It is not a pleasant idea: the flight to the destination is over, the suitcases are unpacked. Suddenly, severe traveler’s diarrhea or traveler’s diarrhea begins. What should I do? And should I be worried?
What is traveler’s diarrhea?
Traveler’s diarrhea – also known as traveler’s diarrhea in medical circles – refers to an infection of the intestines. It is the most common travel illness. Traveler’s diarrhea becomes noticeable within a few hours to days after arrival in a foreign country. In addition to nausea and vomiting, traveler’s diarrhea manifests itself in at least four bowel movements per day, the consistency of which is deformed to watery. Sometimes blood can also be detected in the stool during traveler’s diarrhea. In severe cases, fever or gastrointestinal cramps may also be present. Sometimes, traveler’s diarrhea may not occur until a few days after returning home from vacation.
Causes
In traveler’s diarrhea, the intestinal flora of the affected person is out of balance. The culprits are viruses or bacteria, the best known of which are salmonella, coli bacteria or norovirus. The germs can be ingested through food. Raw food (fruit, salad, meat, fish) or contaminated drinking water play a major role in traveler’s diarrhea. The cause of traveler’s diarrhea can also be poor hygiene conditions in foreign countries. Problems with the time change as well as climate change do the rest. Even stress, for example due to hectic travel preparations, can contribute to the development of traveler’s diarrhea. Travelers’ diarrhea is most likely to occur in countries with low hygiene standards (e.g., India). Traveling in groups or backpackers are also more likely to suffer from typical traveler’s diarrhea.
Symptoms, complaints, and signs
Traveler’s diarrhea is manifested by thin, watery stools passed several times a day. Frequently, traveler’s diarrhea is accompanied by cramps during bowel movements. The diarrhea may be foul-smelling and contain undigested food components, as unfamiliar, incompatible foods are often the cause of diarrhea on vacation. Germs can also be a cause of traveler’s diarrhea, causing abdominal pain, nausea and general malaise. Fever can also occur as an accompanying symptom. Complaints such as abdominal pain may be present hours before the onset of actual diarrhea. Often, the symptoms abruptly subside as soon as the diarrhea has left the body. However, it is also possible that the discomfort lasts for days. In this case, signs of incipient dehydration are often added. Complaints in the context of dehydration can include headaches, dizziness and general circulatory weakness. Complaints of traveler’s diarrhea can vary in intensity. Mild malaise is possible as well as severe feeling of illness due to the heavy loss of water and incipient problems with the electrolyte balance. While the symptoms of diarrhea proper, watery stools, are very easy to recognize, the signs of associated dehydration may not always be clear in children or the elderly.
Diagnosis and course
The myth that cola with saltines helps with diarrhea is not medically proven. A teaspoon of bentonite with a glass of mineral water shows a better effect. Traveler’s diarrhea can be diagnosed when the typical watery diarrhea occurs shortly after the start of the trip. There are two different courses of traveler’s diarrhea: acute and chronic. Almost all patients suffer from acute traveler’s diarrhea. Usually, traveler’s diarrhea is over after a few days to a week. However, if the symptoms persist or intensify, a doctor must be consulted. Some suffer from such severe diarrhea that a stay in the hospital becomes necessary. One in five sufferers becomes bedridden during this time. However, most suffer only mild cases of traveler’s diarrhea. In about ten percent of patients, acute traveler’s diarrhea turns into chronic traveler’s diarrhea. This means that the diarrhea can persist for up to four weeks.
Complications
Traveler’s diarrhea can cause several complications. First, there is the risk of dehydration, which is associated with physical and mental deficits and may be fatal in children, the elderly, and those who are ill.Acute diarrhea also results in a severe loss of nutrients, which is also accompanied by deficiency symptoms. In extreme cases, both dehydration and nutrient deficiency can lead to kidney failure and subsequently to death. The uncertain hygiene situation at the travel destination can cause the symptoms to persist for several days – making the loss of fluids all the more dangerous. In most cases, however, traveler’s diarrhea is less problematic. The affected person merely suffers from a strong feeling of indisposition and the typical feeling of illness. The treatment of traveler’s diarrhea also carries risks. Over-the-counter diarrhea medications such as racecadotril can cause isolated side effects such as skin rashes, headaches and aching limbs. Rarely, severe skin reactions, swelling, hives, or edema occur. If an infusion is necessary, inflammation and injury may occur in the area of the injection site. Occasionally, the area around the puncture swells and symptoms such as itching and pain occur. Rarely, blood clots and other serious complications occur.
When should you go to the doctor?
