The most frequent complaint among world travelers is diarrhea. Although it's not usually serious, it can wreak havoc with your travel plans. Its effects can last for days or weeks, and you can become dehydrated and lethargic.
Bacteria are usually the cause of diarrhea, although viruses and parasites, such as those that cause amoebic dysentery, sometimes can be the culprit. Traveler's diarrhea is contracted by consuming contaminated water or food.
The most common bacterial causes are:
Water and Beverages:
Since contaminated water is one source of bacteria that cause traveler's diarrhea and other illnesses, purify your water by:
- Bringing it to a vigorous boil for at least 1 minute and then allowing it to cool, or
- Putting it through a portable filter capable of capturing bacteria and parasites, or
- Adding iodine tablets.
Other water tips:
- Bring treated or bottled water with you on all outings.
- Don't use ice cubes prepared with untreated water; freezing does not kill offending microbes.
- Drink bottled sodas.
- Hot beverages such as tea and coffee generally are safe to drink.
Contaminated food is the other major source of the bacteria that cause traveler's diarrhea. You should be sure to follow these guidelines even if you are staying at an expensive resort or hotel.
Some common-sense tips:
- Don't eat food from street vendors, unless it's piping hot or boiling.
- Do not eat raw shellfish, such as ceviche, which can carry a variety of microbes.
- Avoid uncooked leafy vegetables and salads.
- Peel all fruits and vegetables.
- Make sure all foods are very hot and well cooked, especially meats and fish.
- Canned foods are always a safe bet.
- Don't eat or drink unpasteurized dairy products.
Remember, in hot climates, debilitating and potentially life-threatening dehydration can occur quickly when diarrhea strikes. Severe diarrhea should be treated with special oral rehydration fluid. Bottled sports drinks are not sufficient for severe diarrhea.
Bring along packets of oral rehydration solution, which can be mixed into purified water. If you don't have any solution, you can make an acceptable alternative by mixing one-half teaspoon of salt, one-half teaspoon of baking soda and four tablespoons of sugar with one liter of clean water.
If you have mild diarrhea, oral rehydration solution is not essential. You can alternate sips of sweet and salty beverages (such as broth and fruit juice), as long as you drink enough to stay well-hydrated. Drink enough so that you produce light-colored urine every three to seven hours.
You may want to ask your doctor for a prescription for the antibiotic ciprofloxacin (or a related drug), and bring it along. When diarrhea strikes, take the antibiotic as your doctor prescribed, starting it as soon as possible, and drink plenty of fluids. In some parts of Asia, certain types of bacteria (such as Campylobacter) may be resistant to ciprofloxacin. Be sure to tell your doctor all countries that you plan to visit on your trip, as this may affect the doctor's antibiotic selection.
Over-the-counter medications such as loperamide (sold under the brand name Imodium, with less costly generic alternatives available) can be helpful for certain situations, such as long bus or car trips.