Traveler’s Diarrhea: Treatment, Antibiotic, and Prevention (2024)

What is traveler’s diarrhea?

Traveler’s diarrhea is a digestive tract disorder. It consists of abdominal cramps and diarrhea that’s most often caused by consuming food or water that the body isn’t familiar with.

If you’re visiting an area where either the sanitary practices or the climate are different than what you’re used to at home, you’re more likely to experience traveler’s diarrhea.

It’s most common to get traveler’s diarrhea while visiting:

  • Mexico
  • Central America
  • South America
  • Africa
  • the Middle East
  • most of Asia (excluding Japan)

It can be caused by bacteria, viruses, or parasites.

Traveler’s diarrhea typically goes away on its own within a few days. It can cause dehydration, which can be dangerous, especially for children. It’s often contagious, however, and passed from person to person regardless of the cause.

Loose, watery diarrhea and abdominal cramps are the most universal symptoms you’ll experience with traveler’s diarrhea. Other symptoms may depend on the cause of the condition. Symptoms can include:

  • nausea
  • vomiting
  • fever
  • bloating
  • excessive gas
  • loss of appetite
  • an urgent need to defecate

These symptoms are all normal. However, there are some symptoms that indicate it’s time to see a doctor immediately. These include:

  • severe, intolerable pain in the abdomen or rectum
  • persistent vomiting for more than four hours, resulting in the inability to keep liquids down
  • fever higher than 102˚F (39˚C)
  • bloody stools
  • symptoms of dehydration

If your traveler’s diarrhea hasn’t resolved within three days or your symptoms worsen, make an appointment to see your doctor.

At your appointment, let your doctor know that you’ve recently been traveling. They’ll perform a physical exam that includes taking your temperature and pressing on your abdomen. They’ll likely order a stool test to search for evidence of parasites, and may order a blood test to check for infections. The blood work can also detect whether or not you’re currently dehydrated.

The most common complication of traveler’s diarrhea is dehydration. This can be very serious. Dehydration can easily occur when the diarrhea causes the body to lose fluids at a faster rate than they can take them in. Vomiting and nausea, which sometimes accompany diarrhea, can make this worse. Dehydration can be particularly dangerous for young children. Know the warning signs of dehydration in toddlers.

Symptoms of dehydration include:

  • dry mouth
  • increased thirst
  • decreased urine output
  • headache
  • dizziness
  • dry skin
  • confusion

Traveler’s diarrhea caused by a parasitic infection typically needs to be treated with medications, or the infection could become more severe. Parasitic infections can cause:

  • seizures
  • fever
  • allergic reactions
  • bacterial infections

Tapeworms embed their heads into the intestinal wall, but can lay eggs that move to other parts of the body. Fluke worms can cause fatigue. Hookworms can cause anemia and fatigue. Trichinosis worms can cause:

  • fever
  • headache
  • conjunctivitis
  • swelling of the face
  • muscle pain

Treatment will depend on the cause of the diarrhea. The first line of defense will often be home remedies and over-the-counter (OTC) treatments to resolve mild cases of the illness.

When you get traveler’s diarrhea, avoid caffeine and alcohol. These may increase dehydration. However, continue to drink other fluids as much as possible to prevent dehydration.

Try to stick to bland foods you know have little risk of contamination and that your body is familiar with.

  1. toast
  2. broth
  3. crackers
  4. white rice
  5. apples (washed with filtered water)
  6. bananas

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If you’re traveling, it’s often a good idea to bring OTC treatments with you just in case you get traveler’s diarrhea. Bismuth subsalicylate (Pepto-Bismol) can be effective for treating mild cases of traveler’s diarrhea. Use it according to the instructions on the box.

Antimotility agents like Imodium can also be used, but they should be saved for emergencies, like airplane travel. They may prolong the illness by not allowing your body to eliminate it.

Doctor-prescribed treatments

If home remedies haven’t worked, your doctor will prescribe treatment based on the cause of the illness. If you have a bacterial infection, they’ll prescribe antibiotics like doxycycline (Acticlate) or ciproflaxin (Cipro).

If you have parasites, your doctor will prescribe oral antiparasitic drugs. The exact prescription will depend on the type of parasite infection you have. You’ll likely need to take several rounds of the parasitic drug to ensure the infection is completely out of your system.

If traveler’s diarrhea has caused dehydration, you’ll be given intravenous fluids that may contain glucose or electrolytes.

Traveler’s diarrhea typically resolves within two to three days, but even mild cases can last up to seven days. It may resolve faster with treatment. Because symptoms may not start until several days after exposure, it may be difficult to pinpoint exactly what made you sick.

While recovering, be particularly careful to avoid any contaminated food or water sources. This will speed up healing and prevent continued or repeat exposure.

The best ways to prevent traveler’s diarrhea is careful sanitation practices and to choose water and food carefully.

When visiting high-risk countries, don’t drink unsterilized water. This includes:

  • drinks with ice made with local water
  • fruit juices with added water
  • brushing your teeth or rinsing out your mouth with tap water

Try to drink bottled water. If that’s absolutely not an option, boil the water for at least three minutes.

To further prevent developing traveler’s diarrhea, you should:

  • Avoid eating food from street vendors.
  • Be mindful of eating fruit washed in contaminated water.
  • Avoid unpasteurized dairy products, even ice cream.
  • Eat foods that are well cooked and served hot.
  • Avoid foods that are moist or stored at room temperature.

Wash your hands often, especially before eating and touching your face. Keep children from putting anything, including their hands, into their mouth. Use alcohol-based hand sanitizer containing at least 60 percent alcohol if clean water isn’t available to you.

