Traveler's Diarrhea
Traveler’s diarrhea causes loose, watery stools and can result from visiting areas with unclean water or poor food safety practices. Traveler’s diarrhea is a gastrointestinal infection that occurs due to the consumption of food and water contaminated with pathogens. In addition to diarrhea, symptoms can include abdominal cramping, fecal urgency, nausea, vomiting, fever, and malaise. For most people, traveler’s diarrhea will self-resolve within a few days.
Traveler's Diarrhea falls under theGut Healthcategory.
Last Updated:October 13, 2024
Traveler's diarrhea is characterized by loose, watery stools that last an average of 4 to 5 days and typically result from consuming contaminated food and water due to poor sanitation. It affects 10% to 40% of travelers to low-and-middle-income nations and can vary in prevalence based on factors such as destination, food choices, and season.
The main signs and symptoms of traveler's diarrhea include loose, watery stools, abdominal cramping, fecal urgency, nausea, vomiting, malaise, fever, and potentially blood or mucus in the stool. A high fever or the presence of blood/mucus indicates a more severe case that requires medical attention.
Traveler's diarrhea is diagnosed based on clinical symptoms and travel history and requires at least 3 unformed stools in 24 hours along with symptoms like abdominal cramps or fever. In severe cases, stool samples may be analyzed to identify the pathogen.
Treatment for traveler’s diarrhea primarily aims to prevent dehydration and manage symptoms using oral rehydration solutions, loperamide, and bismuth subsalicylate. In severe cases, antibiotics may be prescribed alongside antidiarrheal medications to eliminate the underlying pathogen.
Probiotics that contain Saccharomyces boulardii CNCM I-745 may reduce the occurrence of traveler’s diarrhea by 21%, and bismuth subsalicylate is safe and effective, with protection rates of up to 65%. Other probiotics and prebiotics have shown inconsistent results, and there is limited evidence to support the efficacy of hyperimmune bovine colostrum against infectious diarrhea.
Dietary choices can influence the risk of traveler’s diarrhea; high-risk foods include unpeeled raw fruits and vegetables, unpasteurized dairy, and undercooked meats, as well as certain beverages like tap water and drinks with ice. However, a review of studies found no correlation between following dietary precautions and a reduced risk of developing traveler’s diarrhea.
Traveler's diarrhea often resolves on its own within 48 hours without treatment. For mild cases, staying hydrated with regular fluids like tea and soups may be adequate.
Traveler's diarrhea is primarily caused by consuming contaminated food or water, often due to poor sanitation, which leads to infections from bacteria, parasites, or viruses. The most common bacterial culprits include Campylobacter jejuni, Escherichia coli, Salmonella, and Shigella, and prolonged cases may indicate a parasitic infection like Giardia intestinalis.
- ^Steffen R, Hill DR, DuPont HLTraveler's diarrhea: a clinical reviewJAMA.(2015 Jan 6)
- ^Pitzurra R, Steffen R, Tschopp A, Mutsch MDiarrhoea in a large prospective cohort of European travellers to resource-limited destinations.BMC Infect Dis.(2010-Aug-04)
- ^Fernandez V, Ahmed SM, Graves MC, Pender MA, Shoemaker H, Birich H, Pupaibool J, Benson LS, Leung DTIncidence Rate and Risk Factors Associated with Travelers' Diarrhea in International Travelers Departing from Utah, USA.Am J Trop Med Hyg.(2022-Oct-12)
- ^Leung AKC, Leung AAM, Wong AHC, Hon KLTravelers' Diarrhea: A Clinical Review.Recent Pat Inflamm Allergy Drug Discov.(2019)
- ^McFarland LV, Goh SAre probiotics and prebiotics effective in the prevention of travellers' diarrhea: A systematic review and meta-analysis.Travel Med Infect Dis.(2019)
- ^Fagnant HS, Isidean SD, Wilson L, Bukhari AS, Allen JT, Agans RT, Lee DM, Hatch-McChesney A, Whitney CC, Sullo E, Porter CK, Karl JPOrally Ingested Probiotic, Prebiotic, and Synbiotic Interventions as Countermeasures for Gastrointestinal Tract Infections in Nonelderly Adults: A Systematic Review and Meta-Analysis.Adv Nutr.(2023-Feb-22)
- ^DuPont HL, Ericsson CD, Johnson PC, Bitsura JA, DuPont MW, de la Cabada FJPrevention of travelers' diarrhea by the tablet formulation of bismuth subsalicylateJAMA.(1987 Mar 13)
- ^Chandwe K, Kelly PColostrum Therapy for Human Gastrointestinal Health and Disease.Nutrients.(2021-Jun-07)
- ^Otto W, Najnigier B, Stelmasiak T, Robins-Browne RMRandomized control trials using a tablet formulation of hyperimmune bovine colostrum to prevent diarrhea caused by enterotoxigenic Escherichia coli in volunteersScand J Gastroenterol.(2011 Jul)
- ^Sears KT, Tennant SM, Reymann MK, Simon R, Konstantopoulos N, Blackwelder WC, Barry EM, Pasetti MFBioactive Immune Components of Anti-Diarrheagenic Enterotoxigenic Escherichia coli Hyperimmune Bovine Colostrum Products.Clin Vaccine Immunol.(2017-Aug)
- ^Moore KSTravelers' diarrhea: Risk reduction and management.Nurse Pract.(2015-Nov-15)
- ^Shlim DRLooking for evidence that personal hygiene precautions prevent traveler's diarrhea.Clin Infect Dis.(2005-Dec-01)
- Intestinal Parasites - Otto W, Najnigier B, Stelmasiak T, Robins-Browne RMRandomized control trials using a tablet formulation of hyperimmune bovine colostrum to prevent diarrhea caused by enterotoxigenic Escherichia coli in volunteersScand J Gastroenterol.(2011 Jul)
- Intestinal Parasites - C O Tacket, G Losonsky, H Link, Y Hoang, P Guesry, H Hilpert, M M LevineProtection by milk immunoglobulin concentrate against oral challenge with enterotoxigenic Escherichia coliN Engl J Med.(1988 May 12)