NY Travel Clinic

Prevention and Treatment of Traveler’s Diarrhea

Many people experience diarrhea while they travel  outside the United States. Traveler’s diarrhea (TD) can affect from 30 to 70% of travelers, with rates varying based on the destination. High-risk areas include Latin America, South Asia, and Sub-Saharan Africa. The Caribbean, Southeast Asia, Oceania, and the Middle East, represent a moderate risk.

The main way you can get TD is by contaminated food and water.

Before you go

Several months before you travel, speak with your doctor about ways to prevent TD. Although TD is commonly caused by the bacterium E. coli, some viruses, such as hepatitis, can also cause diarrhea, so it’s critical that you be vaccinated against them before you go on vacation. Your doctor will advise you to receive specific vaccinations, based on where you will be travelling. TD can also be caused by parasites.

Another important way to prevent TD is to use probiotics. Products that contain the probiotic Saccharomyces boulardii have been shown to significantly prevent TD, as do those that contain a combination of Lactobacillus acidophilus and Bifidobacterium bifidum. You should start to use them several weeks before you travel.

Bismuth subsalicylate can reduce the incidence of TD, at doses of 2 tablets 4 times per day. If you’re pregnant, or allergic to aspirin, you should avoid this product. Speak with your doctor if you’re taking other medications and want to use bismuth subsalicylate, because of potential interactions between them.

Antibiotics are not recommended to try to prevent TD, because their routine use could lead to resistant strains of bacteria. You can bring them with you as a treatment if you do get diarrhea.

Pack oral rehydration salts so you can use them if you do get diarrhea. Bring iodine and chlorine with you if you have to disinfect water at destination.

While at destination

Wash your hands frequently. If you can’t, then use an alcohol-based sanitizer.

Avoid fruits and veggies you haven’t peeled yourself. Don’t eat raw meats or fish, or unpasteurized dairy products, and avoid foods from outdoor stands. Avoid tap water and ice. You can drink bottled water, and hot beverages such as coffee. Don’t use tap water to brush your teeth.

If you do get diarrhea, and have other symptoms such as fever, and cramps, antibiotics may be used for 3 to 5 days. If you have diarrhea beyond this period, you should go to a doctor, as it might be caused by a parasite.

Drink lots of bottled water, to which you added the rehydration salts.

Don’t use anti-motility drugs, such as loperamide (Imodium), and others, when you have a fever or bloody stools, because it could prolong your infection, and make it even worse.

The best way to avoid traveler’s diarrhea is to practice excellent hygiene. Preventing it should be your main goal, as once you have TD, it could ruin your vacation. So prepare yourself before, use probiotics, and check with your doctor if you need some vaccinations.