Guest Author - Caramy Spencer

If you are not participating in the more traditional Memorial Day activities this year, and have instead decided to embark on a distant vacation during this time, one the many precautionary steps you should take includes safeguarding against traveler’s diarrhea (TD). This is particularly true if you have intended to visit Asia, Africa, Mexico, Central America, or the Middle East. Generally, the warmer the climate you are visiting, the higher your risk for traveler’s diarrhea. According to the Centers of Disease Control and Prevention, travelers’ diarrhea is the most common illness of travelers, affecting between 20%-50% of international tourists or 10 million people annually. In fact, travelers’ diarrhea is so common that the colloquial term “Montezuma's Revenge” was coined to represent travelers’ diarrhea experienced by tourists visiting Mexico.

Cause

This particular illness is most commonly caused by ingesting toxigenic bacteria in contaminated water and food. Although bacterial enteropathogens (basically defined as an organism that is capable of producing intestinal disease), particularly enterotoxigenic Escherichia coli (ETEC), accounts for 80% of cases, other causes include both parasites and viruses – though their incidence is less common. Other bacterial culprits include Campylobacter, Salmonella, Shigella, Aeromonas, and non-cholera Vibrio. Pesky parasitic causes that become prevalent when diarrhea lasts more than two weeks are Giardia lamblia, Entamoeba histolytica, Cyclospora cayetanensis, and Cryptosporidium parvum. Finally, noroviruses and rotavirus are infrequent causes, but they also contribute to the incidence of travelers’ diarrhea. For more information specifically on rotavirus, see my article Rotavirus Information and Natural Therapies.



Those Most at Risk

Although your destination is the primary risk factor for developing travelers’ diarrhea, other risk factors include being of very young or of very old age, a possible genetic susceptibility, having a compromised immune system, and (surprise!) having low gastric acidity by taking medications such as histamine blockers or proton pump inhibitors. This is another great motivation to control acid reflux issues with the use of lifestyle changes instead of drugs that come with unwanted and particularly unhealthy side effects.

Symptoms

Travelers’ diarrhea is a self-limiting illness that is rarely life threatening, but it can certainly be extremely incapacitating and put a damper on your plans, to say the least. According to the Centers of Disease Control and Prevention, most cases typically resolve within one week, and 98% of cases are resolved within one month. However, the concern lies in the significant morbidity the illness causes during its course. Symptoms are abrupt and include watery diarrhea (typically three or more within a 24 hour period) accompanied by intense stomach cramps. Other symptoms may include nausea, vomiting, fever, dehydration, and extreme weakness and exhaustion.

Prevention is the Best Medicine

The following are some tips to reduce the risk of contracting travelers’ diarrhea:

1. It is generally recommended that individuals take probiotic supplements daily. These supplements maintain a healthy incidence of beneficial bacteria in the gut, theoretically preventing pathogens from colonizing.

2. Exercise safe eating habits. Typically, fruits and vegetables are the most contaminated foods, particularly if they are washed in contaminated water. The general rule of thumb here is that if you can’t peel it, don’t eat it. You may also need to exercise caution when eating in restaurants and consuming products from street vendors. Other risky foods include unpasteurized dairy products, raw or poorly cooked meats and seafood, salsas, and cold sauces.

3. Always drink bottled water, juices, and soft drinks. Never drink the tap water. Additionally, the best way to purify water is to boil it for at least five minutes. Remember that freezing water will not kill the bacteria, so it is also best to completely avoid ice cubes.

4. It is best to frequently use good hand washing techniques while traveling and also make good use of hand sanitizing products. Pathogens can be spread from hand to hand and from money to hand.

Remedies

For a list of homeopathic remedies for common gastric ailments including diarrhea, please see my article, Homeopathic Quick Reference for Digestive Problems.



Note: Any information that I have provided regarding gastric issues, their diagnosis, and their treatments are intended for informational purposes only and are not meant as a substitution for the advice provided by your healthcare professional. You should immediately contact your healthcare provider if you believe you or your child may have a health condition. In addition, always talk to your doctor, pharmacist, or other healthcare provider before taking any prescription, over-the-counter medicines, or herbal supplements.