Avoiding Traveler’s Diarrhea: What You Need to Know Before You Go

When we travel, we tend to plan for the best.

But it’s best to also be prepared for the worst, and one of the worst things that can happen on a trip is traveler’s diarrhea. It’s a total bummer, but it happens to the majority of travelers at some point in their lives.

So, this guide will help you prevent, prepare, and manage it if it happens to arise on your next trip.

Let’s get into it.

What is traveler’s diarrhea?

Traveler’s diarrhea is a digestive tract disorder that often affects people visiting foreign countries, particularly in regions where sanitation conditions and water quality may differ significantly from their home environment. It is characterized by loose, watery stools and can be accompanied by cramping, nausea, and general discomfort.

Studies estimate that between 30-70% of travelers experience this condition per the CDC.

The severity of traveler’s diarrhea can vary widely, but most cases are mild and resolve within a few days. However, for certain groups, such as the elderly, children, or those with weakened immune systems, it can pose a greater health risk.

Symptoms of traveler’s diarrhea

Traveler’s diarrhea typically presents itself within a few hours or days of exposure to contaminated food or water. The symptoms can range from mild to severe, depending on the cause and the individual’s health:

• Loose or watery stools
• Abdominal cramping
• Nausea and vomiting
• Urgency
• Fever

In most cases, symptoms disappear within a few days without the need for medical intervention. But in severe cases, there are additional symptoms to watch for that may require medical attention, including:

• Dehydration
• Persistent high fever
• Blood in stool

If these severe symptoms arise, it’s essential to seek medical assistance, as more sophisticated treatment may be necessary.

Causes and risk factors

The primary cause of traveler’s diarrhea is the ingestion of contaminated food or water, which can harbor harmful bacteria, viruses, or parasites. The most common culprits include:

• Bacteria: In about 80-90% of cases, traveler’s diarrhea is caused by bacteria, with Escherichia coli (E. coli) being the most prevalent. Other bacterial causes include Salmonella, Shigella, and Campylobacter.
• Viruses: Norovirus and rotavirus are responsible for some cases, particularly in areas with poor sanitation.
• Parasites: Though less common, parasites such as Giardia or Cryptosporidium can also lead to traveler’s diarrhea, especially in regions with unclean drinking water.

Risk factors for developing traveler’s diarrhea are primarily related to the destination and the types of food and drinks consumed.

While anyone can get traveler’s diarrhea, those with weakened immune systems or underlying gastrointestinal conditions may be at greater risk for severe illness.

Prevention tips for traveler’s diarrhea

While traveler’s diarrhea is common, there are some practical precautions you can take to reduce your risk. By being mindful of food, water, and hygiene practices, travelers can significantly reduce their risk of contracting this illness.

Here are some essential prevention tips:

Pre-trip preparations

Before traveling, consider taking preventative measures, such as:

• Visiting a travel health clinic to get information about vaccinations (like typhoid or cholera) and medications that can reduce your risk.
• Bringing over-the-counter medications like Pepto-Bismol or bismuth subsalicylate tablets, which can be taken as a preventive measure during high-risk meals.
• Stick to food that is cooked thoroughly and served hot. High-risk foods include raw fruits and vegetables that you haven’t peeled yourself, as well as undercooked meats and seafood.

Drink only safe water

In many parts of the world, tap water isn’t safe to drink. Here are some tips to avoid contaminated water:

• Drink bottled water with sealed caps
• Avoid ice in drinks unless it’s made from bottled water
• Use bottled or purified water for brushing your teeth
• Consider using water purification tablets or portable filters if bottled water is unavailable

Hygiene practices

Regularly washing your hands with soap and water, especially before meals and after using the restroom, is one of the simplest and most effective ways to avoid infection. When soap and water aren’t available, carry an alcohol-based hand sanitizer.

Medical assistance

If you do contract a severe case of traveler’s diarrhea that requires specialized care, it’s a huge comfort to have medical assistance protection in place. With medical assistance from Emergency Assistance Plus (EA+), you can speak with a medical professional on the phone 24/7 who will evaluate your condition and guide you to a solution—whether that’s medical evacuation to a suitable facility or just medical advice on how to get through the discomfort.

By following these prevention tips, you can greatly reduce your chances of getting traveler’s diarrhea and enjoy your travels with peace of mind. Learn more here.

Treatment options

Effective treatment can help manage symptoms and speed up recovery in severe cases. Here are some of the best treatment options:

Hydration

The most important treatment for traveler’s diarrhea is staying hydrated. Diarrhea can cause a significant loss of fluids and electrolytes, so it’s essential to drink plenty of water. Oral rehydration solutions (ORS) are ideal because they help replenish both fluids and electrolytes. These can be purchased over-the-counter or made at home using a mix of clean water, salt, and sugar.

