Diet - traveler's diarrhea; Diarrhea - traveler's - diet; Gastroenteritis - traveler's
Traveler's diarrhea causes loose, watery stools. People can get traveler's diarrhea when they visit places where the water is not clean or the food is not handled safely. This can include developing countries in Latin America, Africa, the Middle East, and Asia.
This article tells you what you should eat or drink if you have traveler's diarrhea.
Planning ahead of time can make your travels smoother and help you avoid problems. Let's talk today about vacation health care. Always prepare in advance for health problems you might experience when you travel. Ask your health insurance carrier what they will cover or pay for, and consider buying traveler's insurance when you travel abroad. If your children are not traveling with you, leave a signed consent-to-treat form with their caretaker. And if you are taking medications, talk to your health care provider before leaving. Make sure you carry your medications in your carry-on bag, never in your luggage. Research the health care in the country you are visiting. And if you can, find out where you would go if you needed medical help. So, what should you pack? Well, you'll want to bring several important items on your trip. Pack a first aid kit, immunization records, insurance ID cards, and medical records for any chronic illnesses or recent medical surgery. Bring a list of the names and phone numbers of your pharmacist and health care providers. Pack any nonprescription medications you might need, along with sunscreen, a hat, and sunglasses. So, what do you do on the road? When you travel, know what steps you need to take to prevent different diseases and infections. This includes how to avoid mosquito bites, what foods you can eat safely, where you can eat safely, how to drink water and other liquids, and proper hand washing. If you are visiting an area where traveler's diarrhea is common, know how to prevent and treat it. Be aware of automobile safety and use seat belts when you travel. Upon arriving at your destination, check the local emergency number. If you're traveling a long way, expect your body to adjust to a new time zone at about the rate of 1 hour per day. If you're traveling with children, make sure they know the name and telephone number of your hotel, just in case they get separated from you. Write this information down and put it in their pocket. Give them enough money to make a phone call, and make sure they know how to use phones if you are visiting a foreign country. As always, a little preparation goes a long way to preventing problems.
Function
Bacteria, parasites, and other substances in the water and food can cause traveler's diarrhea. People who live in these areas don't often get sick because their bodies are used to the bacteria or parasites.
You can lower your risk of getting traveler's diarrhea by avoiding water, ice, and food that may be contaminated. The goal of the traveler's diarrhea diet is to make your symptoms better and prevent you from getting dehydrated.
Side Effects
Traveler's diarrhea is rarely dangerous in adults. It can be more serious in children.
Recommendations
How to prevent traveler's diarrhea:
WATER AND OTHER DRINKS
- Do not use tap water to drink or brush your teeth.
- Do not use ice made from tap water.
- Use only boiled water (boiled for at least 5 minutes) for mixing baby formula.
- For infants, breastfeeding is the best and safest food source. However, the stress of traveling may reduce the amount of milk you make.
- Drink only pasteurized milk.
- Drink bottled drinks if the seal on the bottle hasn't been broken.
- Sodas and hot drinks are often safe.
FOOD
- Do not eat raw fruits and vegetables unless you peel 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.
- Do not eat raw or rare meats.
- Avoid uncooked or undercooked shellfish.
- Do not buy food from street vendors.
- Eat hot, well-cooked foods. Heat kills the bacteria. But do not eat hot foods that have been sitting around for a long time.
WASHING
- Wash hands often.
- Watch children carefully so they do not put things in their mouth or touch dirty items and then put their hands in their mouth.
- If possible, keep infants from crawling on dirty floors.
- Check to see that utensils and dishes are clean.
There is no vaccine against traveler's diarrhea.
Your health care provider may recommend medicines to help lower your chances of getting sick.
- Taking 2 tablets of Pepto-Bismol 4 times a day before you travel and while you are traveling can help prevent diarrhea. Do not take Pepto-Bismol for more than 3 weeks.
- Most people do not need to take antibiotics every day to prevent diarrhea while traveling.
- People who are at risk for more dangerous infections (such as people with chronic bowel diseases, kidney disease, cancer, diabetes, or HIV) should talk to their provider before traveling.
- In some cases, your provider may provide a prescription for an antibiotic to be taken if you develop severe diarrhea, especially if it is accompanied by fevers or if there is blood in the stool. Azithromycin is the most common option, though ciprofloxacin may also be recommended.
If you have diarrhea, follow these tips to help you feel better:
- Drink 8 to 10 glasses of clear fluids every day. Water or an oral rehydration solution is best.
- Drink at least 1 cup (240 milliliters) of liquid every time you have a loose bowel movement.
- Eat small meals every few hours instead of three big meals.
- Eat some salty foods, such as pretzels, crackers, soup, and sports drinks.
- Eat foods that are high in potassium, such as bananas, potatoes without the skin, and bottled fruit juices.
Dehydration means your body does not have as much water and fluids as it should. It is a very big problem for children or people who are in a hot climate. Signs of severe dehydration include:
- Decreased urine output (fewer wet diapers in infants)
- Dry mouth
- Few tears when crying
- Sunken eyes
Give your child fluids for the first 4 to 6 hours. At first, try 1 ounce (2 tablespoons or 30 milliliters) of fluid every 30 to 60 minutes.
- You can use an over-the-counter drink, such as Pedialyte or Infalyte. Do not add water to these drinks.
- You can also try Pedialyte frozen fruit-flavored pops.
- Fruit juice or broth with water added to it may also help. These drinks can give your child important minerals that are being lost in the diarrhea.
- If you are breastfeeding your infant, keep doing it. If you are using formula, use it at half-strength for 2 to 3 feedings after the diarrhea starts. Then you can begin regular formula feedings.
In developing countries, many health agencies stock packets of salts to mix with water. If these packets are not available, you can make an emergency solution by mixing:
- 1/2 teaspoon (3 grams) of salt
- 2 tablespoons (25 grams) sugar or rice powder
- 1/4 teaspoon (1.5 grams) potassium chloride (salt substitute)
- 1/2 teaspoon (2.5 grams) trisodium citrate (can be replaced with baking soda)
- 1 liter of clean water
Get medical help right away if you or your child has symptoms of severe dehydration, or if you have a fever or bloody stools.
References
Ananthakrishnan AN, Xavier RJ. Gastrointestinal diseases. In: Ryan ET, Hill DR, Solomon T, Aaronson NE, Endy TP, eds. Hunter's Tropical Medicine and Emerging Infectious Diseases. 10th ed. Philadelphia, PA: Elsevier; 2020:chap 3.
Centers for Disease Control and Prevention website. Travelers' diarrhea.
Nitzberg M, Smereck J. Diarrhea. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 27.
Riddle MS. Clinical presentation and management of travelers' diarrhea. In: Keystone JS, Kozarsky PE, Connor BA, Nothdurft HD, Mendelson M, Leder, K, eds. Travel Medicine. 4th ed. Philadelphia, PA: Elsevier; 2019:chap 20.
Version Info
Last reviewed on: 11/19/2023
Reviewed by: Jacob Berman, MD, MPH, Clinical Assistant Professor of Medicine, Division of General Internal Medicine, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
