What is traveler’s diarrhea?

Traveler’s diarrhea is a digestive tract disorder. It consists of abdominal cramps and diarrhea that’s most often caused by consuming food or water that the body isn’t familiar with.

If you’re visiting an area where either the sanitary practices or the climate are different than what you’re used to at home, you’re more likely to experience traveler’s diarrhea.

It’s most common to get traveler’s diarrhea while visiting:

  • Mexico
  • Central America
  • South America
  • Africa
  • the Middle East
  • most of Asia (excluding Japan)

It can be caused by bacteria, viruses, or parasites.

Traveler’s diarrhea typically goes away on its own within a few days. It can cause dehydration, which can be dangerous, especially for children. It’s often contagious, however, and passed from person to person regardless of the cause.

What are the symptoms of traveler’s diarrhea?

Loose, watery diarrhea and abdominal cramps are the most universal symptoms you’ll experience with traveler’s diarrhea. Other symptoms may depend on the cause of the condition. Symptoms can include:

  • nausea
  • vomiting
  • fever
  • bloating
  • excessive gas
  • loss of appetite
  • an urgent need to defecate

These symptoms are all normal. However, there are some symptoms that indicate it’s time to see a doctor immediately. These include:

  • severe, intolerable pain in the abdomen or rectum
  • persistent vomiting for more than four hours, resulting in the inability to keep liquids down
  • fever higher than 102˚F (39˚C)
  • bloody stools
  • symptoms of dehydration

How is traveler’s diarrhea diagnosed?

If your traveler’s diarrhea hasn’t resolved within three days or your symptoms worsen, make an appointment to see your doctor.

At your appointment, let your doctor know that you’ve recently been traveling. They’ll perform a physical exam that includes taking your temperature and pressing on your abdomen. They’ll likely order a stool test to search for evidence of parasites, and may order a blood test to check for infections. The blood work can also detect whether or not you’re currently dehydrated.

Can traveler’s diarrhea cause complications?

The most common complication of traveler’s diarrhea is dehydration. This can be very serious. Dehydration can easily occur when the diarrhea causes the body to lose fluids at a faster rate than they can take them in. Vomiting and nausea, which sometimes accompany diarrhea, can make this worse. Dehydration can be particularly dangerous for young children. Know the warning signs of dehydration in toddlers.

Symptoms of dehydration include:

  • dry mouth
  • increased thirst
  • decreased urine output
  • headache
  • dizziness
  • dry skin
  • confusion

Traveler’s diarrhea caused by a parasitic infection typically needs to be treated with medications, or the infection could become more severe. Parasitic infections can cause:

  • seizures
  • fever
  • allergic reactions
  • bacterial infections

Tapeworms embed their heads into the intestinal wall, but can lay eggs that move to other parts of the body. Fluke worms can cause fatigue. Hookworms can cause anemia and fatigue. Trichinosis worms can cause:

  • fever
  • headache
  • conjunctivitis
  • swelling of the face
  • muscle pain

How is traveler’s diarrhea treated?

Treatment will depend on the cause of the diarrhea. The first line of defense will often be home remedies and over-the-counter (OTC) treatments to resolve mild cases of the illness.

When you get traveler’s diarrhea, avoid caffeine and alcohol. These may increase dehydration. However, continue to drink other fluids as much as possible to prevent dehydration.

Try to stick to bland foods you know have little risk of contamination and that your body is familiar with.

  1. toast
  2. broth
  3. crackers
  4. white rice
  5. apples (washed with filtered water)
  6. bananas

If you’re traveling, it’s often a good idea to bring OTC treatments with you just in case you get traveler’s diarrhea. Bismuth subsalicylate (Pepto-Bismol) can be effective for treating mild cases of traveler’s diarrhea. Use it according to the instructions on the box.

Antimotility agents like Imodium can also be used, but they should be saved for emergencies, like airplane travel. They may prolong the illness by not allowing your body to eliminate it.

Doctor-prescribed treatments

If home remedies haven’t worked, your doctor will prescribe treatment based on the cause of the illness. If you have a bacterial infection, they’ll prescribe antibiotics like doxycycline (Acticlate) or ciproflaxin (Cipro).

If you have parasites, your doctor will prescribe oral antiparasitic drugs. The exact prescription will depend on the type of parasite infection you have. You’ll likely need to take several rounds of the parasitic drug to ensure the infection is completely out of your system.

If traveler’s diarrhea has caused dehydration, you’ll be given intravenous fluids that may contain glucose or electrolytes.

What’s the outlook for traveler’s diarrhea?

Traveler’s diarrhea typically resolves within two to three days, but even mild cases can last up to seven days. It may resolve faster with treatment. Because symptoms may not start until several days after exposure, it may be difficult to pinpoint exactly what made you sick.

While recovering, be particularly careful to avoid any contaminated food or water sources. This will speed up healing and prevent continued or repeat exposure.

How can traveler’s diarrhea be prevented?

The best ways to prevent traveler’s diarrhea is careful sanitation practices and to choose water and food carefully.

When visiting high-risk countries, don’t drink unsterilized water. This includes:

  • drinks with ice made with local water
  • fruit juices with added water
  • brushing your teeth or rinsing out your mouth with tap water

Try to drink bottled water. If that’s absolutely not an option, boil the water for at least three minutes.

To further prevent developing traveler’s diarrhea, you should:

  • Avoid eating food from street vendors.
  • Be mindful of eating fruit washed in contaminated water.
  • Avoid unpasteurized dairy products, even ice cream.
  • Eat foods that are well cooked and served hot.
  • Avoid foods that are moist or stored at room temperature.

Wash your hands often, especially before eating and touching your face. Keep children from putting anything, including their hands, into their mouth. Use alcohol-based hand sanitizer containing at least 60 percent alcohol if clean water isn’t available to you.