Traveler’s Diarrhea Part 2: Treatment

This is part two of our mini-series on traveler’s diarrhea (TD). If you want more information about what TD is, and how to prevent it, check out part one.

Unfortunately, TD is not completely avoidable. We covered prevention in the last article, but what do you do once you have it? Here are a few tips...

Stop Traveling
Trust me, getting on a plane/train/bus when you have the shits, stinks big time (no pun intended). Get a room, stay put, wait until things clear up a bit. Besides, the less you move, the less likely you are to spread your disease. And if you do have to go to a doctor, at least you’re in a familiar place.

Drink Water, Lots of Water
TD causes dehydration. The longer you have it, the more dehydrated you will be. Start drinking lots of (purified) water as soon as symptoms start. Children are especially susceptible to severe dehydration, which is the leading cause of death from TD. It is unlikely that adults will become severely dehydrated unless you are also vomiting and have been ill for several days. In which case, seek professional help.

Oral Rehydration Salts (ORS)
In addition to drinking water, your body needs to replenish other vitamins and electrolytes. The easiest way to do this is with Oral Rehydration Salts (ORS). Little packets of these salts are sold pretty much worldwide. Although they do their job very well, they taste awful – sort of like dissolving a bottle of aspirin in a vat of salt water. If you are really sick, or in a very remote area, bring some with and use them. Otherwise, just drink whatever fluids you can.

Take Antibiotics
Don’t leave home without a set of broad spectrum (first-line) antibiotics. Ciprofloxacin (Cipro) and Levofloxacin are the most common. In the US, any reasonable doctor will give you a prescription without hassle, and thankfully they are relatively cheap.   

The CDC recommends that at the first onset of TD, you take a dose of antibiotics (500mg). And if you can handle a double dose, take that. The double dose makes me feel like crap. Nothing worse than having TD and taking drugs that make you want to puke. However, studies have shown that a single dose can help cure TD, and it certainly doesn’t harm anything.

Resistance to Antibiotics
Certain bacteria have increasingly built up resistance to first-line antibiotics. If you’re going to certain places (specifically parts of Asia and sub-Saharan Africa), you might want to look into other meds. Unfortunately, there is no good alternative to Cipro and the resistance problem is getting worse. For this reason it is NOT recommended to take antibiotics as a preventative drug. Although it may reduce your chances of getting TD, this practice “may potentially contribute to drug resistance.”

Malaria Meds Don’t Work as Antibiotics
For a while Doxycyline, the daily anti-malaria drug, was highly recommended because it also helped to prevent TD. However, in recent years, most places around the world have built up resistance to this drug. It is no longer considered effective in preventing or treating TD. Don’t worry, it still works to prevent of Malaria.
 
Antimobility Agents
What a great way to describe the drug that plugs you up. I use to live by these meds. Every time I had diarrhea I’d take two and go on with the day. Turns out, that’s really not the best idea.

The reasoning is simple. Whatever it is that is causing you to be ill (vomiting or diarrhea) needs to get OUT of your body. The easiest way for your body to fight the bacteria is to simply remove it from your system.

Preserve the use of anti-mobility drugs for when you really need to travel and you simply don’t have the option of going to the restroom at the drop of a hat. If you’re going to take this drug, be sure to follow it with a dose of antibiotics.

Go See a Doctor
If things don’t get better in 48 hours, for goodness sake, go find a doctor. Generally people are very helpful when you’re in need of medical care and a trip to a doctor isn’t going to break the bank. There are many diseases out there that have similar symptoms to basic TD, but are in fact much more serious. If your symptoms stretch beyond those of rudimentary bacterial infection or last longer than a couple of days, head to the nearest clinic.

Resources

CDC Yellow Book: Chapter 2
CDC Disease Information
CDC Self-Treatable Conditions