico
Central America
South America
When traveling to these areas, it is advised that you:
Choose your food and drink carefully
Drink only beverages in factory-sealed containers
Avoid ice
Peel or wash all fruit and vegetables
Avoid food that has been sitting out at a buffet
Wash your hands frequently or use hand sanitizer
Brush your teeth with bottled water
Avoid swimming in contaminated water
How long does traveler’s diarrhea last?
Dr. Alexander Leung noted in Travelers’ Diarrhea: A Clinical Review, “Travelers’ diarrhea is usually self-limited. If left untreated, approximately 50% of the patients are spontaneously cured in 48 hours and, in the majority of patients, the average duration of diarrhea is 4 to 5 days.”
He does add that “the clinical course tends to be more severe and prolonged in children, especially those younger than 2 years of age.”
Traveler’s diarrhea treatment
The Cleveland Clinic has several suggestions for treatments for traveler’s diarrhea:
Bismuth subsalicylate (Pepto-Bismol) can reduce the duration or frequency of your stools, although it is not recommended for children or pregnant people.
Antibiotics may be prescribed for severe cases or if you have a compromised immune system. Your health care provider may request a stool sample to see what organism is causing your illness, so that they can prescribe the appropriate antibiotic. The most common antibiotics used for traveler's diarrhea are ciprofloxacin (Cipro), levofloxacin (Levaquin), azithromycin (Zmax), rifaximin (Xifaxan), metronidazole (Flagyl) and nitazoxanide (Alinia).
Antidiarrheals such as loperamide (Imodium) or atropine diphenoxylate (Lomotil) may reduce your symptoms, but they could also prolong the infection because they slow down the motility of your gut which may allow the infectious organism to stay in your bowel longer.
If you are infected, you should:
Hydrate frequently with low-sugar sport drinks or Pedialyte
If you can’t tolerate solid food, then try soups or popsicles
The BRAT diet may be helpful, which is bananas, rice, applesauce and toast
Eat small amounts at a time
Call your doctor for any of the severe symptoms above, or if symptoms last longer than two days
It is possible to be infected more than once while you are traveling, and therefore important to continue to use the preventive steps listed above.
Posted June 2023
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