Persistent Diarrhea In Returned Travelers
Bradley A.Connor
Although most cases of travelers diarrhea are acute and self-limited, a certain percentage of travelers will develop persistent gastrointestinal symptoms . The pathogenesis of persistent diarrhea in returned travelers generally falls into one of the following broad categories: 1) ongoing infection or coinfection with a second organism not targeted by initial therapy, 2) previously undiagnosed gastrointestinal disease unmasked by the enteric infection, or 3) a postinfectious phenomenon.
What’s The Treatment For Traveler’s Diarrhea
Most cases are mild and go away on their own. In those instances, sports drinks can help replenish electrolyte loss, according to the CDC. “I tell most of my patients that if they develop traveler’s diarrhea, they should begin treatment, wash their hands, and use bleach-based cleansers in their bathroom until symptoms resolve,” says Dr. Sonpal. Doctors will typically prescribe antibiotics for more serious cases that come with fever or blood, pus, or mucus in the stools, or last longer than a week.
How Is Travelers Diarrhea Diagnosed
If your travelers diarrhea hasnt resolved within three days or your symptoms worsen, make an appointment to see your doctor.
At your appointment, let your doctor know that youve recently been traveling. Theyll perform a physical exam that includes taking your temperature and pressing on your abdomen. Theyll likely order a stool test to search for evidence of parasites, and may order a blood test to check for infections. The blood work can also detect whether or not youre currently dehydrated.
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How Is Traveler’s Diarrhea Treated
Traveler’s diarrhea often is treated with antibiotics. You also can take loperamide , but don’t take it without an antibiotic if you have bloody diarrhea. Children, pregnant women, older adults, and other people who get dehydrated easily should drink rehydration solutions. You can buy packets of rehydration salts at camping/outdoor stores or drug stores. If your child has a fever higher than 102°F, is dehydrated, has blood in the stool, or vomits several times, he or she should see a doctor right away.
What Are The Complications Of Travelers Diarrhea
Dehydration is the biggest concern. If E. coli or other bacteria caused the illness, you may be at risk for dehydration, renal failure or even . Sepsis can be life-threatening in some cases. Having travelers diarrhea may also increase your risk of developing post infectious induced irritable bowel syndrome later on.
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Where Can I Get More Information
You can find more information about traveler’s diarrhea at the Travelers’ Health section of the Centers for Disease Control and Prevention Web site .
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Are There Any Other Precautions Or Warnings For This Medication
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Allergic reactions: Rarely, this vaccine may cause severe allergic reactions. If you notice the signs of a severe allergic reaction , get emergency medical attention immediately.
Immunocompromised people: This vaccine may not be as effective for people with a compromised immune system . People who have reduced immune function should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Protection against cholera and travellers’ diarrhea caused by ETEC: Not all people who take the vaccine will be fully protected against cholera and travellers’ diarrhea caused by ETEC. This vaccine will not protect against diarrhea caused by other organisms. Travellers should take all necessary precautions to avoid contact with, or ingestion of, potentially contaminated sources of food or water .
Pregnancy: This vaccine should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while using this vaccine, contact your doctor immediately.
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Tips To Prevent Travelers’ Diarrhea
Medical Author: Melissa Conrad Stöppler, MDMedical Editor: Charles P. Davis, MD, PhD
Travelers’ diarrhea strikes up to half of all international travelers. It is far and away the most common travel-related illness, affecting about 10 million people per year worldwide. Infectious agents, particularly bacteria from water contaminated with feces, cause travelers’diarrhea. The most commonly identified bacteria associated with travelers’ diarrhea are what are called ETEC, or enterotoxigenic Escherichia coli.
The destination is the most important risk factor for the development of travelers’ diarrhea. Developing countries all over the world represent the highest risk, and the highest-risk destinations are the developing countries of Latin America, Africa, the Middle East, and Asia. Certain groups of people are also more likely to develop travelers’ diarrhea. At-risk groups include:
- immunosuppressed persons,
Eating Unhealthy Foods Cause Diarrhea After Returning From Mexico
You should not simply judge the place you are visiting. All the places are good although they are probably dirty and causing problems. One thing you must evaluate first when suffering from diarrhea after traveling is what you eat.
Of course, traveling may not feel complete without tasting local foods. Moreover, street foods offered to look tasty as well. So, if you think you are eating in a place in which hygiene is not guaranteed, it can be the main cause of you getting diarrhea.
Okay, you may also claim that the foods you are eating in Mexico are provided in a good, clean, and even expensive restaurant. So, why is it still diarrhea? Another factor can be the ingredients of the foods.
Probably, you are allergic to a certain ingredient or food but you just dont realize it. Maybe, it is not the food you commonly eat. Your digestive system can simply reach with the stranger that comes in. Consequently, you experience diarrhea after returning from Mexico.
