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Travellers' diarrhea — how to avoid it and what to do if it happens

If you're like most people, your top vacation fear is contracting travellers' diarrhea. And who can blame you? Few things are worse than having to go when you're on the go – and it's especially hard to see the sights from the bathroom.

Here is a handy guide to understanding, treating and hopefully avoiding travellers' diarrhea, with an emphasis on risk areas, causes, symptoms, prevention and treatment.

Risk Areas and Causes

Travellers' diarrhea is the most common ailment to strike vacationers. The condition affects between 20-50% of international travellers, which the Centers for Disease Control (CDC) estimates as 10 million people. The culprit is almost always fecally contaminated food or water, and high-risk locations include developing countries in Asia, the Middle East, Latin America and Africa.

Symptoms

Symptoms of travellers' diarrhea generally last under a week and can include:

  • Frequent loose or watery bowel movements
  • Nausea
  • Vomiting
  • Abdominal cramps
  • Fever
  • Bloating
  • General malaise

Prevention

Since prevention is the better part of the cure, the smartest thing you can do for your health when travelling is to minimize risk by following basic food and water safety precautions.

  • Boil it, cook it, peel it or leave it! As wonderful as raw fruits and veggies are for your health, it's best to save them for when you get home. This is true even if they have been washed, since substandard water sanitation is one of the biggest causes of bacterial infection. The same goes for meat and fish, i.e., steak tartare and sushi
  • Only use purified water for drinking or brushing your teeth. Either buy commercially bottled water or water that's been boiled or chemically disinfected
  • Avoid ice unless you know it's been made with purified water
  • Avoid unpasteurized dairy and ice cream. They're more susceptible to contamination
  • Leave the street food on the street. It's fun to sample new cuisines from local markets, but it's impossible to be certain of the hygienic conditions of a food cart
  • Respect food temperature safety rules. Keep hot foods hot and cold foods cold to avoid creating a bacteria-friendly environment
  • Wash your hands often – especially after using the toilet or changing a diaper. Use soap, hot water, and really scrub between your fingers, under your fingernails and all over your hands and wrists
  • Carry alcohol-based hand sanitizers. In a pinch they're better than nothing, and they fit neatly into purses and pockets
  • Stock up before you leave town. Your doctor may recommend medications in case of emergency

Treatment

Since travellers' diarrhea can strike even the most seasoned adventurer, here are some tips for dealing and healing.

  • Hydrate: Oral rehydration is key in replacing fluids and electrolytes lost through a vicious attack of the trots. Drink lots of clear (purified!) fluids and bump up the rehydration factor with oral rehydration salts.
  • OTC medication: Some people find relief from cramping and bowel movement urgency in antimotility and antidiarrheal over-the-counter medications
  • Antibiotics: In some cases, your healthcare provider may want to hit the bugs with antimicrobial drugs
  • Watch out for: Worsening symptoms or lack of improvement within 48 hours
    • Signs of a worsening condition include three or more stools in an eight-hour period, severe abdominal pain and bloody stools
Travellers' diarrhea: avoid and treat
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