Traveler’s Diarrhea: Treatment, Antibiotic, and Prevention (2024)

FAQs

Traveler’s Diarrhea: Treatment, Antibiotic, and Prevention? ›

Antibiotic regimens can be combined with loperamide 4 mg, initially, followed by 2 mg after each loose stool, not to exceed 16 mg in a 24- hour period. Use empirically as first-line treatment for travelers' diarrhea in Southeast Asia or other areas if fluoroquinolone- resistant bacteria are suspected.

What antibiotics are used to prevent travelers diarrhea? ›

The fluoroquinolones, such as ciprofloxacin, ofloxacin, norfloxacin, and levofloxacin, have been shown to be highly effective in the prevention of diarrhea in travelers (Table ​ 2). Daily ciprofloxacin given at a dose of 500 mg has been shown to be up to 95% effective in preventing traveler's diarrhea (134).

What is the first line of treatment for travelers diarrhea? ›

Although loperamide is the recommended first-line agent, patients should be informed that if the diarrhea worsens or is accompanied by moderate-severe or invasive symptoms (1 or more of fever, moderate to severe abdominal pain or bloody diarrhea), then antibiotics should be used (Table 2).

What can I take to prevent traveler's diarrhea? ›

Taking 2 tablets of Pepto-Bismol 4 times a day before you travel and while you are traveling can help prevent diarrhea. Do not take Pepto-Bismol for more than 3 weeks. Most people do not need to take antibiotics every day to prevent diarrhea while traveling.

What is the best anti diarrhea medicine for travel? ›

Pepto-Bismol has been used for a number of years to prevent travelers' diarrhea. Studies show that if adults take the equivalent of two tabs four times a day, it can decrease the incidence of travelers' diarrhea up to 60%.

Does doxycycline prevent travelers diarrhea? ›

Nausea alone (8%) or nausea with vomiting (4%) occurred in the doxycycline-treated group only and were the only side effects observed (p = 0.003). We conclude that doxycycline is safe and efficacious for the prophylaxis of traveler's diarrhea for short-term exposure in a high risk area.

What antibiotics treat travelers diarrhea and IBS? ›

Rifaximin (Xifaxan) is an oral antibiotic previously marketed for the treatment of traveler's diarrhea and hepatic encephalopathy. It is now also labeled for the treatment of irritable bowel syndrome (IBS) with diarrhea.

How do doctors treat travelers diarrhea? ›

Traveler's diarrhea often is treated with antibiotics. You also can take loperamide (brand name: Imodium), but don't take it without an antibiotic if you have bloody diarrhea. Children, pregnant women, older adults, and other people who get dehydrated easily should drink rehydration solutions.

Is Cipro good for travelers diarrhea? ›

In most cases, a single dose of a quinolone antibiotic (ciprofloxacin, levofloxacin, and ofloxacin are equivalent for TD) is likely to be adequate, even for severe diarrhea. If symptomatic after 24 hours, continue antibiotic for 2 more days.

Do probiotics help travelers diarrhea? ›

When you're away from home, you may get diarrhea when you eat or drink contaminated food or water. There's no hard proof that probiotics work for this problem. Some research shows they help travelers avoid this kind of diarrhea, but other studies show there isn't any benefit.

Is Zithromax good for travelers diarrhea? ›

If antibiotic is needed, take 1 dose of Azithromycin 500mg. If diarrhea continues take a 2nd dose about 12 hours later. Stop antibiotic when diarrhea resolves. If symptoms are not resolved after 24 hours, continue Azithromycin 500mg daily for up to 3 days.

What antibiotics are used for travel? ›

To fight off traveler's diarrhea, a urinary tract infection or sinusitis that may surprise you on your trip, ask your doctor for a short course of an oral antibiotic like ciprofloxacin, levofloxacin (Levaquin) or azithromycin (Zithromax).

How much Cipro should I take for diarrhea? ›

Table 1
AntibioticDosage (adult)
Fluoroquinolones1
Levofloxacin500 mg (single dose) [500 mg (once a day for up to 3 days) for febrile diarrhea or dysentery]
Ciprofloxacin750 mg (single dose); 500 mg twice a day (up to 3 days)
Rifaximin200 mg three times a day (3 days)
5 more rows
Sep 1, 2018

Is Pepto-Bismol or Imodium better for travelers diarrhea? ›

Imodium A-D mainly treats diarrhea. Pepto-Bismol (bismuth subsalicylate) can treat diarrhea and relieve other symptoms, like heartburn, indigestion, and nausea. There's some evidence that Imodium A-D works faster than Pepto-Bismol. But it can potentially interact with other medications you're taking.

Can I take Imodium to prevent travelers diarrhea? ›

Over-the-counter antidiarrheal medications such as diphenoxylate (Lomotil®) or loperamide (Imodium®) can help with symptom control; however, it is important to follow the directions carefully when using these medications.

Why can't you take Imodium with antibiotics? ›

In some cases of mild antibiotic-associated diarrhea, your doctor may recommend anti-diarrheal medications, such as loperamide (Imodium A-D). But check with your doctor before taking anti-diarrheal medications because they can interfere with your body's ability to eliminate toxins and lead to serious complications.

How long does azithromycin take to work for traveler's diarrhea? ›

Azithromycin starts working soon after you take your first dose. Oral azithromycin usually needs about 2 to 3 hours to reach its full concentration in your body, but the effects might not be noticeable right away. You should start to feel better after a few days of taking azithromycin.

What is the best probiotic to prevent antibiotic diarrhea? ›

There is some evidence that the benefits of probiotics are strain-specific. Lactobacillus rhamnosus GG and Saccharomyces boulardii appear to be the most efficacious choice for preventing antibiotic-associated diarrhoea, while Lactobacillus casei may be the best for specifically preventing severe C.

What is the medicine for diarrhea in Mexico? ›

Azithromycin (Zithromax) is typically used to treat traveler's diarrhea.

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