Traveler’s diarrhea usually does not require medical consultation. The symptoms are based on an internal experience of stress and are temporary in nature. Usually they last for a few hours or days. Subsequently, there is a spontaneous healing. Food intake must be changed so that the general state of health does not deteriorate further. In addition, a sufficient amount of fluid must be taken in so that a life-threatening situation does not develop. If self-help measures do not take effect, a doctor should be consulted. If there is blood in the stool, a disturbance of consciousness or a feeling of internal dryness, be on the alert. A visit to the doctor is necessary so that medical care can be initiated. If dehydration or loss of consciousness occurs, an ambulance must be alerted. The affected person is in a life-threatening condition and needs a doctor as soon as possible. If travel must be canceled or interrupted due to the symptoms, a doctor’s visit is necessary. An increase in irregularity, internal weakness and complete lack of strength must be investigated. Circulatory problems or loss of sphincter control should be evaluated by a physician. Anyone who regularly suffers from traveler’s diarrhea should seek consultation with a physician or therapist well in advance of the start of a trip. There are several preventive options that can be used.
Treatment and therapy
If the first symptoms of traveler’s diarrhea appear, those affected should drink a lot. Tea and packaged drinking water are best suited for this purpose. Accompanying traveler’s diarrhea can also be treated by medications from the pharmacy. They contain vital electrolytes that the body has excreted as a result of the diarrhea. If there are no electrolytes to buy locally, you can easily prepare a solution yourself. To do this, boil a liter of water and add five tablespoons of sugar, one or two tablespoons of salt and a glass of orange juice. Otherwise, there is no need to follow a special diet for traveler’s diarrhea. Nevertheless, it is advisable to avoid heavy and fatty foods. In case of severe fluid loss, only hospitalization will help. For children, elderly and weak people, persistent traveler’s diarrhea can also become life-threatening. If traveler’s diarrhea is accompanied by fever, bloody stools or gastrointestinal cramps, a doctor must be consulted as soon as possible. In such cases, it is essential to check the blood to see whether it is really just the suspected traveler’s diarrhea. Cholera or typhoid fever would also be conceivable, which would then have to be treated separately.
Prevention
Travelers’ diarrhea most commonly affects travelers to Asia, Africa, and Latin America. For this reason, it makes sense to think of appropriate diarrhea medications before departure. There is no preventive vaccination against traveler’s diarrhea. Drinking water should always be boiled. All food should also be eaten thoroughly cooked. Fresh salad and raw vegetables should be taboo. Care should also be taken with fruit. To avoid traveler’s diarrhea, fruits should either be sufficiently washed or peeled. When brushing your teeth, use only packaged drinking water. Of course, to protect against traveler’s diarrhea, hands should be washed regularly.
Aftercare
In the case of traveler’s diarrhea that occurs due to food intolerances in unfamiliar environments, no special aftercare is required. This is equally true for diarrhea that has occurred, for example, due to unclean water in the vacation region. If the persons affected are not particularly weakened, short-lived traveler’s diarrhea is usually well tolerated by the body and can also be brought to a halt by self-help. Provided the diarrhea stops quickly and there is no particular physical weakness or pain, special aftercare measures are not necessary. Follow-up care may be necessary, however, if the traveler’s diarrhea was very severe and prolonged. In this case, there is a risk of dehydration, especially in children and the elderly. This should also be examined by a doctor during the act phase of the traveler’s diarrhea. Once the diarrhea has been overcome, follow-up care serves to check whether there is now sufficient fluid in the body again and whether all blood values have normalized. In the case of extreme diarrhea, this follow-up is important in order to detect organ damage at an early stage and to be able to treat it immediately if necessary. If the doctor determines that the fluid balance is still not in order and damage is imminent, he or she can prescribe infusions or arrange for further internal examinations.
Here’s what you can do yourself
Traveler’s diarrhea is a troublesome phenomenon that is common but both preventable and treatable through self-help. Prevention in traveler’s diarrhea is extremely important. The rule here is that food should be cooked or peeled if possible, but at least washed down with hygienic water. If necessary, take a bottle of water with you when exploring countries where drinking water does not meet the standards of modern medicine. Fruits and vegetables should be cleaned with special care. Special care should also be taken with ice cubes in drinks in southern countries, as these are often not produced hygienically, making even bottled drinks a source of germs for traveler’s diarrhea. Hands should always be washed before touching the mouth or eating food with the fingers. If traveler’s diarrhea has occurred, there are also self-help remedies. Diarrhea usually passes on its own after one or two days, when the germs have been flushed from the intestines. Until then, replenish fluids lost from the body with still water of perfect origin or herbal teas. Charcoal tablets can relieve acute diarrhea. Psyllium husks are also a side-effect-free way to provide lasting relief from diarrhea while traveling. Flatulent, fatty and spicy foods are better avoided for the period of traveler’s diarrhea.
