Diet - traveler’s diarrhea

Alternative names 
Traveler’s diarrhea diet

Definition
Traveler’s diarrhea describes diarrhea that frequently attacks those visiting third-world or developing countries. Traveler’s diarrhea diet refers to the appropriate food and fluids to consume if you develop traveler’s diarrhea.

Function
Bacteria and the toxins that cause traveler’s diarrhea occur in areas with contaminated water supplies, poor sewage systems, or inadequate food handling. People living in these areas often don’t get sick because their bodies have developed some degree of immunity.

Traveler’s diarrhea is rarely life-threatening for adults. It is more serious in children as it can frequently lead to dehydration. You can decrease your risk of developing traveler’s diarrhea by avoiding water and food that may be contaminated. The goal of traveler’s diarrhea diet is to minimize the impact of this illness and avoid severe dehydration.

Recommendations

Prevention of Traveler’s Diarrhea:

     
  • Water:       o Do not use tap water for drinking or brushing teeth.       o Do not use ice made from tap water.       o Use only boiled water (at least 5 minutes) for mixing baby formula.       o For infants, breast-feeding is the best and safest food source. However, the stress of traveling may decrease milk production.  
  • Other beverages:       o Drink only pasteurized milk.       o Drink bottled drinks if the seal on the bottle hasn’t been broken.       o Carbonated drinks are generally safe.       o Hot drinks are generally safe.  
  • Food:       o Do not eat raw fruits and vegetables unless you peel them.       o Do not eat raw leafy vegetables (e.g. lettuce, spinach, cabbage); they are hard to clean.       o Do not eat raw or rare meats.       o Avoid shellfish.       o Do not buy food from street vendors.       o Eat hot, well-cooked foods. Heat kills the bacteria. Hot foods left to sit may become re-contaminated.  
  • Sanitation:       o Wash hands often.       o Watch children carefully. They put lots of things in their mouths or touch contaminated items and then put their hands in their mouths.       o If possible, keep infants from crawling on dirty floors.       o Check to see that utensils and dishes are clean.

Treatment:
If you or your child get diarrhea, continue eating and drinking. For adults and young children, continue to drink fluids such as fruit juices and soft drinks (non-caffeinated). Salted crackers, soups, and porridges are also recommended.

Dehydration presents the most critical problem, especially for children. Signs of severe dehydration include:

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

Oral rehydration fluids are advised for children with traveler’s diarrhea to prevent severe dehydration. These fluids contain salts (mainly sodium, potassium, and chloride) with small amounts of glucose (a form of sugar). They replace lost fluids and minerals. Most stores in the U.S. sell rehydration fluids in the infant section. In third world countries, many health agencies stock packets of salts to mix with water.

If rehydration fluids are not available, you can make an emergency solution as follows:

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

Give the child small amounts to drink often. Small amounts decrease the likelihood of vomiting. One guideline is to give one cup of fluid for every loose stool passed.

If you or your child have signs of severe dehydration, or if fever or bloody stools develop, seek immediate medical attention.

Johns Hopkins patient information

Last revised: December 7, 2012
by Sharon M. Smith, M.D.

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