Over-the-counter medications

Medications like loperamide (Imodium) can help reduce the frequency of bowel movements and provide relief, especially for mild to moderate cases. However, these medications only address symptoms and don’t treat the underlying cause, so they shouldn’t be used for more than a couple of days without consulting a healthcare professional.

Antibiotics

In severe cases, or when symptoms persist for more than a few days, a doctor may prescribe antibiotics to treat bacterial infections like E. coli or Shigella. Common antibiotics used for traveler’s diarrhea include ciprofloxacin or azithromycin, but they should only be taken under medical guidance, as inappropriate use of antibiotics can lead to resistance or worsen the condition.

Probiotics

Some travelers find that taking probiotics can help balance the gut microbiome and potentially shorten the duration of diarrhea. Probiotics are available in supplement form, or naturally in foods like yogurt, and can support the body in recovering faster.

Rest and dietary adjustments

Allow your body time to recover by resting, and switch to a bland diet to minimize irritation to your digestive system. The BRAT diet—bananas, rice, applesauce, and toast—is a simple and effective approach to easing symptoms. Avoid dairy, caffeine, alcohol, and spicy foods until your stomach settles.

For most travelers, these treatment options are sufficient, but if symptoms worsen or show no sign of improvement after 48 hours, seeking medical attention is important.

Myths and misconceptions about traveler’s diarrhea

There are a few myths and misconceptions surrounding traveler’s diarrhea, which can lead to unnecessary anxiety or poor decision-making during your trip. Here are some common myths debunked:

Myth 1: All street food will make you sick

Street food often gets a bad reputation, but not all street vendors are careless. While it’s true that food safety practices can vary, you can still enjoy street food safely by selecting vendors with high turnover, clean stalls, and properly cooked food.

Myth 2: Bottled water is always safe

While bottled water is generally safer than tap water in many developing regions, it’s not always foolproof. Be sure to inspect the bottle’s seal carefully to ensure it hasn’t been tampered with, as some unscrupulous vendors may refill bottles with tap water. Additionally, be cautious of ice in drinks, as ice is often made with tap water.

Myth 3: Traveler’s diarrhea only happens in developing countries

Although traveler’s diarrhea is more common in regions with poor sanitation, it can happen anywhere if food or water is contaminated. Even in developed countries, eating improperly handled food or drinking untreated water can lead to digestive issues.

Myth 4: Taking antibiotics prevents traveler’s diarrhea

Many people mistakenly believe that taking antibiotics as a precaution will prevent traveler’s diarrhea. However, this is not recommended unless prescribed by a doctor for a specific situation, as inappropriate use of antibiotics can lead to side effects, resistance, and more serious infections. Preventative measures, such as proper food handling and hygiene, are much more effective.

When to seek medical help

Knowing the warning signs can help you avoid complications and ensure that you get the care you need. Here are some situations when you should seek medical attention:

Persistent high fever

If your fever exceeds 102°F (39°C) and doesn’t subside with over-the-counter medications, it could indicate a more severe infection that requires medical intervention.

Dehydration symptoms

Dehydration can become dangerous, especially if you’re losing fluids rapidly and aren’t able to replace them. Signs of dehydration include dizziness, dark urine, dry mouth, or an inability to urinate for several hours. Severe dehydration may require intravenous fluids, which can only be administered by a healthcare provider.

Blood in the stool

If you notice blood in your stool, it could be a sign of a more serious bacterial infection like Shigella, Campylobacter, or E. coli. These types of infections can lead to more severe complications if left untreated.

Severe or prolonged diarrhea

If diarrhea lasts for more than 3-4 days without improvement, or if it’s extremely severe (more than six bowel movements a day), you should consult a doctor. Prolonged diarrhea can cause significant fluid loss and may indicate an infection that requires antibiotics.

Vomiting that prevents hydration

If vomiting is so frequent that you can’t keep fluids down, this increases the risk of dehydration, and medical attention may be necessary to administer fluids and manage symptoms.

If you need medical help while traveling, it’s important to know where to find care. Many countries have clinics and hospitals that specialize in treating travelers, and it’s worth researching healthcare facilities at your destination before leaving home.

Traveler’s diarrhea can be an unpleasant but manageable part of international travel. By understanding the causes and risk factors, practicing effective prevention methods, and knowing how to treat symptoms if they arise, you can significantly reduce its impact on your trip.

If you’re concerned about the area you’re traveling to, have an underlying condition, or just want to be prepared, EA+ is the worldwide leader in travel assistance—including medical assistance and evacuation—and is ready to coordinate your care 24 hours a day, 7 days a week, and 365 days a year.