The food you eat during your trip can affect digestion when you are sick, such as sulfur burps and diarrhea that smells like rotten eggs.
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How Does This Medication Work What Will It Do For Me
This medication belongs to the class of medications called vaccines. It is used to help prevent travellers’ diarrhea caused by enterotoxigenic E. coli and cholera in adults and children 2 years of age and older. It is recommended for people travelling to areas with a high risk of cholera or travellers’ diarrhea.
This vaccine works by introducing very small amounts of dead cholera bacteria and nontoxic components of cholera toxin into the body. This allows the body to make antibodies against the bacteria and toxin so that if the bacteria does get into the body and produce the toxin, they are immediately attacked by the body’s own defense system. The cholera toxin is very similar to the toxin produced by ETEC, the bacteria that causes most cases of traveller’s diarrhea. Therefore, the body’s defenses against cholera toxin will also work against the ETEC toxin. It generally takes one week after finishing the first course of immunization for the body’s defenses to develop protection against the bacteria.
Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are being given this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.
Lifestyle And Home Remedies
If you do get traveler’s diarrhea, avoid caffeine and dairy products, which may worsen symptoms or increase fluid loss. But keep drinking fluids.
Drink canned fruit juices, weak tea, clear soup, decaffeinated soda or sports drinks to replace lost fluids and minerals. Later, as your diarrhea improves, try a diet of easy-to-eat complex carbohydrates, such as salted crackers, bland cereals, bananas, applesauce, dry toast or bread, rice, potatoes, and plain noodles.
You may return to your normal diet as you feel you can tolerate it. Add dairy products, caffeinated beverages and high-fiber foods cautiously.
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Which Is Safer: Street Food Or The Hotel Buffet
Eating street food is one of the best ways to get to know a culture. Would you be surprised to learn it is often safer than the buffet at your westernized hotel?
A lot of street food is cooked to order, coming off the grill or out of the wok directly to you. Unlike at a restaurant, you can see how clean the food prep area is, watch how long your dish sits before you get it, and make sure the cook isnt putting your cooked chicken back on the plate that held the raw meat.
While the Public Health Agency of Canada recommends taking additional precautions with street food, go ahead and eat it. But, choose your street food carefully. Pick a busy food stall that has a steady flow of customers, preferably locals, and preferably parents with kids they wont go to a seller who makes kids sensitive stomachs sick. If the seller doesnt use disposable plates and cutlery, look carefully to see how these are cleaned before theyre used by the next customer. Wipe them down with hand sanitizer if needed.
While they may be tempting to the budget traveller, avoid the fill-your-plate-for-a-set-price buffet type streets stalls, especially later in the day. While theres usually a fascinating collection of homemade dishes, you have no idea how long the food has been sitting around letting bacteria grow. And these buffet stalls have the same problems as hotel buffets your fellow travellers.
How Long Will A Travelers Diarrhea Last
travelers diarrhea will last up to 3 or 4 days on mild diarrhea symptoms. However, moderate to severe diarrhea will last longer even reach 1 month.
The time for diarrhea last can be caused by several things such as:
- Types of microbes that are ingested into the gastrointestinal tract.
- The condition of the body when it gets diarrhea.
- The first mode of emergency treatment when diarrhea.
- Travelers diarrhea diet. Type of food consumed when attacked by diarrhea.
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Investigations And Differential Diagnosis
Diagnosis of acute watery diarrhea is evident from the history and the need to make a specific etiological diagnosis is rarely necessary. The most common organism to cause traveler’s diarrhea is ETEC, but as this is not identified routinely in the laboratory a specific diagnosis is never made. Vomiting with limited diarrhea is usually due to a virus or preformed toxin.
However, it is important to identify patients with potentially dangerous diarrhea or dysentery: large volume diarrhea, bloody and mucoid stools or high-grade fever. Pathogen identification is important in aiding treatment for those at-risk patients with stool microscopy and culture as the first line of investigation. A fresh stool specimen should be prepared as a saline wet mount and examined microscopically three stool samples should be examined under the light microscope for parasites by an experienced observer, and then cultured for bacterial enteropathogens.
What To Do If You Get Travelers’ Diarrhea
Robert Burakoff, MD, MPH, is board-certified in gastroentrology. He is the vice chair for ambulatory services for the department of medicine at Weill Cornell Medical College in New York, where he is also a professor. He was the founding editor and co-editor in chief of Inflammatory Bowel Diseases.
Travelers’ diarrhea can turn a trip into a nightmare luckily, treatment options are available. Here is an overview of the symptoms of travelers’ diarrhea, with an in-depth discussion of available treatment options, so that you can know what you need to do to take care of yourself.
Travelers’ diarrhea is generally caused by pathogens found in food and water. Bacteria is the most likely culprit, along with viruses and parasites. Your greatest defense against travelers’ diarrhea is prevention, so be sure to observe strict adherence to food and drink safety practices.
