Do you get diarrhea when you travel? Let's talk about Traveler's Diarrhea!

Imagine being on a trip to a beautiful place and suddenly feeling sick, having to go to the toilet several times a day... Maybe even vomiting along with a fever. The whole trip can be a bit boring, right? Most of the time, this is because we unknowingly eat or drink something dirty. This condition is called 'Traveler's Diarrhea'. As the name suggests, it is a common occurrence among travelers.

What is Traveler's Diarrhea?

Simply put, this 'Traveler's Diarrhea' is an infection that occurs in the stomach when we travel, especially when we go to another region or country, due to unclean food or drink. To be precise, this is a minor nuisance that affects our digestive system (gastrointestinal tract) . That is, an infection that occurs in your intestines. Although this usually gets better in a few days, it is a very annoying experience during those few days. Your stomach starts to hurt, you need to go to the toilet frequently, and sometimes you vomit and feel weak. Imagine how upset you would be if you went to your favorite place, tasted some food there, and something like this happened!

Most often, this is caused by bacteria . However, sometimes viruses or intestinal parasites can also be responsible. This risk increases when we travel to places that are different from our usual environment and have poor hygiene conditions.

How common is this?

In fact, 'Traveler's Diarrhea' is a very common health problem among travelers. According to surveys, this condition can occur in between 30% and 70% of travelers , depending on the destination and the time of year. That means that out of ten people traveling, three to seven are likely to develop it.

This risk is especially high in countries with hot and humid climates . This is because bacteria are more likely to grow in such environments. For example, in parts of Asia, the Middle East, Africa, Mexico, and Central and South America, people who travel to these places are more likely to develop 'traveler's diarrhea'.

What are the symptoms?

If you suspect you have Traveler's Diarrhea, look out for these symptoms:

• Passing loose stools (like water) more than three times in 24 hours .
• Frequent, sudden need to go to the toilet.
• Stomach cramps and vomiting.
• Nausea and vomiting.
• Fever.

Most of the time, these symptoms are not severe. If it is a bacterial or viral infection, symptoms may start to appear within 6 to 24 hours of infection . However, if it is caused by a parasite, it may take a week to three weeks for symptoms to appear. This is why some people continue to have these symptoms even after returning home from a trip.

How long do symptoms last?

That depends on the reason.

• If it's a bacterial infection , you'll start to feel better in two to three days, even if you don't take any treatment. However, it can take up to a week for the symptoms to completely disappear.
• If it's a viral infection , it will get better in a few days.
• However, if traveler's diarrhea is caused by a parasitic infection , the symptoms can last for weeks, even months. In that case, you should definitely see a doctor.

Why does Traveler's Diarrhea occur?

Traveler's diarrhea is actually your immune system's response to a foreign invader that has entered your digestive tract. These invaders can be bacteria, viruses, or parasites. Whatever they are, your immune system tries to destroy them and expel them from your body. The inflammatory response that occurs in this attempt is what causes symptoms like diarrhea and stomach cramps.

Simply put, what's happening here is like your body's soldiers (the immune system) fighting an enemy (the germ) that has entered your body. These symptoms are a byproduct of that fight.

What kind of germs cause this?

As we mentioned before, bacteria, viruses, and parasites can cause this condition.

• Bacteria: Bacterial infections are the most common. Among them , E. coli is the main culprit. In addition:
• Salmonella
• Cholera germ
• Campylobacter jejuni
• Bacteria like Shigella can also cause it.

• Viruses:
• Norovirus
• Rotavirus
• Viruses like Astrovirus also affect this.

• Parasites:
• Giardia
• Cryptosporidium
• Parasites like Cyclospora can also cause this condition.

Is this contagious?

Yes, Traveler's Diarrhea can be contagious. Germs in your digestive tract can be passed to someone else through tiny particles in your stool or vomit. For example, if you have diarrhea and you go to the toilet and touch the sink before washing your hands, the next person who uses it can get the germs on their hands. If they then touch their mouth without washing their hands, they can get the germs from you. That's why you need to be very careful about your personal hygiene .

Who is more likely to develop this?

Eating contaminated food and drinking water is the main risk factor, but some groups are more likely to develop it than others.

• Young adults: Although experts don't know the exact reason, younger people are more likely to get traveler's diarrhea than older people. This may be because young people are more likely to try new things, especially street food.
• People with a weak immune system: Like any other infection, traveler's diarrhea can easily develop in someone whose immune system is already weak.
• People with chronic digestive diseases: For example, people with conditions such as Crohn's disease , GERD (Gastroesophageal Reflux Disease) , or Irritable Bowel Syndrome (IBS) are at higher risk.

What complications can this cause?

Dehydration is the most common complication. This means that the amount of water and salts in the body decreases. Severe dehydration can be a medical emergency.

