Traveler's diarrhea is a sudden intestinal infection that you may get when you travel to another country. Other names for this problem are gastroenteritis, Montezuma's revenge, turista, or the GI trots.
Up to half of the people who travel internationally get traveler's diarrhea. High-risk areas include some parts of Latin America, Africa, the Middle East, and Asia. Problems with the water supply and sanitation facilities are more likely in these areas.
Traveler's diarrhea occurs when you have food, ice, water, or other drinks that contain germs from human or animal bowel movements. The germs may be in cooked or uncooked food. The germs may be a virus, parasite, or bacteria.
Escherichia coli (E. coli) bacteria are often a cause of traveler's diarrhea. E. coli bacteria are normally found in the human intestine. There are many varieties of E. coli bacteria. Usually your body becomes used to the E. coli in your environment and the bacteria do not cause problems. However, exposure to new varieties of E. coli in new places may cause diarrhea.
Sometimes diarrhea while you are traveling is caused by the stress of traveling, jet lag, a different diet, or other things, like stomach flu.
You may have the following symptoms:
Your symptoms may be mild and not require seeing a healthcare provider during your travels. But in some cases you may keep having diarrhea and other symptoms after you return home.
Your healthcare provider will ask about your symptoms, including:
Your provider will also ask about your travels:
Your provider will also ask about any medicines you may have used.
Your provider will examine you. A sample of bowel movement may be tested to look for signs of infection and to try to identify the germ. You may also have blood tests. These tests help find what is causing the diarrhea.
You may become dehydrated by the diarrhea. Dehydration happens when your body loses more fluids and salts than it takes in. Dehydration can cause serious problems. It is very important to try to prevent it.
To replace lost fluids and salts, you can make a drink with packets of oral rehydration salts. You can buy the packets at a drugstore. You can also make a rehydration solution by mixing:
Or you can buy a solution that is already made. One brand is Pedialyte.
Drinking other nonalcoholic drinks made with clean water (boiled or bottled) will also help prevent dehydration, but you may not get all the salts you need. Avoid using ice (especially if you are still out of the US), unless you know it’s made from boiled or bottled water. Try to drink at least 8 ounces of fluid for each watery stool you have.
Taking bismuth subsalicylate (for example, Pepto-Bismol or Kaopectate) 4 times a day may help prevent or treat traveler's diarrhea. Do not take it longer than 3 weeks. You do not need a prescription to get this medicine, but it can have some serious interactions with other medicines. Check with your healthcare provider before you leave on your trip about using it. You should not use it if:
Be cautious about taking antidiarrheal medicines. Nonprescription medicines such as loperamide (sold as Imodium and other trade names) or the prescription medicine Lomotil can make you sicker, especially if you have fever or the diarrhea is bloody. If you take one of these medicines, make sure you use only the dose recommended on the package. Do not use these medicines every day to control diarrhea. They can keep the germs causing the diarrhea in the intestine. Do not give antidiarrheal medicine to small children. If you have chronic health problems, always check with your healthcare provider before you use any medicine for diarrhea.
See a healthcare provider as soon as possible if:
Do not try to treat these serious symptoms on your own.
Traveler's diarrhea usually does not last long. It often stops without treatment in 1 to 5 days. Rarely, it lasts 2 to 3 weeks.
If you are traveling to a place where you think you might get traveler's diarrhea:
If you get diarrhea:
Follow these guidelines:
You may discuss with your healthcare provider the pros and cons of taking antibiotics with you on your trip. Most current recommendations are to start antibiotics only if you have diarrhea. Doxycycline, Bactrim, Septra, and ciprofloxacin (Cipro) have been used in the past. However, bacteria are getting resistant to these medicines. The usual antibiotic prescription is for 3 days only. The medicines may cause side effects, including an increased risk of sunburn and allergic reactions. Ask your provider about side effects.
The US Centers for Disease Control and Prevention (CDC) does not recommend preventive antibiotics. Taking antibiotics throughout your trip to try to prevent infection puts you at risk for infection with germs that are resistant to most antibiotics. The CDC does recommend the use of bismuth subsalicylate, as described above for prevention and treatment, if you need it for prevention in addition to the other safety steps.