Travelers' Diarrhea

Diarrhea is the most common travel illness complaint. If diarrhea is an inconvenience or a significant illness depends on the causing agent. Bacteria account for about 80% of diarrhea symptoms. Simple diarrhea symptoms from diet or climate changes are less severe than those caused by bacteria or other microorganisms. Regardless of the cause, to avoid diarrhea illness prevention is number one. The most common source of travelers' diarrhea is contaminated food and water.

Prevention begins with food and water precautions. Boil it, peel it, cook it, or forget it.

Handwashing prevents transmission of diarrhea causing bacteria or parasites to your food or mouth.

Prophylaxis or treatment medications can prevent and provide prompt relief of diarrhea symptoms.

For short duration trips (less than 3 weeks) Pepto-Bismol taken two tablets four times a day for adults can act to prevent as much as 50-70% of diarrhea symptoms. Pepto-Bismol should not be used with Aspirin products and those on prescription medicines should consult with their physician to avoid any medication interactions. Typical side effects include darkening of the tongue and stools, ringing in the ears, and constipation.

Antibiotics such as Cipro may be used as prevention. However, antibiotics would be best held as treatment modalities. A Quinolone antibiotic such as Cipro, Floxin, or Levaquin can control and stop diarrhea symptoms within 24 hours for simply diarrhea or three-five days for dysentery, diarrhea with blood in the stool or diarrhea with fever. Diarrhea that is chronic or long lasting, or is not relieved with antibiotics requires prompt physician attention.

Treatment options for travelers' diarrhea include Pepto-Bismol, Loperamide (Imodium), antibiotics, or a combination. If you treat initial symptoms with Imodium or Pepto-Bismol and your symptoms are not improved after four-six hours start an antibiotics. Quinolones lead the choices.

Cipro 500mg one tablet twice a day for at least 3-5 days or Levaquin 500 mg one tablet a day for at least 3-5 days is usually needed to stop most bacteria caused diarrhea it may also require a complete 10-day course and or medical attention and follow up.

If you start antibiotics stop Pepto-Bismol as this may reduce absorption of the antibiotic. If your symptoms are primarily vomiting and minimal diarrhea you may have an intestinal virus.

In all cases of diarrhea and vomiting, fluid replacement is very important. Plenty of clear liquids and water replaces volume loss, however oral rehydration packets or other methods of salt and electrolyte replacement may be needed. Consultation with a medical provider is very important as dehydration, especially in children, can be a medical emergency.