Additionally, although rare, traveler's diarrhea can worsen an underlying digestive condition. For example, you may develop a condition called post-infectious irritable bowel syndrome (PI-IBS) . If you have a genetic predisposition to developing inflammatory bowel disease (IBD) , your first symptoms of IBD may occur after you have traveler's diarrhea. If your traveler's diarrhea is severe and caused by a bacterial infection, you may also experience symptoms such as blood or mucus in your stool and fever.

How does a doctor recognize this?

Most of the time, a doctor can tell if you have traveler's diarrhea by asking about your symptoms and where you've been. But sometimes, your doctor may recommend a stool test to find out exactly what type of infection you have. This can help determine the right treatment, especially if a parasitic infection is suspected. It may be necessary to test more than one sample to confirm the infection.

What are the treatments?

Your doctor will tell you to get plenty of rest and drink plenty of fluids . Some sports drinks and over- the-counter sports rehydration formulas can help replace lost electrolytes .

However, if your symptoms are severe or do not improve within a few days, your doctor may prescribe antidiarrheals or antibiotics .

Antidiarrheal drugs

These medications only control your diarrhea, they don't cure the infection. They just slow down your bowel movements (motility) – the contractions of the muscles that push stool through your intestines – a little. This gives your intestines more time to absorb water from your stool back into your body.

The downside is that the germs are still in your body. You are still sick, and you can still spread the disease to others. So you should follow your doctor's instructions exactly when using these medications. It is wise to carry a few of these medications with you when traveling:

• Atropine diphenoxylate (e.g. Lomotil® )
• Bismuth (e.g. Pepto-Bismol® )
• Loperamide (e.g. Imodium® )

Antibiotics

If you have a severe bacterial infection, or if your diarrhea doesn't improve after a few days, your doctor may prescribe antibiotics. Some of the most common types of antibiotics are:

• Ciprofloxacin (e.g. Cipro® )
• Levofloxacin (e.g. Levaquin® )
• Azithromycin (e.g. Zmax® )
• Rifaximin (e.g. Xifaxan® )
• Metronidazole (e.g. Flagyl® ) (especially for parasitic infections)
• Nitazoxanide (e.g. Alinia® ) (for parasitic infections)

Important: Never take antibiotics on your own without consulting a doctor. Doing so can cause other problems.

Are there natural treatments?

Some natural remedies, such as oil of oregano or extract of echinacea, are said to help prevent infections that cause traveler's diarrhea. However, you should always check with your doctor to make sure these are safe for you to use.

What to expect if you develop Traveler's Diarrhea?

Like most people, you will recover in a few days. If you have severe symptoms, or if symptoms persist, and you are still traveling, ask your embassy in your country, a trusted person, or a good doctor in the area.

How can you survive this?

It's impossible to avoid all the germs that cause traveler's diarrhea, but you can greatly reduce your risk by following these steps:

• Wash your hands thoroughly , especially before eating. Apply soap and rub your hands together for at least 20 seconds.
• Carry an alcohol-based hand sanitizer to use in places where handwashing facilities are not available.
• When bathing, be careful not to let the water from the shower enter your mouth .
• Use bottled water to brush your teeth. Never use tap water.
• Avoid drinks with ice cubes, as the ice cubes may have been made with tap water.
• If you eat fresh vegetables and fruits, choose only those that you can peel yourself. Avoid buying pre-cut fruits from the store.
• Only eat well-cooked, hot food. Don't go to every food stall you come across.
• Only use canned or bottled beverages. Also check that they are properly sealed.

How do I take care of myself?

If you or your child gets traveler's diarrhea, these things may help:

• Drink plenty of fluids: Bottled water, some sports drinks, and oral rehydration solutions like Jeevani, which you can buy at the pharmacy, all help maintain body water levels.
• Eat, but be careful: First , try light soups and ice packs . Then try the BRAT diet ( Bananas , Rice, Applesauce, Toast ). These are easier to digest. It's best to avoid oily, spicy, and dairy foods for a few days.

When do you need to see a doctor?

If you experience any of these symptoms, be sure to see a doctor:

• If you have blood or mucus in your stool , or if you see any of these things after going to the toilet and wiping.
• High fever (over 38.5 degrees Celsius / 101.3 degrees Fahrenheit).
• If you have loose stools more than three times a day , whether during treatment or while taking medication.
• If you have a severe stomach ache .
• If you have signs of dehydration (dry mouth, sunken eyes, decreased urination, dark urine, excessive thirst, rapid heartbeat, dizziness).
• If symptoms do not improve after a few days or become worse.

The most important thing (Take-Home Message)

Traveler's diarrhea may not be a factor in your travel plans, but it can happen if you accidentally ingest contaminated food or drink. You can reduce your risk by washing your hands frequently, drinking bottled water, and limiting your intake of well-cooked foods and canned drinks .

If you are unfortunately affected by this condition, don't panic. Get plenty of rest and fluids. Most of the time you will feel better in a few days. If not, see a doctor immediately. Have a safe and healthy journey!

` Traveler's diarrhea, diarrhea, stomach upset, germs, travel, food poisoning, dehydration