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
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.