Traveller's Diarrhoea

About Travellers' Diarrhoea

Travellers’ diarrhoea is a common illness affecting travellers, typically caused by consuming contaminated food or water. The condition is characterised by the sudden onset of loose, watery stools, often accompanied by abdominal cramps and nausea. Travellers’ diarrhoea can significantly impact travel plans, but it is generally self-limiting and resolves within a few days with proper treatment and care. For those seeking effective travellers’ diarrhoea treatment, medications can help alleviate symptoms and speed up recovery.

Symptoms of Travellers' Diarrhoea

Travellers’ diarrhoea typically begins abruptly and can significantly impact your travel experience. Here are the common symptoms to watch for:

● Frequent, Loose Stools: Three or more loose or watery stools within a 24-hour period.
● Abdominal Cramps and Pain: Discomfort and cramping in the stomach area.
● Nausea and Vomiting: Feeling nauseous and possibly vomiting, which can worsen dehydration.
● Fever: A mild to moderate fever may accompany the diarrhoea.
● Urgency and Bloating: An urgent need to have a bowel movement, along with feelings of bloating.
● Dehydration: Symptoms of dehydration such as dry mouth, intense thirst, decreased urine output, and fatigue are common, especially if fluid intake is not maintained.

In severe cases it can lead to more serious complications such as significant dehydration, which can cause dizziness, confusion, and even hospitalisation if not properly managed.

Diagnosis

Diagnosing travellers’ diarrhoea typically involves evaluating a patient’s symptoms and recent travel history. Here’s a more detailed look at the diagnostic process:

● Symptom Review: Healthcare providers will assess the frequency and nature of diarrhoea, presence of accompanying symptoms like abdominal pain, nausea, vomiting, fever, and any signs of dehydration. The typical onset of travellers’ diarrhoea is 12 to 72 hours after consuming contaminated food or water.
● Travel History: A detailed history of recent travel, especially to regions with known sanitation issues, helps in diagnosing the condition. Providers will inquire about specific destinations, duration of stay, and any potential exposure to contaminated food or water sources.
● Physical Examination: In cases where symptoms are severe or persistent, a physical examination may be conducted to check for signs of dehydration and other complications.
● Stool Tests: While not always necessary, stool tests can be used to identify the specific bacteria, viruses, or parasites causing the diarrhoea. This is particularly important if the diarrhoea is severe, bloody, or persists for more than a few days. Stool cultures help determine the most effective treatment, especially if antibiotics or antiparasitic medications are required.
● Further Testing: If symptoms last longer than 10 to 14 days, additional tests may be performed to rule out other gastrointestinal conditions or infections that might mimic travellers’ diarrhoea.

Most cases of travellers’ diarrhoea are self-limiting and resolve within a few days without the need for extensive diagnostic testing.

Treatments

Antibiotics: Antibiotics are often prescribed to treat travellers’ diarrhoea caused by bacterial infections. They can significantly reduce the duration of symptoms. Commonly prescribed antibiotics include:

● Ciprofloxacin and Levofloxacin: These are broad-spectrum antibiotics effective against a range of bacteria that cause diarrhoea.
● Azithromycin: Preferred in regions with high resistance to other antibiotics, such as South and Southeast Asia.
● Rifaximin: Useful for non-invasive strains of E. coli and other bacteria.
● Antidiarrheal Medications: These help manage symptoms but do not treat the underlying infection. They are particularly useful for mild to moderate cases where controlling symptoms is necessary for convenience, such as during travel:
● Loperamide (Imodium): Slows down bowel movements, reducing the frequency of diarrhoea.

Prescription medications should be used as directed by a healthcare provider to avoid complications and ensure effectiveness.

Over-the-Counter (OTC) Treatments

● Bismuth Subsalicylate (Pepto-Bismol): Can help reduce the duration and severity of diarrhoea. It works by coating the stomach and intestines, reducing inflammation, and preventing the bacteria from growing.
● Oral Rehydration Solutions (ORS): Essential for preventing dehydration. These solutions contain the right balance of salts and sugars to help replenish lost fluids and electrolytes.
● Probiotics: Can help restore the natural balance of bacteria in the gut, potentially reducing the duration of diarrhoea.

OTC treatments are often sufficient for mild cases and can be used in conjunction with preventive measures to maintain hydration and manage symptoms effectively.

Prevention Strategies

Preventing travellers’ diarrhoea involves a combination of safe food and water practices, personal hygiene, and precautionary measures. Here are some effective strategies:

● Be Careful with Food and Water: Always drink bottled, boiled, or properly treated water. Avoid tap water, ice cubes, and beverages made with local water sources. Stick to well-cooked foods that are served hot. Avoid raw or undercooked meats, seafood, and eggs. Peel fruits and vegetables yourself and avoid pre-cut or peeled produce.
● Avoid Street Food: Be cautious with food from street vendors, as it may be prepared under less sanitary conditions.
● Practise Good Hygiene: Wash your hands frequently with soap and water, especially before eating and after using the bathroom. If soap and water are not available, use an alcohol-based hand sanitizer with at least 60% alcohol.
● Avoid Touching Your Face: Reduce the risk of transferring germs from your hands to your mouth by avoiding touching your face, particularly your mouth, nose, and eyes.
● Use Preventive Medications and Products: Products like Pepto-Bismol can be taken as a preventive measure. They help reduce the risk of developing diarrhoea by coating the stomach lining and providing mild antibacterial action.
● Probiotics: Taking probiotics before and during your trip can help maintain a healthy balance of gut bacteria, potentially reducing the risk of diarrhoea.
● Drink Plenty of Fluids: Maintain good hydration by drinking safe fluids. This is especially important in hot climates or if you are engaging in strenuous activities.
● Be Cautious in High-Risk Destinations: When travelling to regions known for poor sanitation, take extra precautions with food and water. High-risk areas include parts of Asia, the Middle East, Africa, Mexico, and Central and South America.

Related Reading

For more in-depth information on preventing and treating travellers’ diarrhoea, visit our blog. Our articles provide valuable insights and practical advice on this topic and other health-related matters.