Health Risks of Vacation Travel

If you have been vacationing internationally, or even camping and backpacking this summer, beware of traveler’s diarrhea!  You may find yourself returning home from holiday with an unwanted companion in your digestive tract.   Traveler’s diarrhea afflicts 30% to 70% of international travelers.  It is a common symptom of infection with one of several intestinal pathogens.  While traveler’s diarrhea may resolve on its own, it is important to recognize when you need additional treatment.  Fortunately, there are many home remedies and natural treatment that, in most cases, can help quickly return your digestion to normal.

Upsetting and uncomfortable though it may be, acute traveler’s diarrhea is actually one of your body’s best defenses for getting rid of toxins and pathogens quickly.  Diarrhea is a way of expelling harmful substances through the digestive tract before they can cause more trouble or lead to complications.  

Nonetheless, if you have more than three loose and watery stools in 24 hours, take note.  Severe traveler’s diarrhea causes significant loss of fluid and electrolytes, the mineral nutrients (sodium, potassium, magnesium, calcium and other trace minerals) that are vital to a balanced metabolism.  If left unaddressed, this can lead to symptoms of dehydration (see below) in addition to the discomfort of watery stools. 

While most cases of traveler’s diarrhea resolve quickly, in a small percentage of people it can trigger chronic digestive issues.  This is especially true in small children, the elderly, or anyone with a frail immune system.  If diarrhea continues for more than two weeks, it’s time to seek out a health care professional to diagnose and treat the problem.

Symptoms of Traveler’s Diarrhea

If you don’t know them already, here are the symptoms to look for:

  • Frequent bowel movements with loose or watery stools
  • Abdominal pains and cramping
  • Possibly nausea and vomiting
  • Stomach pains 
  • Loss of appetite
  • Possibly fever, depending on the cause of the traveler’s diarrhea
  • Symptoms of dehydration (weakness, brain fog, headache, dizziness, nausea, thirst)

Risk Factors for Traveler’s Diarrhea

Risk factors for developing traveler’s diarrhea are all related to poor hygiene and exposure to contamination with bacterial, viral and protozoal pathogens.  This includes:

  • eating in restaurants with poor hygiene, especially while traveling in developing countries
  • inadequate hand-washing and personal hygiene prior to preparing food yourself
  • drinking contaminated water
  • using contaminated water to wash vegetables, fruit and utensils
  • swimming in contaminated water
  • coming in contact with stool at primitive toilet facilities

It’s worth remembering that most of these pathogens are present in our environment all of the time, and much of the time we can handle exposure without noticing any symptoms.  Infection results only with prolonged or intense exposure, or if we are already ill or stressed.  Paying attention to good hygiene practice can do a lot to prevent traveler’s diarrhea in the first place.

Causes of Traveler’s Diarrhea

You may never know exactly which pathogen caused your traveler’s diarrhea, since many of the symptoms are similar.  However, the timing of onset, duration and intensity of illness can give you a clue.

Food poisoning is usually caused by preformed bacterial toxins already present in contaminated food.  It appears about 6 hours after ingestion, and usually resolves in about 12 hours.  The onset is sudden and can be severe.  It may range from mild cramping and loose stools to severe abdominal pain, fever, vomiting and bloody diarrhea.

Bacterial or viral infection has symptoms similar to food poisoning, but takes longer to appear (up to 72 hours), and resolves in 2 to 7 days.

Giardia infection is caused by a protozoal parasite.  It is sometimes called “beaver fever” because it is often contracted while swimming in contaminated lakes or rivers.  (It is not caused by beavers.)  It can also be transmitted person-to-person through contact with infected stools.  Dogs and domestic animals can also become infected and pass it via stool.  If you are camping in a place with poor bathroom facilities, or if you perform tasks (such as changing diapers or picking up dog poop) that expose you to stool, you may be at risk.

Giardia has a longer onset than traveler’s diarrhea due to food poisoning or bacterial infection, and can take 1 to 2 weeks to appear.  Symptoms appear more gradually and are less intense than food poisoning.  All of this makes it more difficult to diagnose from symptoms.  There may be fatigue, loss of appetite, and digestive upset, as well as watery stools.  

If left untreated, giardia infection can last for weeks or months, with periodic bouts of diarrhea.  If you think you are infected with giardia, it is important to treat it right away.  Fortunately, traveler’s diarrhea cause by giardia does respond to natural treatments and home remedies.  If it persists for more than a couple of weeks without improvement, you may need to consult a health care professional.

Prevention of Traveler’s Diarrhea

  • Wash your hands frequently, especially before preparing food or eating, and after going to the bathroom.
  • If you are camping near lakes, streams or springs, filter your drinking water or boil it for at least ten minutes.
  • If you are traveling internationally, especially in a place with poor sanitation, you may wish to boil your drinking water, or drink bottled water.
  • If you are traveling in places with poor sanitation, choose restaurants and food carts where you can see the food being cooked.
  • If you swim in potentially contaminated water, avoid swallowing water and shower promptly afterwards.
  • Cooking vegetables and other food helps kill pathogens.
  • If you eat raw fruit and vegetables while traveling, be sure to wash them with drinking water that is filtered, boiled or otherwise not contaminated
  • Take a prebiotic and probiotic supplement while traveling to help prevent bacterial and viral infection from developing, by supporting the beneficial microorganisms in the gut.
  • Eat a nutrient-dense whole foods diet which strengthens your immune system and leaves you less vulnerable to infection.   Chronic digestive problems, which can be triggered by acute traveler’s diarrhea, may be related to nutrient deficiencies.

Natural Treatment of Traveler’s Diarrhea

Whatever the cause, there are several first-line steps to treating traveler’s diarrhea:

  • Oral rehydration therapy:  Avoiding dehydration is key to recovery.  Replenish fluids and electrolytes by drinking plenty of water (about 16 ounces per hour) and adding an electrolyte supplement.  Drinking bone broth also helps replenish fluids and provides additional nutrients (electrolytes and amino acids) in an easily digestible form.
  • Bulk up stools by eating starchy whole foods, which contain insoluble fiber.  Sweet potatoes and brown rice are especially good for adding bulk.  You may wish to add a fiber supplement, such as Standard Process Gastro-Fiber.
  • Eat probiotic foods (plain yogurt, kefir, raw sauerkraut and fermented vegetables) and take a probiotic supplement to help the beneficial gut bacteria recover balance.
  • Get plenty of rest and avoid strenuous exercise until you are fully recovered.
  • Eat bland or mild foods that are easily digested, and avoid spicy or greasy foods, until you are fully recovered.

If home remedies are not enough, Chinese herbal remedies are very effective for both stopping traveler’s diarrhea and fighting the underlying infection.  Acupuncture treatment can be helpful for wholistic treatment of any digestive imbalance, including traveler’s diarrhea.  Herbs and acupuncture provide a way to avoid unnecessary use of antibiotics and other pharmaceuticals, unless you really need them.  Always consult a professional Chinese herbalist/acupuncturist to prescribe the right herbal formula for you.

If your traveler’s diarrhea fails to clear up with natural home remedies, or persists beyond two weeks without improvement, consult a health care professional.  You may need further diagnosis and additional treatment.

Inner Works Acupuncture, located in NW Portland, offers acupuncture, herbal medicine and nutritional therapy for many health conditions, including digestive disorders.  Call us at 503-227-2127 for more information or to schedule an appointment.