Traveler's Diarrhoea (Traveller's Dysentry): Symptoms, Causes, Diagnosis & Treatment

Travelers’ diarrhoea is defined as an increase in the frequency of bowel movements to three or more loose stools per day during a trip abroad, usually to a less economically developed region. This is usually an acute, self limiting condition and is rarely life threatening.

Travelers’ diarrhoea usually is contracted by the ingestion of contaminated food or water. Contrary to common belief, food – not water – is the primary cause. The CDC estimates up to 80% of cases of travelers’ diarrhoea are caused by bacteria. The most common bacterium that causes travelers’ diarrhoea is enterotoxigenic E. coli

Men and women are at equal risk for developing travelers’ diarrhoea. Younger individuals are more commonly afflicted, perhaps because of more adventurous eating habits. Twenty percent to 50 percent of international travelers may develop diarrhea depending on the region of the world they visit. Diarrhea is the most common illness of travelers, affecting 10 million people each year, according to the Centers for Disease Control (CDC).

How does Traveler’s Diarrhoea affect your body?

The most common cause of traveler’s diarrhea is enterotoxigenic Escherichia coli (ETEC) bacteria. These bacteria attach themselves to the lining of your intestine and release a toxin that causes diarrhea and abdominal cramps.

What are the Causes of Traveler’s Diarrhoea?

Travelers’ diarrhea usually is contracted by the ingestion of contaminated food or water. Contrary to common belief, food – not water – is the primary cause. The CDC estimates up to 80% of cases of travelers’ diarrhea are caused by bacteria. The most common bacterium that causes travelers’ diarrhea is enterotoxigenic E. coli.

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What are the Risk Factors of Traveler’s Diarrhoea?

Common risk factors include :

  • Young adults – The condition is slightly more common in young adult tourists. Though the reasons why aren’t clear, it’s possible that young adults lack acquired immunity. They may also be more adventurous than older people in their travels and dietary choices, or they may be less vigilant in avoiding contaminated foods.
  • People with weakened immune systems – A weakened immune system increases vulnerability to infections.
  • People with diabetes, inflammatory bowel disease or cirrhosis of the liver – These conditions can leave you more prone to infection or increase your risk of a more-severe infection.
  • People who take acid blockers or antacids – Acid in the stomach tends to destroy organisms, so a reduction in stomach acid may leave more opportunity for bacterial survival.
  • People who travel during certain seasons – The risk of traveler’s diarrhea varies by season in certain parts of the world. For example, risk is highest in South Asia during the hot months just before the monsoons.
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What are the symptoms of Traveler’s Diarrhoea?

The symptoms of travelers’ diarrhea vary. Generally, diarrhea occurs within the first week of travel and lasts up to three to four days. Affected individuals on average pass up to five loose or watery bowel movements per day, which may be associated with cramps.

On occasion, individuals may experience fever or bloody stools. The diarrhea may be accompanied by abdominal pain and cramping, bloating, or increase in stomach or intestinal noises or gurgling (borborygmi).

Also read: Peptic ulcer Symptoms

How is Traveler’s Diarrhoea diagnosed?

The presumptive diagnosis of travelers’ diarrhea is based solely on the development of diarrhea when visiting a part of the world where this condition is common among travelers. The diarrhea usually is mild, self-limited, and resolves spontaneously. Symptoms usually can be controlled with over-the-counter medications (see below.) Only when the diarrhea is severe or complicated, and possibly when antibiotics are contemplated, should attempts be made to identify the exact organism responsible for the diarrhea so that the correct drug therapy can be selected. Identification may be difficult or impossible in undeveloped countries because of the lack of medical laboratories. When laboratories are available, the stool can be examined for parasites and cultured for bacteria. Identification of the pathogen results in the definitive diagnosis.

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How to prevent & control Traveler’s Diarrhoea?

  • Eat hot foods when they are hot and cold foods when they are cold – Don’t eat room temperature sauces. Diarrhea-causing microorganisms can multiply in foods that are allowed to cool or warm to room temperature.
  • Avoid raw or undercooked meat, fish, or shellfish – Don’t eat leafy salads, unpeeled fruit, or fresh vegetables in developing countries. Boiled, baked, or peeled foods are the safest.
  • Make sure you drink and eat only pasteurized milk and dairy products.
  • In foreign countries, boil tap water before drinking to eliminate bacteria.

Treatment of Traveler’s Diarrhoea Allopathic Treatment

To treat mild diarrhea:

  • Drink lots of fluids to prevent dehydration.
  • Take over-the-counter medications such as loperamide (e.g., Imodium) to manage symptoms. Moderate diarrhoea is distressing and can interfere with your planned activities.

To treat moderate diarrhoea:

  • Drink lots of fluids to prevent dehydration. Oral rehydration salt is widely available in stores and pharmacies in most countries. Mix as directed in clean water.
  • Take over-the-counter medications such as loperamide (Imodium) to manage symptoms. Consider taking an antibiotic if your doctor has prescribed you one.

To treat severe diarrhoea:

  • Take antibiotics if prescribed by your doctor.
  • You can also take over-the-counter medicines to manage symptoms.
  • Stay hydrated by drinking lots of fluids, such as oral rehydration solution.
  • Seek health care if you are unable to tolerate fluids or if you develop signs of dehydration. It is especially important to look out for signs of dehydration in infants and young children.

