Traveler’s Diarrhea: Avoiding or addressing this unwelcome travel companion

You’re finally on that long-awaited overseas trip when you find yourself repeatedly and frantically running to the bathroom with unwelcome bouts of diarrhea. To top it off, you have explosive gas, cramps, fever, nausea and vomiting, malaise, bloating and loss of appetite. You are the unfortunate victim of traveler’s diarrhea – an illness that can wreck the best made vacation plans.

Traveler’s diarrhea is most often caused by a stomach or intestinal infection contracted by eating contaminated food or drinking contaminated water. More rarely, it is caused by the stress or change of diet related to traveling. So how do you avoid this dreaded illness and what do you do if you fall victim to it?

Follow these tips to help avoid traveler’s diarrhea:

  1. Don’t consume dangerous or risky food and drink. See below for a quick reference list prepared by the U.S. Centers for Disease Control and Prevention (CDC).
  2. Wash your hands frequently. Use soap and water if available and wash thoroughly for at least 20 seconds – about the time it takes to sing the “Happy Birthday” song twice. If you don’t have access to soap and water, use an alcohol-based hand sanitizer.
  3. When visiting a high-risk country, brush your teeth with bottled water. In fact, avoid unsterilized water for any use.
  4. Talk to your physician before leaving the country. Some doctors recommend taking antibiotics with you on the trip. That way, should you contract traveler’s diarrhea you are able to start treating the infection immediately. However, taking antibiotics as a preventive measure is not recommended. Other doctors suggest taking Pepto-Bismol as a preventive measure. It’s best that you take medications with you, as the safety and accessibility of medications in other countries cannot be guaranteed.

What to do if you contract traveler’s diarrhea:

  1. Take anti-diarrheal medication, preferably purchased in the United States to ensure its safety and efficacy.
  2. Drink a lot of fluids to stay hydrated.
  3. Watch for signs of dehydration. The “skin pinch test” is a good indicator. Pinch the skin on the back of your hand and pull it up. Once you let loose, the skin should quickly go back into place. Skin that stays up and slowly drops into place indicates dehydration. Other signs of dehydration are low urine output, dark urine, headache, extreme thirst and heart palpitations.
  4. Contact your physician immediately if you show signs of dehydration or have diarrhea that is severe, lasts more than a few days or is bloody.

The CDC has compiled a handy reference list for individuals traveling to high-risk countries, which include most of Asia (except Japan), Middle East, Africa, Mexico, Central America and South America.


  • Food that is cooked and served hot (do not eat food from a buffet)
  • Food from sealed packages
  • Hard-cooked eggs
  • Fruits and vegetables that have been washed in safe water or that you have peeled yourself
  • Pasteurized dairy products

Don’t Eat

  • Food served at room temperature
  • Food from street vendors
  • Raw or soft-cooked (runny) eggs
  • Raw or undercooked (rare) meat or fish
  • Unwashed or unpeeled raw fruits and vegetables
  • Condiments (such as salsa) made with fresh ingredients
  • Salads
  • Flavored ice or popsicles
  • Unpasteurized dairy products
  • Bushmeat (monkeys, bats or other wild game)


  • Water, sodas or sports drinks that are bottled and sealed (carbonated is safer)
  • Water that has been disinfected (boiled, filtered, treated)
  • Ice made with bottled or disinfected water
  • Hot coffee or tea
  • Pasteurized milk

Don’t Drink

  • Tap or well water
  • Fountain drinks
  • Ice made with tap or well water
  • Drinks made with tap or well water (such as reconstituted juice)
  • Unpasteurized milk

If you are planning to travel and concerned about gastrointestinal issues, talk to your GIA physician before the trip. Make an appointment today at 865-588-5121.