QUESTION: Everybody seems to have another scheme for traveler's diarrhea.
As our long planned and awaited trip comes closer, we are more anxious about not losing precious time from our costly vacation to the "runs".
What's your advice?
ANSWER: Since traveler's diarrhea is usually caused by consuming contaminated food or water in foreign countries where sanitation may be unsatisfactory, the most effective strategy regarding the problem is to be aware of the many sources of infection and then to avoid them.
Certain foods that have been contaminated with E.
coli or other common pathogens (disease causing bacteria) are the primary cause of the disorder, so the first precaution is to only eat well cooked foods piping hot.
Sauces served at room temperature are among the most hazardous and should be avoided at all costs.
Though peeled fresh fruit is usually safe, fresh fruit juice should be avoided.
The moist nature of a fresh salad creates a prime environment for bacterial growth, so it is advisable not to eat salads while traveling abroad as well.
Bread, on the other hand, is usually safe, even when it's left out on a table. Water is a second serious cause of infection and even if it is satisfactorily treated in purification plants, it may still arrive contaminated at the tap.
Tap filters do not decontaminate, so water should be boiled for a minute and then chilled before drinking.
Treating water with sterilization tablets is another option, though it usually effects the taste. The alcohol in alcoholic beverages kills organisms and is therefore safe to consume, but bear in mind that if drinks are served with ice, the ice may cause infection.
Bottled water and bottled carbonated beverages pose no threat. Despite efforts to prevent this condition, travelers may still develop the problem.
In such cases, fluid replacement with mineral water, tea, clear soup, or carbonated beverages is essential for preventing dehydration.
In mild to moderate cases, further treatment should include a nonantibiotic agent such as bismuth subsalicylate suspension.
However, be warned that it may turn the stool black.
In more severe cases with high fever, or if symptoms do not improve within two days, antibiotic therapy may be called for, and you may require the services of a local physician. Whatever the case, diet is a key factor in recovering from a bout of traveler's diarrhea.
Milk and dairy products should be eliminated from the diet during the acute phase, as should caffeinated beverages, alcohol, and most fruits, vegetables, and meat.
Bland foods such as clear soup, crackers, bread, and toast are advisable to start with, and as the diarrhea subsides, rice, potatoes, and chicken soup (why not?) with rice or noodles can be added. When the stools regain consistency, baked fish or chicken, applesauce, and bananas should be introduced to the diet before other foods that may aggravate the system. Since the safety of antidiarrheal drugs taken during pregnancy is unknown, it is worth mentioning that pregnant women should avoid travel into areas recognized as potentially hazardous whenever possible. By taking all these precautions, and maintaining a moderate schedule that neither fatigues nor stresses you, and with just a little bit of luck, you should be able to avoid one of the less pleasant aspects of travel, and enjoy your much anticipated vacation.
The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician.
Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.
