Traveler's diarrhea

Traveler's diarrhea is a common medical problem for people traveling from developed, industrialized countries to developing areas of the world.

High-risk areas for traveler's diarrhea include developing countries in Africa, Asia, the Middle East, and Latin America. Low-risk areas include the developed countries of North America, Central Europe, Australia, and Japan.

Traveler's diarrhea can be mild to severe. Most people who develop traveler's diarrhea experience symptoms within the first 2 weeks, and often within 2 to 3 days, of arriving in a developing area. Symptoms include:

• Diarrhea.
• Abdominal cramps.
• Mild to severe dehydration.
• General lack of energy, nausea, and vomiting.
• Fever, vomiting, and stools with blood or mucus. These symptoms mean you have serious diarrhea, which is more likely to lead to problems with dehydration. Dehydration may alter the effect of any medicines being taken, such as oral contraceptives or antimalarials.

Treatment for traveler's diarrhea includes drinking fluids to avoid dehydration, taking nonprescription medicines, and in some cases, antibiotics and intravenous (I.V.) fluids.

• Take frequent, small sips of bottled or boiled water or a rehydration drink.
• If possible, drink a solution made with World Health Organization (WHO) oral rehydration salts. Packets of the salts are available at stores and pharmacies in most developing countries. Add one packet to boiled or treated water, making sure to read the instructions regarding the proper amounts of salts and water. Drink the solution within 12 hours if kept at room temperature, or within 24 hours if refrigerated.
• Let your stomach rest. Start to eat small amounts of mild foods if you feel like it. After your diarrhea is gone, you may eat a regular diet again.

Children 2 years old or younger are at high risk of dehydration from diarrhea. If your child has diarrhea:

• Give your child a solution of WHO rehydration salts in addition to your child's regular food as long as diarrhea continues. If your baby has trouble keeping the liquids down, try giving frequent sips by spoon.
• Continue breastfeeding normally. Bottle-fed babies should continue their usual formula.
• Feed your child starches, cereals, yogurt, fruits, and vegetables.
• Seek medical help immediately if you or your child has bloody diarrhea, fever, or persistent vomiting, and give rehydration fluids in the meantime.

Medicines

• Your doctor may recommend an over-the-counter medicine. These may include bismuth subsalicylate (Pepto-Bismol) or loperamide (Imodium). Read and follow all instructions on the label. Do not use these medicines if your doctor does not recommend them.
• Be safe with medicines. If your doctor recommends prescription medicine, take it as prescribed. Call your doctor if you think you are having a problem with your medicine. You will get more details on the specific medicines your doctor prescribes.
• If your doctor prescribes antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

• Watch for signs of dehydration. This means your body has lost too much water. Dehydration is serious and needs to be treated right away. Signs of dehydration are:
  • Feeling more thirsty than usual.
  • Dry eyes and mouth.
  • Feeling faint or lightheaded.
  • A smaller amount of urine than normal.
• To prevent dehydration, drink plenty of fluids. Choose bottled or boiled water and other clear liquids until you feel better. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
• Start to eat small amounts of mild foods if you feel like it.
• Your doctor may recommend an over-the-counter medicine. These may include bismuth subsalicylate (Pepto-Bismol) or loperamide (Imodium). Read and follow all instructions on the label. Do not use these medicines if your doctor does not recommend them.
• Be safe with medicines. If your doctor recommends prescription medicine, take it as prescribed. Call your doctor if you think you are having a problem with your medicine. You will get more details on the specific medicines your doctor prescribes.
• If your doctor prescribes antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.