Traveler’s Diarrhea (TD) is a common problem associated with international travel, so having a plan for preventing it or rapidly treating it is important because TD can really ruin your trip. Your risk is related to your destination and your eating/drinking habits while there. The Centers for Disease Control and Prevention (CDC) divides the world into risk categories as follows:
Low-risk countries: United States, Canada, Australia, New Zealand, Japan, and countries in Northern and Western Europe.
Intermediate-risk: Eastern Europe, South Africa, and some Caribbean Islands
High-risk: most of Asia, the Middle East, Africa, Mexico, Central America, and South America
So, if you are travelling to a country in the intermediate or high-risk categories, you should have a plan for preventing TD. That strategy should focus on food and beverage selection. The safest foods are thoroughly cooked and served while hot and foods that are dry or packaged. Fruits and vegetables should be washed in safe water and/or peeled yourself. The safest beverages are bottled and sealed . Here is more information on food and beverage safety from the CDC:
Food and beverage safety
One might wonder if there is anything else one can do to prevent TD. Some studies show that bismuth subsalicylate (BSS), the active ingredient in Pepto-Bismol, can reduce the incidence of TD by around 50%. However, the dosage used is high; 2 tablets or 2 ounces of the liquid 4 times a day. Also, BSS is related to aspirin, so some people should not take it, such as those taking anticoagulants and some other medicines and children less than 12 years old. For these reasons, Pepto-Bismol is not often used for prevention of TD, even though it may be effective.
If you do get TD, then rapid treatment is essential to reduce dehydration and quickly getting back to enjoying your trip. In mild cases of TD, you can usually prevent dehydration with any safe liquid. For more severe cases of diarrhea, however, fluid losses are best treated with oral rehydration solutions. One example is Pedialyte packets, but there are others, too. Pedialyte can be used in children and adults. An over-the-counter anti-diarrheal agent like loperamide (Imodium) is useful and should be on your packing list, too.
Some antibiotics can be used to treat TD, but these are prescription items, and our travel health specialists can coordinate this with your physician as part of our consultation service.
In summary, don’t let TD keep you down on your trip. Have a plan…we can help you develop that plan if you like.