Preventing and Treating Travelers Diarrhoea

Preventing and Treating Travelers Diarrhoea

This post discusses preventing and treating travelers diarrhoea. It also talks about the symptoms of travelers diarrhoea, preventing travelers diarrhoea, re-hydration plans, BRAT foods, antibiotics, what to do if it is more serious then travelers diarrhoea, symptoms of dysentery, treatment of dysentery, and natural remedies for diarrhoea and dysentery.

To me there is nothing worse than having to go to the bathroom when you are stuck on a bus (or train, boat, plane, etc.) In fact, avoiding this is a big factor when I plan my travel. I almost never go on a journey from more than a few hours if I think there won’t be a bathroom on board, and when I know I am going on a journey for more than an hour I will purposely eat and drink less. I also do my best to pick my journey times so that it will not clash with those times my body is used to going to the bathroom.

All these prevention acts work fine when I’m feeling healthy but what happens when the dreaded travelers diarrhoea (or worse) kicks in? It’s happened to me quite a few times and its enough to make me not want to leave the safety of my accommodation with a bathroom not more than a few steps away.

Note: The information in this post has been sourced from Sam Fury’s book Wilderness and Travel Medicine.

What is Travelers Diarrhoea?

Diarrhoea is when you get frequent, loose, watery stool.

Traveler’s diarrhoea is the onset of diarrhoea caused by unsanitary food and/or water. It usually last between a few days to a week. In most cases it passes without further complications.

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Symptoms of Travelers Diarrhoea

Not all of these symptoms need be present.

  • Bloating.
  • Gas.
  • General weakness and discomfort.
  • Loss of appetite.
  • Nausea.
  • Stomach cramps.
  • Sudden diarrhoea.
  • Vomiting.

Preventing and Treating Travelers Diarrhoea

Preventing Travelers Diarrhoea

As always, prevention is the best cure.

Treating Travelers Diarrhoea

Most cases of diarrhoea will resolve itself in 24 hours if you restrict the patient to nothing but easily digested foods, i.e., applesauce, bananas, crackers, noodles, potatoes, rice, soups and toast.

Unfortunately, traveler’s diarrhoea can last up to a week.

Treat the cause if possible. As an example, I got sick in India. I stopped eating street food and I got better.

It is best to just let diarrhoea pass, but if you need to slow the symptoms (such as if you have to catch a plane or bus), these medications can help:

Anti-fever medication: This is not usually needed for travelers diarrhoea.

Antisecretory: Pepto-Bismal every hour, max 20/day.

Loperamide: Imodium, 4mg initial dose then 2 mg every 4 hours, max 16 mg/day.

It is important to monitor and treat yourself for dehydration. Even better than that is to pre-empt the possibility of dehydration and put yourself on a re-hydration plan as soon as you get sick.

Re-hydration Plan

Oral re-hydration solutions are available commercially or can be easily made by combining 6 teaspoons sugar, 0.5 teaspoon salt and 1 liter of drinkable water.

Intake 50 to 200 ml/kg/24 hours (the stomach can only absorb 1 liter of liquid per hour).

BRAT Foods

When you feel good enough to eat again start with Bananas, Rice, Applesauce, Toast or crackers (plain) before moving up to solid foods.

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Antibiotics

In severe cases you can take antibiotics. I highly suggest seeing a doctor first. If for some reason that is not possible then you can take Ciprofloxacin. 500 mg every 12 hours for 3 to 7 days.

In South and South-East Asia it is better to take Azithromycin due to the probability of the cause, i.e., the “bug” making you sick in South/South-East Asia may be resistant to Ciprofloxacin.

The recommended dosage for Azithromycin for travelers diarreah is 500mg every 24 hours for 3 days.

If the TD is “fixed” you can stop taking the antibiotics. You may only need to take one dose of 500mg of either drug to solve the problems. Note that this is contrary to the normal rule of having to take the full course of antibiotics.

More Serious than Diarrhoea

Diarrhoea in many cases is just diarrhoea, but sometimes it is the sign of something more serious, e.g., appendicitis, cholera, colitis, intestinal bleeding, liver dysfunction.

If you encounter any of the following symptoms you should seek advanced medical care. Do not take antimotility agents, e.g., loperamide (Imodium).

  • Black or grey-white stool.
  • Blood or mucus in the stool. May be dysentery.
  • Diarrhoea lasting more than 7 days.
  • Diarrhoea violent for more than 24 hours.
  • Fever equal to or greater than 38 °C (101 °F).
  • “Rice water” diarrhoea with fishy smell indicates Cholera.
  • Severe vomiting.
  • Major abdominal distension and pain.
  • Moderate to severe dehydration.

Dysentery

Dysentery is diarrhoea which contains blood. It may be caused by an infection (viral, bacterial or parasitic), ingestion of contaminated food or water, oral contact with contaminated objects or hands, poor hygiene etc.

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Symptoms of Dysentery

  • Abdominal pain.
  • Diarrhoea.
  • Feeling of incomplete defecation.
  • Fever.

Treatment for Dysentery

Seek advanced medical care!

  • Drink lots of boiled water.
  • Do not give antimotility agents, e.g., loperamide (Imodium).
  • Specific medications for dysentery depend on the type, i.e., amoebic or bacillary. The diagnosis of these is usually made in a lab with stool samples.
  • If there is no advanced medical care available, and the dysentery does not self-resolve, a combination of an amoebicidal drug (to kill parasites) and an antibiotic (to treat bacterial infection) may help, e.g., ampicillin (antibiotic) 500 mg every 6 hours and metronidazole (systemic amoebicide) 750 mg 3 times a day for 5 to 10 days.

Alternative/Natural Remedies for General Diarrhoea and Dysentery

  • Brown rice water. Boil brown rice in double the amount of water with a pinch of salt. Strain and drink. the water.
  • Tea every two to three hours: Chamomile (strong), garlic and honey, peppermint, plantain seeds, tannin (strong for dysentery, will taste terrible), ginger tea will decrease any abdominal cramps.

For Severe Cases When Nothing Else is Available

  • Bones: Burn then grind them into a powder. Swallow the powder.
  • Chalk: Consume school chalk
  • Activated charcoal. If that is unavailable, mix tea and wood charcoal (not briquettes) and add milk of magnesia if available.

Got anything to add about preventing and treating travelers diarrhoea? Share your thoughts/questions in the comments 😀 .

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