Traveler's diarrhea

Traveler's diarrhea is defined as a clinical syndrome, which may includes abdominal cramp, vomiting and diarrhea, that can result from a variety of microorganisms.

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Traveler's diarrhea can be caused by bacteria, viruses or parasites. The latter is relatively uncommon compare to the others. Escherechia coli is the most common bacterial cause of traveler's diarrhea. Other bacteria includes Acromonas spp. And Plesiomonas spp. Viruses may include norovirus which is common pathogen to cause diarrhea in cruise ships, rotavirus and astrovirus. Most common parasite causing diarrhea among traveler's is Giardia intestinalis. Other parasites are relatively uncommon such as Entamoeba histolytica, Cryptosporidium, Cyclospora and Dientamoeba fragilis.

Several factors have been identified for increase risk of diarrhea occurrence among travelers. These includes : 1)Poor hygiene and sanitation 2)Poor food handling 3)Inadequate water supplies 4)Inadequate electrical supplies 5)Inadequate water treatment.

Upon digesting contaminated food, body's defense mechanism is activated, leading to symptoms such as vomiting, diarrhea and abdominal pain. More serious infection of intestine may lead to symptoms like fever, bloody stool, and even seizure.

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Preventive measures established to reduce risk of diarrhea during traveling may help to ensure that one can make the most of the vacation.

Eating buffet food increase risk to get traveler's diarrhea as the food usually
left open or cold on the table

Eat food while it is still hot, as most germs that cause diarrhea can not live in
high temperature

Choose bottled carbonated beverages as some noncarbonated beverages
may contain tap water added by some vendors

Use disinfecting tablets to disinfect water if you wish to use local water which might be contaminated or has been not treated adequately

Prophylactic antibiotic is not routinely used for traveling. It is indicated only
in special cases for example in immunocompromised individuals
who are at higher risk to get infection, and develop complications

Most causes of traveler's diarrhea have no vaccine except for some infection
such as Hepatitis A

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Treatment usually supportive. Good hydration is maintain by drinking plenty of fluid. Oral rehydration salts help to replace electrolyte loss. Sometimes, antimotility drug is used for convenient, however it should not be used if there is present of fever, bloody stool and more serious symptoms. Antibiotic is useful when bacteria is suspected to cause the disease.

Keep well-hydrated during the illness

Replace electrolyte loss by taking oral rehydration salts

Antimotility drugs help to reduce diarrhea, but it is contraindicated
in the present of fever, bloody stool or more serious symptoms, which may
need more definitive treatment. Antimotility drugs do not treat the cause,
it just relieving the symptom.

If bacteria is suspected to cause the diarrhea, antibiotic might be needed

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Consult a doctor if: 1)Persistent vomiting, diarrhea 2)Presence of fever, bloody stool and other serious symptoms 3)Unable to tolerate orally 4)Vomiting and diarrhea in children.

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