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Traveler’s Diarrhea

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Although international medical insurance is important it is also important to be so prepared in order to avoid health problems overseas.

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Traveler’s Diarrhea

Traveler’s diarrhea, or “Montezuma’s Revenge” can be prevented by careful selection of food and water.

  • Safe, hot-cooked foods, fruits you peel yourself, carbonated beverages, fresh bread are among those.
  • Unsafe are street vendor foods, ice, salads, unpeeled fruits, uncooked vegetables, unpasteurized dairy, tap water, pastry, icing.

Unsafe are street vendor foods, ice, salads, unpeeled fruits, uncooked vegetables, unpasteurized dairy, tap water, pastry, icing.

Remember the Peace Corps adage: “Boil it, cook it, peel it, or forget it.”

Active Intervention of traveler’s diarrhea: food disinfection by boiling, cooking, baking

  • Avoidance of contamination after cooking
  • Eat food while hot
  • Disinfect water by boiling 3-5 minutes
  • Chemical disinfection: chlorine bleach 5%, tincture of iodine 2%, or tertraglycine hydroperiodine
  • Tablets (trade name Potable Agua found at camping stores)
  • Filter pumps will be helpful (viruses and hepatitis A are not filterable, however)

Travelers are urged to seek medical help when severe diarrhea develops especially if blood is present,

  • If diarrhea lasts more than 3 days
  • If accompanied by high fever, shaking, chills
  • If diarrhea results in dehydration

Remember in children, extra caution is indicated; high fever, dehydration, and loss of appetite are a signal for medical intervention

Practical advice

Prepare a glass of one of the following:

Orange, Apple or Other Fruit Juice, 8 oz AND 8 oz. carbonated or boiled water
or ¼ tsp. baking soda in 6 oz
Honey or Corn Syrup, ½ tsp. in 6-8 oz.
Table Salt, 1 whole pinch in 8 oz
  • Drink alternately from each of the glasses, supplemented with carbonated beverages if desired.
  • It is important that infants receive clean, plain water as desired when taking these salt solutions.
  • Finally, eating solid foods will not delay recovery from diarrhea. It may help preserve your strength. EAT!

When to Treat Traveler’s Diarrhea

  1. After the 2nd or 3rd day, especially if you cannot afford to be sick.
  2. High risk patients who are immune compromised, chronically ill or with gastric surgery, after 24 hours
  3. Bismal salicylate (Pepto-Bismal) is effective but should be avoided in pregnancy
  4. Ciprofloxin 500 mg. daily can be taken
  5. Bactrim, which is Tri-Sulfa once a day
  6. Doxycycline 100 mg. once a day (one of the advantages of using it as an anti-malarial)
  7. CDC recommends, however, using drugs like Immodium 2 tabs initially and 1 after each loose stool as the primary approach
  8. Ofloxacin, 400 mg. has been used as well
  9. 2nd line options: Zithromax or Flagyl if diarrhea is not responding
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