Traveler’s diarrhea: symptoms and treatment


Traveler’s diarrhea

Traveler’s diarrhea is the most common disease in people who travel abroad.
Every year, 20-30% of foreign travelers suffer from diarrhea (Pitzurra et al. – 2010), which is about 10 million people. This symptom usually becomes noticeable within the first week of travel, but can occur at any moment of the trip and up to two weeks after returning.
The risk depends on which country is visited; a high risk exists in the developing countries of Latin America, Africa, Asia and the Middle East.

What causes traveler’s diarrhea?

The primary cause lies in infectious diseases caused by bacteria, viruses and parasites.
Bacteria cause about 80% of traveller’s diarrhoea.
The main representative of these pathogens is Escherichia coli (Shah et al. – 2009) and causes diarrhoea and convulsions (de la Cabada Bauche et al. – 2011), but hardly any fever.


As a rule, infections that lead to diarrhea are highly contagious. In most cases, the infection can be transmitted as long as the patient suffers from diarrhea.

Possibilities of infection in infection-related diarrhoea:

  • Dirty hands (Henry et al. 1990)
  • Water or food contaminated with germs
  • Certain pets
  • Direct contact with pathogens in the stool (e.g. dirty diapers, toilet)

The pathogens can be transmitted to anything that comes into contact with them; these include, but are not limited toys, changing tables, sanitary surfaces, and the hands of a person who may be preparing food.
If you touch these surfaces and then touch your mouth, you can become infected with the pathogen.

What are the typical symptoms of traveler’s diarrhea?

In most cases, symptoms appear suddenly.
With diarrhea, the frequency, amount and weight of bowel movements is usually increased. The consistency is also changed.
The traveler has a bowel movement four to five times a day, which is liquid or watery.

Concomitant symptoms may also include nauseavomitingabdominal cramps, abdominal bloating, fever, urge to defecate and malaise.
The infection can begin with mild symptoms, which then in the course of the following two times also affects the stomach, the initial symptoms may be:

  1. Anorexia
  2. Tiredness.

When is there cause for concern? Complications of diarrhea

The skin complication is dehydration, which is caused by the large loss of water, salt and nutrients. Dehydration can be the trigger for other serious illnesses, such as low blood pressure (hypotension), convulsions, kidney failure and even death.
A visit to the doctor is necessary in the following cases:


Diagnosis of diarrhea

The doctor first interviews the patient in detail about their medical history and then performs a thorough physical examination to determine the cause of the diarrhea. He may order urine and blood samples.
Depending on the patient’s condition, in some cases further tests and examinations are useful to determine the cause of diarrhoea and related diseases; These include:
stool cultures to detect bacteria, parasites or signs of disease.

Pharmacological treatment

In many cases, diarrhea disappears on its own. In more severe cases, the doctor may prescribe diphenoxylate and atropine (Lomotil). If the diarrhea is caused by a bacterial infection, an antibiotic helps.

During pregnancy, no medication may be taken, here is an appropriate diet to follow.

How long does diarrhea last? The prognosis for recovery

The disease is usually harmless and improves on its own within 3 days (Steffen et al. – 1983). Traveler’s diarrhea is rarely fatal.
In terms of prognosis, 90% of cases resolve over the course of a week, 98% over the course of a month.
When the typical symptoms (fever, vomiting and sharp diarrhea) subside, a feeling of fullness may remain after eating, especially after a sumptuous meal.

What protects against traveler’s diarrhea?

Travellers can reduce the risk of developing traveler’s diarrhoea by taking the following protective measures:

  1. Do not buy food and drinks from street vendors or other establishments that lack hygiene.
  2. Do not eat fried, raw or undercooked foods, especially meat,
  3. Eggs and fish. Wash and peel fruits and vegetables well.

Well-cooked or packaged food should not pose a danger.

Tap water, ice cubes, unpasteurized milk and dairy products increase the risk of gastroenteritis and traveler’s diarrhea.
Safe drinks include bottled carbonated drinks, hot tea or coffee, beer, wine, and boiled or iodine and chlorine-treated water.

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