Treatment of Traveler’s Diarrhoea Homoeopathic Treatment –

  • Arsenicum album: This is one of the common remedies in acute diarrhea and food poisoning. The patient is usually restless and has a thirst for cold water, often taken in small sips. A sense of anxiety is typical which may progress to a fear of death. The diarrhea is often foul, burning, watery, and may include undigested food. There may be simultaneous vomiting and diarrhea.
  •   Chamomilla: Patients needing this remedy are almost always emotionally oversensitive with the illness. They are snappish and the pains are intolerable. Children want to be carried and may ask for things which they then reject. The stools may be slimy, green, or yellow. They are often sour or smell of rotten eggs—a sulphurous odour. (This is a common remedy for diarrhoea associated with teething.)
  •  China: The patients needing this remedy tend to be very flatulent with bloating. The diarrhoea is painless (although there may be gas pains), and there is often undigested food being passed. This is one of the main remedies for exhaustion following a bout of diarrhoea or blood loss, especially when the patient feels weak, oversensitive, and nervous. (This remedy is also called Cinchona officinalis.)
  •  Colocynth: The leading characteristic of Colocynth is severe abdominal colic that compels the patient to bend double and/or to press into the abdomen. The stools are often frothy or watery. The symptoms are often brought on by anger and the patient is easily vexed.
  •   Cuprum: The patients needing Cuprum often have spasms and cramps regardless of their main complaint. This may produce an abdominal colic similar to that described above for Colocynth (i.e., better with pressure), or there may be jerking muscles, “charley horses,” leg cramps at night, finger and foot cramps, etc. There is usually a thirst for cold drinks and the diarrhea is often profuse and spurts out.
  •  Podophyllum: The diarrhea tends to be profuse, gushing, and painless. It usually has an offensive, often putrid, odor. Gurgling through the abdomen commonly precedes the diarrhea. It is sometimes confused with Arsenicum because the patient may be restless, fidgety, and desire cold drinks. I have found this to be a commonly indicated remedy in patients with diarrhea.
  •  Pulsatilla: The typical patient needing Pulsatillafeels tearful and desires sympathy and company. They are usually worse for heat, and desire cool, open air. Their diarrhea is often associated with a qualmish nausea and a rising with tasting of food after eating. The stools may be changeable with no persistent characteristic. They may have colic, gas, and diarrhea which is worse at night. The patients are rarely thirsty and have little appetite.
  • Veratrum album: Like the Arsenicum listed above, this remedy is known for the possibility of simultaneous vomiting and diarrhea. One of its leading characteristics is cold sweat, especially of the forehead. When this symptom is found in patients with exhausting, profuse, watery diarrhea (with or without flatus and colic), think of this remedy. Like the Cuprum mentioned above, there may be muscle spasms. The patient often desires cold drinks despite the fact they feel cold in general.
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Traveler’s Diarrhoea – Lifestyle Tips

  • Eat food that is cooked and served hot, fruits and vegetables you have washed in clean water or peeled yourself, and pasteurized dairy products.
  • Don’t eat food served at room temperature, food from street vendors, or raw or undercooked (rare) meat or fish.
  • Drink bottled water that is sealed, ice made with bottled or disinfected water, and bottled or canned carbonated drinks.
  • Don’t drink tap or well water or drinks with ice made with tap or well water or unpasteurized milk.

What are Recommended Exercises for Person with Traveler’s Diarrhoea?

Some forms of exercise, usually high-impact ones like running, can exacerbate diarrhoea. So, try doing something a bit gentler like yoga or pilates.

Traveler’s Diarrhoea & Pregnancy – Things to know

Pregnant women who develop travelers’ diarrhoea or other gastrointestinal infections may be more vulnerable to dehydration than are nonpregnant travelers. … The treatment of choice for travelers’ diarrhea is prompt and vigorous oral hydration; however, azithromycin may be given to pregnant women if clinically indicated.

Common Complications Related to Traveler’s Diarrhoea

Dehydration caused by diarrhea can cause serious complications, including organ damage, shock or coma. Signs and symptoms of dehydration include a very dry mouth, intense thirst, little or no urination, and extreme weakness.

Other FAQs about Traveler’s Diarrhoea

Can travelers diarrhea be contagious?

Yes, no matter what the pathogenic cause (bacterial, viral or parasitic, see above) traveler’s diarrhea is contagious. The vast majority of individuals obtain the pathogens by orally ingesting them. Common routs that lead to oral ingestion are by eating food or drinking water contaminated with the pathogens.

Will Traveler’s diarrhoea go away?

If you don’t treat traveler’s diarrhoea, it usually will go away in four to five days. But treatment with an antibiotic and loperamide often can cure you within 24 hours.

Is yoghurt good for travelers diarrhoea?

Before and while you’re travelling, bolster your immune system by filling up on fermented foods such as yoghurt, kefir, and miso, which contain beneficial microbes and have a long history of promoting health. Live-culture yoghurt in particular has been shown to help derail some kinds of diarrhoea.

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