Traveler's Diarrhea: Symptoms, Causes and Treatment

Traveler's diarrhea is a very common pathology in people who visit Latin American countries and other regions. Fortunately, the infection clears up on its own after a few days.

Some activities, such as travel to developing countries, increase the likelihood of gastrointestinal infections. One of the most frequent conditions in tourists is traveler’s diarrhea. Fortunately, it’s mild in most cases. Do you want to know more about this illness? Keep reading!

Traveler’s diarrhea is a syndrome that is frequently seen in people who travel to low-income countries. The disease is characterized by the presence of diarrhea and some minor gastrointestinal symptoms.

Multiple studies claim that between 20% and 50% of travelers are affected by this condition. The pathology is due to the presence of germs in water and food due to poor sanitary conditions. However, the people living in those countries have adapted to the microorganisms, and so they don’t suffer from the disease.

Symptoms

Traveler’s diarrhea is characterized by the sudden onset of symptoms within a few hours of ingesting contaminated food or water. The main symptom reported by people is, as you would expect, diarrhea. In fact, it is possible to have 3 or more loose or watery stools in less than 24 hours.

The number of bowel movements per day may vary depending on the situation. However, the disease doesn’t create major complications in adults. Diarrhea can also be accompanied by one or more of the following symptoms:

• Abdominal cramps
• Urgent need to defecate
• Nausea and vomiting
• A slight fever
• Muscle pains
• Bloody stools

On the other hand, children with traveler’s diarrhea may show signs of dehydration such as a dry mouth and crying without tears. Parents should pay special attention to sick children, especially if there’s a high fever, frequent bowel movements, and profuse vomiting.

Causes of traveler’s diarrhea

This gastrointestinal condition occurs due to the ingestion of food or drink contaminated with pathogenic germs. Traveler’s diarrhea is characteristic of those who visit developing countries, due to poor sanitary conditions.

The countries with the highest incidence of traveler’s diarrhea are in Latin America, Asia, the Middle East, and Africa. Bacteria are the main etiological agents responsible for the disease.

Some research establishes that enterotoxigenic Escherichia coli is the main culprit, causing up to 30% of cases in Latin America. However, the infection can also be due to the action of other bacteria such as:

• Shigella spp
• Salmonella spp
• Campylobacter spp
• Aeromonas
• Vibrio cholerae

For their part, some viruses and parasites are also capable of causing the condition, however, their frequency is much lower. Among the viral agents found most frequently, noroviruses and rotaviruses stand out. The most relevant parasites in the pathology are Giardia lamblia and Entamoeba histolytica.

Risk factors

Although anyone can get traveler’s diarrhea, this disease is seen more frequently in certain groups of people. The risk factors will depend on both the guest and the characteristics of the trip and the destination. In this sense, it’s possible to identify the following risk factors:

• Trips lasting more than a week
• Immunocompromised people
• Taking antacids consistently
• Traveling during the warm months
• Being young
• Having diabetes, hypertension or some other underlying disease

Diagnosis

The diagnosis of traveler’s diarrhea is usually clinical and doesn’t warrant laboratory tests. The presence of diarrhea for at least a day and a travel history are sufficient to make the diagnosis.

Tests for the diagnosis of diarrhea are necessary in the most severe cases. All people with blood in their stools or diarrhea for more than 3 days should have a direct stool test. This turns out to be the fastest and most effective way to identify the pathogen.

Treatment of traveler’s diarrhea

Traveler’s diarrhea usually goes away on its own after 2 or 3 days without the need for medication. Ideally, people maintain adequate fluid replacement for the duration of the symptoms to avoid dehydration.

The consumption of oral rehydration serums are especially useful in children, since they are the most vulnerable. Some medications such as loperamide decrease intestinal motility, thus helping with intestinal cramps. Also, the use of probiotics can reduce the duration of diarrhea.

Antibiotics are only recommended for those with severe diarrhea or severe symptoms. These drugs are used to treat specific bacteria or parasites. In fact, studies show that antibiotics reduce the duration of diarrhea by 1 and a half days in moderate and severe cases.

How to prevent traveler’s diarrhea?

Fortunately, there are many measures that can be applied to prevent the occurrence of traveler’s diarrhea. The measures are aimed at reducing the probability of contagion through water and food. In this way, people can follow these recommendations:

• Always consume bottled water
• Avoid using non-sterile water from faucets, wells, or streams
• Boil the water to be used for 3 minutes
• Eat at well-established restaurants
• Avoid food sold by street vendors
• Keep your mouth closed while showering
• Don’t eat unpeeled fruit
• Wash your hands regularly with soap and water

A mild, self-limited illness

Fortunately, traveler’s diarrhea occurs as a mild infection of the gastrointestinal tract, so it doesn’t cause major complications in adults. The greatest consequences of the disease are on the trip itself, as it could enforce changes to the length of your stay and your plans.

In some cases, the disease can be caused by very harmful germs, which require antibiotic treatment for several days. In addition, children can suffer severe dehydration if there’s heavy diarrhea. Because of this, it’s important to contact a doctor whenever symptoms of the disease appear.