Traveler's Diarrhea: Remedies And Relief For Your Next Trip (2024)

Traveler's diarrhea is an intestinal infection caused by consuming contaminated food or water. It is characterized by loose, watery stools and abdominal cramps, and typically occurs when individuals visit places with different sanitary practices, climates, and food handling methods than their home country. While it usually resolves on its own within a few days, it can lead to dehydration, especially in children, which may require medical attention. This text will explore the recommended treatments and preventive measures for traveler's diarrhea, ensuring a safer and healthier journey.

Drink bottled water and avoid ice cubes

Drinking bottled water and avoiding ice cubes is a crucial step in preventing traveller's diarrhea. This is because traveller's diarrhea is an intestinal infection caused by consuming contaminated food or water. The condition typically arises when visiting places with different foods, climates, and cleaning practices compared to your home country, such as Central and South America, Southeast Asia, and parts of Africa.

To ensure you are drinking safe water, opt for bottled water with unbroken seals. If you must use tap water, boil it first for at least one minute at low altitudes and three minutes at high altitudes. Let the water cool, then store it in clean, tightly covered containers. It is important to note that you should avoid adding ice cubes to your drinks, as they may be made from contaminated water. If you want ice in your drink, make sure to use ice cubes made from water you know is clean.

In addition to following these guidelines for drinking water, it is also important to be mindful of how water is used in other daily activities. For example, when brushing your teeth, use purified water, and be careful not to swallow water in the shower. These precautions will help reduce your risk of ingesting contaminated water and developing traveller's diarrhea.

By taking these simple precautions, you can significantly reduce your chances of contracting traveller's diarrhea and ensure a more enjoyable travel experience.

Eat well-cooked, hot meals

Eating well-cooked, hot meals is one of the most important ways to prevent traveller's diarrhea. This is because bacteria, parasites, and other substances in the water and food can cause traveller's diarrhea, and heat kills the bacteria.

When eating out, make sure to eat food that is cooked and served hot. Avoid food that has been sitting out, such as buffets. If you are travelling with children, be extra vigilant as traveller's diarrhea can be more serious in kids. Watch them carefully so they do not put things in their mouths or touch dirty items and then put their hands in their mouths. If possible, keep infants from crawling on dirty floors.

If you are preparing food yourself, only use boiled water (boiled for at least 5 minutes) for mixing baby formula. Drink only pasteurized milk. Do not use tap water to drink or brush your teeth. Do not use ice made from tap water. Drink bottled drinks if the seal on the bottle hasn't been broken. Sodas and hot drinks are often safe.

If you are eating raw fruits and vegetables, only eat them if you have washed them in clean water or peeled them. Wash all fruits and vegetables before eating them. Do not eat raw leafy vegetables (e.g. lettuce, spinach, cabbage) because they are hard to clean.

Avoid street vendors and buffets

Street vendors and buffets are common sources of contaminated food, which can lead to traveller's diarrhea. Here are some tips to avoid street vendors and buffets when travelling:

