Traveler’s Diarrhea
Photo by Vlada Karpovich from Pexels
Some of the best parts of cruising in a foreign country are when you can enjoy a meal out at a restaurant. Savoring the local cuisine and lavishing in a night away from cooking and cleaning in your small, cramped galley are moments many look forward to. Want to know some of the worst parts of cruising - when that lovely meal you had last night doesn’t sit so well in your stomach the next morning. Your belly starts bubbling from gas pains and then you have to immediately drop everything you’re doing and pray you are going to make it to the bathroom in time. Traveler’s Diarrhea has struck again! It’s one of the most common ailments that can befall a traveler in a foreign country and can zap the fun out of any trip. Diarrhea and a belly ache are just a few of the unpleasant symptoms you may experience. And let’s not even think about the kind of havoc the durchfall can wreak on a marine head! Let’s see how we can avoid such an unpleasant and messy situation and still enjoy a night out every now and then.
What is traveler’s diarrhea?
Anyone who travels to a foreign country is at risk of coming down with a bout of diarrhea. Diarrhea is the most common travel-related illness. It’s caused by bacteria and viruses that may be present in food and water in areas with warmer climates. It is also more prevalent in less developed countries where clean water and plumbing may be scarce or expensive to run. It can last for 1-3 days and for most people it will not develop into anything more serious. It is also not unusual to experience more than one bout of diarrhea during a trip. You are more likely to experience traveler’s diarrhea if you are visiting countries in the following areas:
· Central and South America
· Africa
· Asia and Southeast Asia (excluding Japan and South Korea)
· Some Caribbean islands
· Mexico
· Middle East
A bacteria called E. coli is the most common cause of diarrhea and can appear in food and water when conditions are unsanitary. Some other common contaminants are rotavirus, shigella, salmonella, giardiasis, and norovirus just to name a few. Food products rinsed in contaminated water or drinking untreated water can make you sick. Residents of these areas have built up immunity and do not seem to become ill like foreign travelers do.
What are some symptoms of traveler’s diarrhea and do I need to see a doctor?
Symptoms can appear within a few hours to a few days of ingesting the bacteria. Most people will get sick for 1-3 days and be completely recovered in about a week with no treatment necessary. Diarrhea is the most notable sign but some other unpleasant symptoms are cramping, nausea, vomiting, and fever. Dehydration is a big concern and you want to try your best to prevent that from happening. I know it’s hard to consume enough fluids when you feel like you are just evacuating all your insides, but a trip to the hospital would be worse.
If dehydration does occur you should seek medical attention. What are some other signs that further help is needed? If the diarrhea lasts for more than a few days or at any point becomes black or bloody, see a doctor. Also if you develop a persistent fever over 102 F and cannot stop vomiting, you’ll want to get treated as well. Children are especially susceptible to dehydration when they are sick so monitor them closely. Dehydration can happen very fast in little ones so call a doctor if you notice any of the following signs:
· Fever of 102 F or more
· Persistent vomiting
· Bloody stools
· No tears when crying
· Decreased urine output
· Being unusually tired or unresponsive
How to treat traveler’s diarrhea
1. Stay Hydrated - If you do get sick, generally you will get better without any treatment. Keeping hydrated will be the most important thing you can do to prevent further complications and to feel better quickly. Using oral rehydration packets or liquids will keep you hydrated and prevent electrolyte loss. There are several you can buy these days. Companies like Liquid IV and Pedialyte make a powder solution you can add to water and drink. They come in small packets which make for easy storage on a boat. Pedialyte is great for both children and adults to use. Remember to boil the water and let it cool before mixing and drinking. Drinking the local water is potentially what got you here in the first place so take every precaution! Drink small amounts throughout the day along with food as you can stomach it. Small quantities spread out will help prevent nausea and vomiting. If dehydration persists or your symptoms continue to worsen you should go to the doctor right away.
2. Anti-Diarrhea Medications – Imodium (or the generic Loperamide) is available over-the-counter and can be taken to help reduce the amount of time you are spending on the toilet in the head. This medication is only to help with diarrhea and will not treat the actual infection. Imodium is for adults and children 6 and older. Always follow the instructions carefully on the back of the package, especially if giving to children. Dosing by your child’s weight and age is available on the Imodium website. You should not take Imodium if you have a fever, bloody stools, or if you are immunocompromised.
3. Bismuth Subsalicylate – known as Kaopectate or that pink stuff we all know as Pepto-Bismal. Either are available over-the-counter can be used to help treat diarrhea, nausea and general upset stomach. These are for adults only (unless you buy the kids Pepto) and should not be taken if you are pregnant or have an aspirin or NSAID allergy. They can interact with many medications so you should not take it if you are on aspirin therapy, certain antibiotics, methotrexate or probenecid just to name a few. If you plan on carrying this med with you on your travels for scenarios such as this, check with your doctor or pharmacist before you leave home to determine if any of your current medications will cause an interaction. Also keep in mind that these products can cause black, tarry stools which should go away when you discontinue use.
4. Antibiotics – In more severe cases of diarrhea, your doctor may prescribe antibiotics. Typically these are reserved as last line due to the risk of developing antibiotic resistant microbes. Azithromycin, ciprofloxacin, levofloxacin and rifamycin are the most common antibiotics prescribed. Follow all directions given by your doctor and always finish your prescription of antibiotics regardless of if you are feeling better. This helps to prevent antibiotic resistance in bacteria.
Watch what you eat and wash your hands!
The number one way to prevent diarrhea from making an unwelcome visit is to be very aware of what you are eating and drinking when in a foreign country. Stick to drinking only bottled water and do not have ice in any of your drinks. Use bottled water to brush your teeth and if washing fruits or vegetables that you will be eating raw. Make sure to keep your mouth shut when showering and that all dishes and utensils are dry before using. Using tap or untreated water to cook is generally considered safe as long as you bring the water to a boil for at least three minutes and cook the food entirely. Heat will destroy any bacteria present.
When eating out, stick to places that look like they are following safe food handling practices. Only eat food that is thoroughly cooked and try to avoid street vendors and buffets where hand washing practices may be lax or non-existent. You should also follow good hygiene routines. Always wash your hands for at least 20 seconds with soap and water before handling and eating food. If water is unavailable, use an alcohol based hand sanitizer with at least 60% alcohol instead.
Preventative antibiotics are not recommended anymore due to the growing possibility of antibiotic resistance. Pepto-bismal and Kaopectate taken as a preventative measure have been shown to reduce your risk of contracting traveler’s diarrhea but they do come with the risk of side-effects (constipation, black tongue and stool) and should not be used for more than 2 weeks at a time. Remember, they are not suitable for everyone so you should talk to your doctor before deciding to take these products.
Stay safe out there
Traveler’s diarrhea can happen to anyone anywhere so knowing your risk and what to do if you get sick are important factors in having a healthy and happy trip. Always keep those good hygiene practices in mind. If anything good has come from Covid I would say it has been teaching us all some proper hand-washing techniques. Do your best to avoid unsanitary conditions or undercooked food and hopefully you’ll prevent some prolonged hangouts in the head!
*This post contains affiliate links, so I may earn a small commission when you make a purchase through links on this site at no additional cost to you. Thank you so much for your support!*