The Basics
Written by the doctors and editors at UpToDate � �
What is travelers ' diarrhea? " � Travelers ' diarrhea is runny or watery bowel movements in people who are traveling. It is usually caused by bacteria but can also be caused by a virus or parasite. � �
You are more likely to get travelers ' diarrhea if you travel in: � �
- Asia (except Singapore and Japan)
- Africa
- South America, Central America, and Mexico
- Countries around the Mediterranean Sea, including Israel
- Caribbean islands
What are the symptoms of travelers ' diarrhea? " � The main symptom is runny or watery bowel movements. These usually start about 4 to 14 days after arriving. Other symptoms can include: � �
- Feeling sick
- Loss of appetite
- Cramps in the lower belly
- Nausea and vomiting
- Fever
- Gas and bloating " � Feeling like the belly is full, with pain in the middle or top of the belly.
- Blood in the bowel movements
- Feeling as though you need have a bowel movement even if you just did, or like you need to get to the toilet in a hurry
Travelers ' diarrhea usually lasts 1 to 5 days, but some people are sick for a week or longer. � �
Should I see a doctor or nurse? " � If your doctor or nurse gave you antibiotics to take in case you got diarrhea, you can take them instead of going to a doctor or nurse in another country. But you might need to see a doctor or nurse if: � �
- You are sick for 10 to 14 days or longer.
- You have a fever of 102 � � � (40 � � �) or higher.
- You have severe belly pain.
- You have bloody diarrhea or you are vomiting.
- The antibiotics you took did not help.
Will I need tests? " � Probably not. If you see a doctor or nurse, he or she will ask where you traveled and what you did. If the doctor thinks a parasite might be causing the diarrhea, he or she might ask for a bowel movement sample. Testing it can show if you have a parasite. But this is not usually needed. � �
How is travelers ' diarrhea treated? " � The most important treatment is getting enough fluid. Thats because diarrhea can cause the body to lose fluid. Adults with mild diarrhea can drink lots of fluids with water, salt, and sugar. Soup broth and water mixed with juice are good choices. If you are drinking enough, your urine will look light yellow or almost clear. � �
If you have diarrhea more than 4 times a day, you can drink an "oral rehydration solution. " � You can buy this in a packet at the pharmacy. Mix it with bottled or boiled drinking water. � �
Other treatments include: � �
- Antibiotics " � These medicines fight infections.
- Medicines that ease diarrhea, such as loperamide (brand name: Imodium) diphenoxylate (sample brand name: Lomotil), or bismuth subsalicylate (sample brand names: Pepto-Bismol, Kaopectate) " � These medicines can help, but they can also cause other health problems. Bismuth salicylate might not be safe for pregnant women or people who take aspirin for another condition. You should only take loperamide or diphenoxylate if you are also taking antibiotics.
Can travelers ' diarrhea be prevented? " � You can reduce your chances of getting travelers ' diarrhea by being careful about what and how you eat and drink. While you are traveling: � �
- Do not drink tap water. Drink bottled carbonated drinks, beer, wine, or hot tea or coffee instead. Brush your teeth with bottled water.
- Do not use ice in drinks. Ice is usually made from tap water.
- Do not eat food from carts or stands in the street.
- Do not eat sauces set out on restaurant tables. These include salsa and ketchup.
- Do not eat fresh foods at room temperature. These include guacamole, fruit or chicken salads, and buffet food on a steam table.
- Do not eat foods or drinks made with unpasteurized milk.
- Ask for drinks in the bottle, without ice. If you drink from a glass, use a straw.
- Do not eat fruits unless they have a peel and you have peeled them yourself.
- Make sure meat and seafood are well done and eggs have a firm yolk.
If you can't find bottled water or soft drinks, you can make your drinking water safe by: � �
- Boiling it for 3 minutes (let it cool before drinking)
- Adding 5 drops of tincture of iodine to 4 cups of water and waiting 30 minutes " � Tincture of iodine is a liquid you can buy at most pharmacies or camping goods stores.
- Using a water treatment filter from a camping or sports store
Wash your hands after going to the bathroom, changing diapers, blowing your nose, touching animals, or taking out the trash. � �
If you have a serious health condition, travelers ' diarrhea could cause you to lose too much water. This can be dangerous and even cause death. If you are going on a trip, talk to your doctor or nurse ahead of time. He or she might give you antibiotics to take while you are traveling. � �
All topics are updated as new evidence becomes available and our peer review process is complete. � �
This topic retrieved from UpToDate on: Nov 04, 2014. � �
Topic 83761 Version 4.0 � �
Release: 22.8 - C22.206 � �
� � 2014 UpToDate, Inc. All rights reserved. � �
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