Preventing or treating traveler’s diarrhea

I had my reservations about writing on traveler’s diarrhea, until I read that it affects up to 70% of travelers. It usually doesn’t require medication, but it sure can ruin a trip.

Some precautions include staying away from tap water, lettuce, ice cubes and undercooked foods (in high-risk locations). Another option would be preventive antibiotics before your trip or antibiotics that you bring and take at the first symptom. Travel medicine specialists are divided about which medicinal approach is best.

“We arm every traveler [going to high-risk areas] with antibiotics,” says Dr. Herbert L. DuPont, director of the Center for Infectious Diseases at the University of Texas School of Public Health, Houston, and chief of internal medicine at St. Luke’s Episcopal Hospital, Houston.

For prevention, he prescribes rifaximin (Xifaxan), a drug that blocks most of the organisms that cause traveler’s diarrhea. DuPont helped develop the drug but has no financial connection with the manufacturer. He recommends it for travelers to Mexico and Latin America, Southeast Asia and Africa if the trip is three weeks or less.

“If you’re going longer, it’s not a good idea,” he says, because the drug is expensive at $3.50 a pill and because immunity develops over time with repeated exposure.

But others, including the federal Centers for Disease Control and Prevention, don’t recommend antibiotics as a preventive for traveler’s diarrhea. I’m not sure why exactly when they are mostly effective.

“Most travel medicine doctors don’t give preventive medicine across the board,” says Dr. Terri Rock, a travel medicine physician in Santa Monica. She prescribes preventive antibiotics for “those who have had a tough time with traveler’s diarrhea or those who can’t miss a single day of their trip.” Travelers might bring emergency antibiotics such as Cipro (ciprofloxacin) instead.

I was surprised to read that traveler’s diarrhea is such a common problem, never having suffered from it personally. I think these are things that helped me avoid the problem.

I tend to eat safe foods: steaming hot or dry (like bread). Moist, room temperature foods are the worst. In a developing country avoid foods like salad and cold meat. Also avoid milk products unless you can be certain they were pasteurized. Beer and wine should be fine, but alcohol diluted with water or ice could be a problem. Even fruit juices served in a glass could be diluted with contaminated water.

Medications like Prilosec reduce stomach acid and put you at higher risk for traveler’s diarrhea. Just in case you needed some extra incentive to be careful…

Filed Under: International travel medical insurance

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  1. Scott says:

    I’d suggest stop listening to out of touch physicians.

    Why antibiotics AREN’T the most effective? Taking them before you are infected kills the beneficial fauna in your intestines. And in this day of increasing resistance to antibiotics I am very suprised any physician would recommend taking then as prophylacticly.

    This leaves you even more susceptible to getting sick. You would be better off reinforcing your own bio-fauna (yogurt cultures, acidophilous, etc) before traveling. If you do get sick, two schools of thought – get it out as quickly as possible by letting the body react or take an anti-diarrheal.

  2. A. MC LEISH says:

    HAVING TRAVELED A LOT TO OFFSHORE PLACES, I HAVE FOUND THAT GETTING A BOTTLE OF LACTINEX AND TAKING IT BEFORE TRAVELING PUTS ENOUGH (BILLIONS)

    OF INTESTINAL FLORA IN ME AND KEEPS ME FROM HAVING ANY DIGESTIVE UPSETS. I RECCOMMENDEDED IT TO MY MD WHO ALWAYS HAD PROBLEMS WHEN VISITING ARGENTINA AND HE BECAME A BELIEVER AFTER NOT GETTING SICK FOR SEVERAL TRIPS. ONE SIMPLY CHEWS 4 TABLETS AND DRINKS WATER OR MILK AND DO THIS A COUPLE DAYS BEFORE TRAVELING…….EVEN AIRPLANE FOOD CANT ADVERSLY AFFECT YOU!

  3. A. MC LEISH says:

    SCOTT, YOUR POST OF MARCH 14 IS RIGHT ON AND I AGREE WITH YOU ABOUT THE ADVERSE EFFECTS ON THE DIGESTIVE TRACT.

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