• Plan ahead: Research the local food safety standards and practices of your destination before travelling. Identify restaurants or eateries that adhere to high food safety standards and have positive reviews from other travellers. Knowing where to eat beforehand can help you make informed decisions and reduce the risk of consuming contaminated food.
• Cooked food: Prioritise consuming well-cooked, hot meals. Heat kills bacteria, so opting for hot meals can reduce the risk of foodborne illnesses. However, avoid hot foods that have been sitting out for a long time, as bacteria can multiply even in cooked food if left at room temperature.
• Avoid street vendors: Street vendors often lack proper food handling practices and adequate sanitation facilities, increasing the risk of food contamination. It is best to avoid purchasing food from street vendors to minimise the chances of traveller's diarrhea.
• Skip the buffets: Buffets, especially those that have been sitting out for extended periods, pose a high risk of food contamination. It is challenging to maintain proper food temperatures and prevent bacterial growth on buffet spreads. Opt for freshly prepared meals instead.
• Packaged food: When possible, choose packaged food with intact seals. Check the expiration dates, and avoid anything that appears damaged or tampered with. Packaged food tends to have stricter production and sanitation standards, reducing the likelihood of contamination.
• Fruits and vegetables: If you must eat raw fruits or vegetables, ensure you wash them thoroughly and peel them yourself. Leafy greens, such as lettuce and spinach, should be avoided, as they are challenging to clean and can harbour harmful bacteria.
• Drink bottled water: Stick to bottled water or other drinks with intact seals. Avoid tap water, including ice made from tap water, as it may be contaminated. If you need to brush your teeth, use bottled or purified water, and be cautious not to swallow any water while showering.
• Breastfeeding infants: For infants, breastfeeding is the safest and most recommended food source while travelling. The stress of travelling may reduce milk production, so it is essential to prioritise the mother's nutrition and hydration to support milk production.

Wash and peel fresh produce

To prevent traveller's diarrhea, it is important to wash and peel fresh produce before consumption. This is because fresh produce is grown in the soil and water, which means it will naturally be exposed to microorganisms, including bacteria and parasites. These can cause foodborne illnesses, with symptoms such as nausea, vomiting, diarrhea, and abdominal pain. In more severe cases, food poisoning may lead to kidney failure, meningitis, and even death.

To wash fresh produce, follow these steps:

• Wash your hands for 20 seconds with soapy warm water before and after handling the produce.
• Cut away any damaged or bruised areas on the fruits and vegetables before preparing or eating.
• Rinse all produce with water before peeling it. This will prevent cross-contamination from dirt and bacteria that may be transferred from the knife onto the produce.
• Gently rub fruits and vegetables under plain, running water. Soap or produce wash is not recommended.
• For firm produce, such as apples, melons, cucumbers, and pears, use a clean vegetable brush to scrub the surface.
• Dry the produce with a clean cloth or paper towel. This will help remove any remaining bacteria.

Additionally, it is recommended to remove the outermost leaves of leafy vegetables like lettuce and cabbage. Even if you plan to peel the produce, it is important to wash it first to avoid any transfer of dirt and bacteria.

Take bismuth subsalicylate (Pepto-Bismol)

Bismuth subsalicylate (Pepto-Bismol) is an effective medication for treating and preventing traveller's diarrhea. It is available over the counter and does not require a prescription, making it a preferred self-treatment option for mild diarrhea. It is also available in suspension or chewable tablet form. The medication has been around for over 100 years and was first FDA-approved in 1939.

Bismuth subsalicylate has been shown to be significantly superior to a placebo in treating traveller's diarrhea. It decreases stool frequency and speeds up symptom relief. It is also useful in preventing traveller's diarrhea, although its efficacy is lower than that of antimicrobials (62% vs. 80%). To prevent traveller's diarrhea, it is recommended to take 524 mg of bismuth subsalicylate four times a day with meals and at bedtime during the time of risk. However, it is important to note that the frequency of administering multiple doses may decrease patient adherence.

For the treatment of traveller's diarrhea, the recommended dosage for adults is 524 mg every 30 minutes to 1 hour as needed (regular strength) or 1050 mg every 60 minutes (maximum strength) for up to 2 days (maximum dose of approximately 4,200 mg). It is important not to take Pepto-Bismol for more than three weeks at a stretch. Additionally, it is not recommended for pregnant people, children aged 12 and younger, or anyone allergic to aspirin.

Bismuth subsalicylate has antimicrobial properties and may form a protective coating along the stomach and intestinal wall. It is an alternative to antimicrobials for treating nausea and diarrhea and has been shown to be effective in situations where patients experience mild gastrointestinal discomfort. It reduces the severity and incidence of flatulence and diarrhea. It is also useful in managing Helicobacter pylori (H. pylori) gastrointestinal tract infection.

Frequently asked questions