Please note: This information was current at the time of publication but now may be out of date. This handout provides a general overview and may not apply to everyone. 

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Am Fam Physician. 1999;60(1):135-136

See related article on traveler's diarrhea.

What is traveler's diarrhea?

Traveler's diarrhea is a kind of diarrhea you might get when you're traveling in less developed countries. Many countries in Africa, Asia and Central and South America are risky places for travelers' diarrhea. It's usually caused by eating food or drinking water that is contaminated with bacteria. The illness may also cause nausea, vomiting and cramps. Fortunately, travelers' diarrhea is usually mild, and recovery is usually quick.

If you're planning a trip to a developing country, talk to your family doctor first about what you can do to stay healthy on your trip. Your doctor can give you advice about things you can do to help prevent illnesses like traveler's diarrhea. Your doctor also may prescribe an antibiotic for you to take along with you, in case you get traveler's diarrhea.

What can I do to prevent traveler's diarrhea?

You can help prevent traveler's diarrhea by being very careful about the foods you eat and the beverages you drink when you're traveling.

Do these things:

  • Tie a ribbon around the water faucet handle so you'll remember not to use tap water.

  • Keep safe, bottled water by the sink to use for drinking and tooth brushing.

  • Always clean your hands before you eat, but use prepackaged hand wipes or antiseptic gel to clean your hands, not just tap water.

Don't do these things:

  • Don't drink tap water. Don't even use it for brushing your teeth.

  • Don't use ice unless you know it was made from boiled or filtered water.

  • Don't eat raw vegetables or salads.

  • Don't eat unpasteurized dairy products.

  • Don't eat any fruits unless you peel them yourself.

  • Don't buy food and drinks from street vendors.

  • Don't go swimming in streams and lakes because of the risk of water pollution.

What foods and drinks are safe to eat in developing countries?

Coffee and tea made with boiled water are safe. Carbonated soft drinks (without ice), beer and wine are safe. Tap water that has been boiled, filtered or purified with iodine is safe to use. Most of the time, though, it's easier to buy purified bottled water for drinking than to purify the tap water.

It's safe to eat foods that are thoroughly cooked and served piping hot. Fresh breads and most dry foods are safe to eat.

What should I do if I get traveler's diarrhea?

When you're packing for your trip, take along some loperamide just in case you get travelers' diarrhea. This medicine usually stops diarrhea quickly. You may know this drug by its brand name—Imodium A-D. Take two tablets right after your first bout of diarrhea. Then take one tablet after each episode of diarrhea. Don't take more than four tablets a day.

How will I know if I need to take an antibiotic for traveler's diarrhea?

If loperamide doesn't stop your diarrhea, you may need to take an antibiotic to get rid of the infection. Your doctor might prescribe an antibiotic for you to take with you on your trip, just in case.

Several antibiotics can be used to treat traveler's diarrhea. One antibiotic commonly used for traveler's diarrhea is ciprofloxacin (brand name: Cipro). Often, only a few doses are needed to clear up the infection. (You shouldn't take Cipro if you're pregnant or under 18.)

If the diarrhea stops 12 hours after you took the first dose of the antibiotic, you probably don't need to take any more of the medicine. But see a doctor if your diarrhea hasn't stopped after you've been taking antibiotics for three days.

What should I do so I don't get dehydrated when I have traveler's diarrhea?

One of the biggest problems caused by diarrhea is dehydration. You can prevent dehydration by drinking lots of clear liquids, such as water, juices and soft drinks. Remember to keep drinking safe, purified water.

You can also drink a product that's made just to prevent and treat the dehydration caused by diarrhea. It's called “oral rehydration” mix. You can buy it in drug stores. It comes in a powder. You mix it with safe water and drink it. You can take some packets of oral rehydration mix with you on your trip, just in case.

What are danger signs that mean I have severe diarrhea?

If you're having diarrhea and you notice blood in your stool or you also have a high fever, you may have a severe infection. Stop taking loperamide and start taking an antibiotic. See a doctor if you don't get better in a day or two.

Traveler's diarrhea can turn a great vacation into a bad vacation. But taking a few simple precautions and knowing what to do if travelers' diarrhea strikes can make the difference in your trip.

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