Traveler's Diarrhea

What is traveler's diarrhea?

Diarrhea is the term for bowel movements that are loose or watery. Traveler's diarrhea occurs within 10 days of travel to an area with poor public hygiene. It’s the most common travel-related illness.

What causes traveler's diarrhea?

It’s caused by drinking water or eating food that has bacteria, viruses, or parasites. Most traveler's diarrhea is from bacteria. Diarrhea from viruses and parasites is less common. Food and water can be infected by people:

• Not washing hands after using the bathroom

• Storing food unsafely

• Handling and preparing food unsafely

• Not cleaning surfaces and utensils safely

Who is at risk for traveler's diarrhea?

You are at risk for this condition if you travel to a country that has poor public sanitation and hygiene. Poor hygiene in local restaurants is also a risk factor. Places that have the highest risk are often:

• Africa

• Asia, except for Japan and South Korea

• Central and South America

• The Middle East

• Mexico

If you travel to a developing country, you are more likely to get this illness if you eat food or have drinks:

• Bought on the street, such as from a food cart

• In someone’s home

• At lodging that provides all meals (all-inclusive)

You’re also at increased risk if you:

• Take some kinds of ulcer medicine

• Have had some kinds of gastrointestinal surgery

What are the symptoms of traveler's diarrhea?

The main symptom is loose stool that occurs suddenly. The stool may be watery. Other symptoms may include:

• Nausea

• Vomiting

• Bloating

• Belly (abdominal) pain or cramps

• Blood in the stool

• Trouble waiting to have a bowel movement (urgency)

• Feeling tired

• Fever

In most cases, symptoms last less than a week.

How is traveler's diarrhea diagnosed?

Your healthcare provider will ask about your health history and your symptoms. They will ask about your recent travel. You may also have a stool culture or other tests. A stool culture is done by taking a small sample of stool. It is then sent to a lab to check for bacteria, viruses, and parasites. If your symptoms last longer than 10 to 14 days, you may have other tests.

How is traveler's diarrhea treated?

Traveler's diarrhea often goes away in a few days. Often the only treatment is replacing fluids. You may be told to drink lots of fluids. These can include clear broth, flat soda, or juice. In more serious cases, you may need an oral rehydration solution. You may be given antibiotics or other medicines if your symptoms don’t get better. Combination treatment with an antibiotic and an antidiarrheal medicine may help you get better more quickly. Your healthcare provider may give these to you before you travel so you can take them at the first signs of traveler's diarrhea.

What are possible complications of traveler's diarrhea?

The loss of body fluid from diarrhea and vomiting can lead to dehydration. This can be serious. Contact your healthcare provider if you are not urinating as much as usual.

A small number of people can develop postinfectious irritable bowel syndrome. This can cause symptoms, such as:

• Long-term diarrhea

• Belly pain and cramping

• Bloating

What can I do to prevent traveler's diarrhea?

You can take steps to prevent traveler's diarrhea.

Only use bottled water or water that has been boiled or chemically disinfected for:

• Drinking

• Making tea or coffee

• Making ice

• Brushing your teeth

• Washing your face

• Washing your hands (or use alcohol-based gel)

• Washing fruits and vegetables

• Washing food utensils, equipment, or surfaces

• Washing the surfaces of food or drink tins, cans, and bottles

Don't eat foods, such as:

• Raw fruits, vegetables, or salad greens

• Unpasteurized milk, cheese, ice cream, or yogurt

• Raw meat or undercooked meat

• Shellfish

• Any fish caught in tropical reefs rather than the open ocean

• Condiments that are left on the table, such as ketchup, mustard, sauces, or dips

Also make sure to:

• Not eat food from unknown sources

• Not put ice in drinks unless you are sure the ice was made from disinfected water

• Only have drinks that are bottled and sealed

• Wipe the lids of canned beverages before opening them

• Use drinking straws instead of drinking directly from cans, glasses, or cups

• Only take antibiotic or antidiarrheal medicine if advised by your healthcare provider (these can make symptoms worse, which can be dangerous)

When should I call my healthcare provider?

Call a healthcare provider if you:

• Have diarrhea that is severe or bloody. Severe diarrhea is diarrhea that is disabling or completely prevents planned activities.

• Have belly pain that is getting worse or not going away

• Have a high fever

• Are not getting better within a few days

• Have signs of dehydration, such as dark urine or urinating less

Key points about traveler's diarrhea

• Traveler's diarrhea occurs within 10 days of travel to an area with poor public hygiene. It’s the most common illness in travelers.

• It’s caused by drinking water or eating foods that have bacteria, viruses, or parasites.

• It usually goes away without treatment in a few days. Treatment with an antibiotic and an antidiarrheal medicine can often shorten the course of the illness.

• Dehydration from diarrhea can be serious. You need to replace body fluid that has been lost.

• See a healthcare provider if your symptoms are severe or last for more than a few days.

• You can prevent it by staying away from unsafe water and not eating unsafe foods.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are and when they should be reported.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your healthcare provider if you have questions, especially after office hours or on weekends and holidays.