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Treatments and drugs
By Mayo Clinic staffBecause traveler's diarrhea tends to resolve itself, you may get better without any intervention. It's important to try to stay hydrated with safe liquids, such as bottled water or canned juice. If you don't seem to be improving quickly, you can turn to several medications to help relieve symptoms.
- Anti-motility agents. These agents — which include loperamide (Imodium A-D), medications containing diphenoxylate (Lomotil), and opiates, such as paregoric and codeine — provide prompt but temporary relief by reducing muscle spasms in your gastrointestinal tract, slowing the transit time through your digestive system and allowing more time for absorption. They aren't recommended for infants or people with fever or bloody diarrhea, as they can delay clearance of the infectious organisms and make the illness worse. Also, stop using anti-motility agents after 48 hours if you have abdominal pain or your signs or symptoms worsen and your diarrhea continues. In such cases, see a doctor.
- Bismuth subsalicylate (Pepto-Bismol). This over-the-counter medication can decrease the frequency of your stools and shorten the duration of your illness. However, it isn't recommended for children, pregnant women or people who are allergic to aspirin.
- Antibiotics. If you have severe symptoms or three or more loose stools within eight hours, a doctor may prescribe a three- to five-day course of antibiotics.
Before you leave for your trip, talk to your doctor about appropriate medications to take with you so that you don't have to buy diarrhea medications while traveling. Some of the drugs available in other countries may be unsafe. Some may even have been banned in the United States.
Avoiding dehydration
Dehydration is the most likely complication of traveler's diarrhea, so it's important to try to stay well hydrated.
An oral rehydration solution (ORS) is the best way to replace lost fluids. These solutions contain water and salts in specific proportions to replenish both fluids and electrolytes. They also contain glucose or another carbohydrate, such as rice powder, to enhance absorption in the intestinal tract.
Bottled oral rehydration products are available in drugstores in developed areas, and many pharmacies carry their own brands. You can find packets of powdered oral rehydration solution, labeled WHO-ORS, at stores, pharmacies and health agencies in most countries. Reconstitute the powder in bottled or boiled water according to the directions on the package.
If these products are unavailable, you can prepare your own rehydrating solution in an emergency by mixing together:
- 1/2 teaspoon salt
- 6 teaspoons sugar
- 1 liter safe drinking water
You or your child can drink the solution in small amounts throughout the day as a supplement to solid foods or formula, as long as dehydration persists. Small amounts reduce the likelihood of vomiting. Breast-fed infants also can drink the solution, but should continue nursing on demand. If dehydration symptoms don't improve, seek medical care right away. Oral rehydration solutions are intended only for urgent short-term use.
- Wanke CA. Traveler's diarrhea. http://www.uptodate.com/home/index.html. Accessed April 21, 2011.
- Travelers' diarrhea. Centers for Disease Control and Prevention. http://www.cdc.gov/nczved/divisions/dfbmd/diseases/travelers_diarrhea/. Accessed April 26, 2011.
- de la Cabada Bauche J, et al. New developments in traveler's diarrhea. Gastroenterology & Hepatology. 2011;7:88.
- Travelers' health: Self-treatable diseases. Centers for Disease Control and Prevention. http://wwwnc.cdc.gov/travel/yellowbook/2010/chapter-2/travelers-diarrhea.aspx. Accessed April 26, 2011.
- Sur DK, et al. Evaluating fever of unidentifiable source in young children. American Family Physician. 2007;75:1805.
- Pawlowski SW, et al. Diagnosis and treatment of acute or persistent diarrhea. Gastroenterology. 2009;6:1874.
- Frequently asked questions and information for travelers. World Health Organization. http://www.who.int/cholera/technical/FaqTravelersNov2010.pdf. Accessed April 26, 2011.
- Traveler's diarrhea (turista). The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/print/sec02/ch016/ch016b.html. Accessed April 26, 2011.
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