Definition

Traveler's diarrhea causes loose, watery stools. People can get traveler's diarrhea when they visit places where the water is not clean or the food is not handled safely. This can include developing countries in Latin America, Africa, the Middle East, and Asia.

This article tells you what you should eat or drink if you have traveler's diarrhea.

Alternative Names

Diet - traveler's diarrhea; Diarrhea - traveler's - diet; Gastroenteritis - traveler's

Function

Bacteria, parasites, and other substances in the water and food can cause traveler's diarrhea. People who live in these areas don't often get sick because their bodies are used to the bacteria or parasites.

You can lower your risk of getting traveler's diarrhea by avoiding water, ice, and food that may be contaminated. The goal of the traveler's diarrhea diet is to make your symptoms better and prevent you from getting dehydrated.

Side Effects

Traveler's diarrhea is rarely dangerous in adults. It can be more serious in children.

Recommendations

How to prevent traveler's diarrhea:

WATER AND OTHER DRINKS

• Do not use tap water to drink or brush your teeth.
• Do not use ice made from tap water.
• Use only boiled water (boiled for at least 5 minutes) for mixing baby formula.
• For infants, breastfeeding is the best and safest food source. However, the stress of traveling may reduce the amount of milk you make.
• Drink only pasteurized milk.
• Drink bottled drinks if the seal on the bottle hasn't been broken.
• Sodas and hot drinks are often safe.

FOOD

• Do not eat raw fruits and vegetables unless you peel them. Wash all fruits and vegetables before eating them.
• Do not eat raw leafy vegetables (e.g., lettuce, spinach, cabbage) because they are hard to clean.
• Do not eat raw or rare meats.
• Avoid uncooked or undercooked shellfish.
• Do not buy food from street vendors.
• Eat hot, well-cooked foods. Heat kills the bacteria. But do not eat hot foods that have been sitting around for a long time.

WASHING

• Wash hands often.
• Watch children carefully so they do not put things in their mouth or touch dirty items and then put their hands in their mouth.
• If possible, keep infants from crawling on dirty floors.
• Check to see that utensils and dishes are clean.

There is no vaccine against traveler's diarrhea.

Your health care provider may recommend medicines to help lower your chances of getting sick.

• 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.
• People who are at risk for more dangerous infections (such as people with chronic bowel diseases, kidney disease, cancer, diabetes, or HIV) should talk to their provider before traveling.
• In some cases, your provider may provide a prescription for an antibiotic to be taken if you develop severe diarrhea, especially if it is accompanied by fevers or if there is blood in the stool. Azithromycin is the most common option, though ciprofloxacin may also be recommended.

If you have diarrhea, follow these tips to help you feel better:

• Drink 8 to 10 glasses of clear fluids every day. Water or an oral rehydration solution is best.
• Drink at least 1 cup (240 milliliters) of liquid every time you have a loose bowel movement.
• Eat small meals every few hours instead of three big meals.
• Eat some salty foods, such as pretzels, crackers, soup, and sports drinks.
• Eat foods that are high in potassium, such as bananas, potatoes without the skin, and bottled fruit juices.

Dehydration means your body does not have as much water and fluids as it should. It is a very big problem for children or people who are in a hot climate. Signs of severe dehydration include:

• Decreased urine output (fewer wet diapers in infants)
• Dry mouth
• Few tears when crying
• Sunken eyes

Give your child fluids for the first 4 to 6 hours. At first, try 1 ounce (2 tablespoons or 30 milliliters) of fluid every 30 to 60 minutes.

• You can use an over-the-counter drink, such as Pedialyte or Infalyte. Do not add water to these drinks.
• You can also try Pedialyte frozen fruit-flavored pops.
• Fruit juice or broth with water added to it may also help. These drinks can give your child important minerals that are being lost in the diarrhea.
• If you are breastfeeding your infant, keep doing it. If you are using formula, use it at half-strength for 2 to 3 feedings after the diarrhea starts. Then you can begin regular formula feedings.

In developing countries, many health agencies stock packets of salts to mix with water. If these packets are not available, you can make an emergency solution by mixing:

• 1/2 teaspoon (3 grams) of salt
• 2 tablespoons (25 grams) sugar or rice powder
• 1/4 teaspoon (1.5 grams) potassium chloride (salt substitute)
• 1/2 teaspoon (2.5 grams) trisodium citrate (can be replaced with baking soda)
• 1 liter of clean water

Get medical help right away if you or your child has symptoms of severe dehydration, or if you have a fever or bloody stools.

References

Ananthakrishnan AN, Xavier RJ. Gastrointestinal diseases. In: Ryan ET, Hill DR, Solomon T, Aaronson NE, Endy TP, eds. Hunter's Tropical Medicine and Emerging Infectious Diseases. 10th ed. Philadelphia, PA: Elsevier; 2020:chap 3.

Centers for Disease Control and Prevention website. Travelers' diarrhea. wwwnc.cdc.gov/travel/page/travelers-diarrhea. Updated May 3, 2023. Accessed November 28, 2023.

Nitzberg M, Smereck J. Diarrhea. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 27.

Riddle MS. Clinical presentation and management of travelers' diarrhea. In: Keystone JS, Kozarsky PE, Connor BA, Nothdurft HD, Mendelson M, Leder, K, eds. Travel Medicine. 4th ed. Philadelphia, PA: Elsevier; 2019:chap 20.