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Montezuma’s Revenge: Get The Facts Know The Symptoms
Have you ever visited a new country and suddenly found that instead of a trip to the museum, you feel compelled to explore the foreign bathrooms? If so, you may have experienced Montezumaâs Revenge. Montezumaâs Revenge is diarrhea that is usually experienced by people traveling south of the U.S. border, especially to Mexico and Central Americaâ¯â hence the dramatic name. This unpleasant souvenir is usually caused by an intestinal bacteria, virus or other microbes that are present in the water or food supply of the country visited.
Can Travelers Diarrhea Cause Complications
The most common complication of travelers diarrhea is dehydration. This can be very serious. Dehydration can easily occur when the diarrhea causes the body to lose fluids at a faster rate than they can take them in. Vomiting and nausea, which sometimes accompany diarrhea, can make this worse. Dehydration can be particularly dangerous for young children. Know the warning signs of dehydration in toddlers.
Symptoms of dehydration include:
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What Is Travelers Diarrhea
Travelers diarrhea is an affliction almost every international traveler gets at some point, particularly in developing countries. Its exactly what it sounds like: severe stomach upset and loose stools, sometimes accompanied by nausea, vomiting or fever. TD is usually caused by ingesting food or water that’s contaminated with E. coli.1
For most people, travelers diarrhea is an unpleasant experience that ends quickly. While severe cases can be treated with antibiotics, the usual recommendation is to take an anti-diarrheal medication and/or Pepto-Bismol and stay hydrated. Its wise to tuck a few rehydration packets into your travel bag. If you become severely dehydrated, develop a high fever, or have symptoms lasting for more than a few days, you should see a doctor.2 E. coli isnt the only nasty bug that causes travelers diarrhea, however. Here are three other villains you may encounter while traveling.
Why Stomach Pains Watery Diarrhea
Meanwhile, the feces also tend to be watery. Some factors that cause diarrhea are bacteria, viruses, and fungi infections. Uniquely, many people suddenly suffer from diarrhea after traveling, including from Mexico. You need to know how long does travelers diarrhea last. How can it be? Here are some reasons?
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What Is Travelers’ Diarrhea
Travelers’ diarrhea is defined by most experts as three or more unformed stools in a 24 hour time period, passed by a person who is traveling. Travelers’ diarrhea is commonly accompanied by abdominal cramps, nausea, and bloating. Travelers’ diarrhea is a general term and does not specify any cause. Travelers’ from temperate regions of the world frequently experience diarrhea four days to two weeks after arriving in certain other areas of the world. Other terms used to describe this illness include “Montezuma’s Revenge,” the “Aztec Two Step,” and “Turista” in Mexico, the “Delhi Belly” in India, and the “Hong Kong Dog” in the Far East.
How Is Travelers Diarrhea Treated
Treatment will depend on the cause of the diarrhea. The first line of defense will often be home remedies and over-the-counter treatments to resolve mild cases of the illness.
When you get travelers diarrhea, avoid caffeine and alcohol. These may increase dehydration. However, continue to drink other fluids as much as possible to prevent dehydration.
Try to stick to bland foods you know have little risk of contamination and that your body is familiar with.
If youre traveling, its often a good idea to bring OTC treatments with you just in case you get travelers diarrhea. Bismuth subsalicylate can be effective for treating mild cases of travelers diarrhea. Use it according to the instructions on the box.
Antimotility agents like Imodium can also be used, but they should be saved for emergencies, like airplane travel. They may prolong the illness by not allowing your body to eliminate it.
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Epidemiology And Clinical Features
The incidence of TD varies among various destinations, and the risk is inversely related to the socioeconomic status of the visited countries . The relative risks are higher for southern Asia and India, followed by sub-Saharan Africa and South America. In a broad survey of TD, the standardized incidence rate for a 2-week stay ranged from below 40% to more than 60% .
On the average, TD typically occurs around the fourth or fifth day of stay abroad . Classical TD is defined as the voiding of at least three unformed stools per 24 h, with at least one accompanying symptom . Classical TD is the most frequent form but milder forms are also taken into account in studies.
Although it may cause considerable incapacitation, since approximately one third of patients are unable to pursue planned activities , TD is rarely severe. Slightly fewer than one in four patients voids more than six unformed stools per day, no more than 8.4% has more than ten movements per day, and between 1% and 7% have subjective fever and/ or blood in their stool . The self-reported mean duration of symptoms is between 61106 hours. Objective information about the duration of TD may be derived from the placebo arms of randomized controlled trials: in a representative historic study of antibiotics for the treatment of TD, 100% of patients allocated to the placebo arm were in remission after 5 days . In a survey of 73,630 short-term travelers, 14 were hospitalized and no fatalities were reported .