The etiology of traveler’s diarrhea (TD) often varies by region of travel, but is most commonly caused by bacterial enteropathogens. Although viral and parasitic infections can cause TD they are less commonly seen. The most common bacterial strain linked to TD is Escherichia coli, which can be found in none-purified water sources. However, both food and water can be the source of an infection.
The diagnosis of TD involves both clinical and laboratory assessment. Signs and symptoms include: loose or watery stools beginning 24-72 hours after consumption of contaminated food or water (severity can vary), nausea, vomiting, abdominal cramps and fecal urgency. TD is typically self-limiting and may take anywhere from 3 to 5 days to achieve symptom relief.
Some risk factors to be aware of that my increase your chances of contracting traveler’s diarrhea include:
- Immunodeficiency state
- Chronic gastrointestinal disease
- Young age
- Drinking untreated or none bottled water
- Use of acid-blocking drugs
The following red flags are symptoms that will require immediate medical care:
- Bloody diarrhea
- High fever
- Jaundice (yellowing of skin)
- Enlarged lymph nodes
- Neurological symptoms
Tips to Prevent Traveler’s Diarrhea:
- Drink water from clean sources which include: bottled water, carbonated drinks, heated drinks and those without ice
- Use bottled or treated water when brushing your teeth
- Opt for fruits that can be peeled
- Avoid raw or undercooked meats
- Avoid unpasteurized dairy
- Frequently and carefully wash your hands with soap and hot water
- Bismuth subsalicylate has been shown to have a protection rate of 65%
- Certain classes of antibiotics have shown efficacy for the prevention of TD when taken prophylactically
- Probiotics depending on strain, brand and dosing can be used create an optimal gut environment and prevent foreign invaders
- Immunization or natural remedies which support the immune system can assist in boosting the immunity in order to recognize and eradicate invading pathogens
As previously stated, TD is often a self-limiting condition that resolves within a week. It is important to keep in mind that while you allow the symptoms to resolve some extra steps should be taken to prevent complications.
- Oral rehydration and electrolyte replacement
- Antibiotics including ciprofloxacin and azithromycin are commonly used in the treatment of TD
- Antimotility agents such as loperamide are often prescribed to provide symptomatic relief
- Several natural antimicrobials have shown great benefit in the treatment of TD, the various options can be discussed with a naturopathic doctor
- Soothing teas including chamomile and ginger tea can help to ease GI discomfort
Some cases of TD can persist and develop into chronic gastrointestinal disorders including irritable bowel syndrome (IBS). If you have long-standing digestive concerns (diarrhea, constipation, bloating etc.) that may have arisen from a disruption in your gut microbiota or intestinal damage, consider having an open discussion with your health care provider about the various treatment options available to you.