Travel diarrhea is especially troublesome, but can be dangerous without treatment. Everything about the causes, symptoms and therapy of diarrhea when traveling – and why especially older people and children should exercise caution.
- A wise advice from Montezuma to avoid diarrhea on vacation: Peel it, cook it or forget it! (Peel it, cook it – or forget it!)
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There is a high risk of travel diarrhea, especially when traveling to Africa, Asia and South America. The frequency of illness also depends on the season – during the rainy season (monsoon season), for example, traveler's diarrhea occurs more frequently.
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Tips for a vacation without diarrhea
How to prevent traveler's diarrhea
By adhering to a few rules when eating, illness from traveler's diarrhea can be prevented in many cases. Food should always be fried or cooked, fruit should be peeled. Drinks should be boiled or bought in bottles. Drinking water should be disinfected. Shellfish should not be eaten raw or incompletely cooked.
Preventive use of antibiotics is recommended in exceptional cases, for example in the seriously ill with cancer or a weak immune system.
When traveling to certain countries, a vaccination against cholera is recommended, which is very well tolerated and at the same time protects in a large part of the cases against enterotoxin-forming E. coli (ETEC). Vaccination against hepatitis A and B is also possible to reduce the risk of traveler's diarrhea.
What is traveler's diarrhea?
Travel diarrhea, medical travel diarrhea, is diarrhea that occurs in connection with a long-distance trip. Uncomplicated travel diarrhea affects around 20 to 50 percent of all long-distance travelers. Travelers who come from industrialized countries contract it much more often than people from developing countries.
Causes of traveler's diarrhea
The uncomplicated traveler's diarrhea is caused by bacteria in about 65 percent of the cases, especially by strains of the intestinal bacterium Escherichia coli (enterotoxin-producing E. coli = ETEC). About 30 percent of cases are caused by viruses (e.g. hepatitis A virus) and five percent by pathogens such as amoebas or Giardia lamblia.
The transmission is usually fecal-oral via a smear infection: the pathogens are excreted by infected people or animals, get food or drink directly or through the hands and are absorbed through the mouth. The hygienic standards for food preparation in the respective travel countries are decisive for the frequency of the illnesses.
Diarrhea can also be a symptom of a systemic tropical disease such as malaria. Especially if you have persistent diarrhea after returning from your destination, this should also be considered.
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You can recognize traveler's diarrhea by these symptoms
Travel diarrhea is characterized by sudden onset of liquid to watery bowel movements. In many cases, there are stomach cramps, nausea and flatulence. The symptoms usually begin a few days after entering the country of destination and last for an average of about three to four days.
In the case of complicated traveler's diarrhea, the sufferer typically suffers from a fever, which often lasts longer than three days. Blood and mucus in the stool also occur in some cases.
Diagnosis of traveler's diarrhea
The decisive step in diagnosing traveler's diarrhea is to take a medical history (medical history). For a precise determination of the pathogen, a stool sample can be taken and examined in the laboratory.
This investigation is particularly important for the detection of diarrhea in complicated traveler's diarrhea. In some cases, a blood test may be particularly useful for determining inflammation levels.
Treating diarrhea while traveling
The uncomplicated traveler's diarrhea usually stops on its own after a few days.
The most important measure for treating traveler's diarrhea is fluid replacement: the fluid that is excreted by the diarrhea must be returned to the body. Since salts (electrolytes) are also lost with the liquid, these should also be replaced.
Electrolyte solutions for children and the elderly
Especially in children, the natural balance of the electrolytes in the body can quickly be disturbed and, in severe cases, lead to serious diseases such as cardiac arrhythmias. Special electrolyte solutions are available in pharmacies; alternatively, foods containing sugar and salt can be consumed. In case of complicated traveler's diarrhea with fever, an antibiotic is usually given over a few days.
The number of bowel movements can be reduced by medication, for example by the opioid loperamide, which reduces the increased bowel movements. Coal can make the chair firmer. If possible, however, these drugs should be avoided, since the thin stool also eliminates the germs from the intestine and the infection heals faster overall.
History of traveler's diarrhea
In the majority of cases, traveler's diarrhea heals itself without complications. The average duration of illness is about three to four days. If digestive problems and fever persist, a visit to the doctor is urgently required. For this purpose it is best to have a dictionary in the respective national language ready.
What to do if you have persistent diarrhea after a trip?
If symptoms of diarrhea persist after the stay abroad and no improvement is in sight, the complaints must be clarified by a doctor. In particular, if accompanying symptoms such as fever or blood appear in the stool, the doctor will always examine a stool sample for parasites and salmonella, among other things. After traveling to malaria risk areas, if the patient has diarrhea and a fever that occurs at the same time, it should also be taken into account that the affected person may have malaria tropica. If you have chronic diarrhea, it could also be a tropical sprue. This rare condition can be dangerous and is treated with antibiotics.
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