Overview
Diagnosis
Diagnosing traveler’s diarrhea usually starts with a detailed medical and travel history. A physical exam may be performed to check for signs of dehydration. If symptoms are severe or persistent, a stool sample may be analyzed to identify the microorganism causing the infection.
Treatment
Traveler’s diarrhea often improves without treatment, but staying hydrated is essential. Safe liquids include bottled water or oral rehydration solutions with electrolytes.
Medications
• Anti-motility agents – Loperamide and diphenoxylate can reduce gastrointestinal muscle spasms, slow transit time, and allow more absorption. These are not recommended for infants, or for people with fever or bloody diarrhea. If diarrhea persists beyond 48 hours, consult a doctor.
• Bismuth subsalicylate – Can decrease stool frequency and shorten illness duration. Not recommended for children, pregnant women, or those allergic to aspirin.
• Antibiotics – Prescribed if there are more than four loose stools per day or severe symptoms such as fever, blood, pus, or mucus in stools. Travelers may discuss carrying a prescription for emergencies.
Avoiding dehydration
Dehydration is the most common complication, so maintaining fluid balance is critical. Oral rehydration solutions (ORS) contain water, salts, and glucose to restore fluids and electrolytes.
Bottled ORS products are widely available, and powdered WHO-ORS packets can be reconstituted in safe water according to package instructions.
In emergencies, a homemade ORS can be prepared with:
• 3/4 teaspoon table salt
• 2 tablespoons sugar
• 1 quart uncontaminated bottled or boiled water
• Optional sugar-free flavor powder
Drink small amounts throughout the day, supplementing solid foods or formula, to reduce vomiting risk. Breastfed infants should continue nursing on demand.
Seek medical care immediately if dehydration signs such as dry mouth, intense thirst, minimal urination, dizziness, or extreme weakness persist. Oral rehydration solutions are intended for short-term, urgent use.
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