Traveler's diarrhea overview: Difference between revisions
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===Medical Therapy=== | ===Medical Therapy=== | ||
TD usually is a self-limited disorder and often resolves without specific treatment; however, [[oral rehydration therapy]] is often beneficial to replace lost [[fluid]]s and [[electrolytes]]. [[Antibiotic]]s are used in those who develop three or more loose stools in a 24-hour period — especially if associated with [[nausea]], [[vomiting]], [[abdominal | TD usually is a self-limited disorder and often resolves without specific treatment; however, [[oral rehydration therapy]] is often beneficial to replace lost [[fluid]]s and [[electrolytes]]. [[Antibiotic]]s are used in those who develop three or more loose stools in a 24-hour period — especially if associated with [[nausea]], [[vomiting]], [[abdominal cramps]], [[fever]] or [[blood in stool]]s | ||
===Primary Prevention=== | ===Primary Prevention=== | ||
Revision as of 18:12, 13 December 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Traveler's diarrhea (TD) is the most common illness affecting travelers. Traveler's diarrhea is defined as three or more unformed stools in 24 hours, commonly accompanied by abdominal cramps, nausea, and bloating.
Causes
There are many causes of diarrhea and it is important to recognize which ones are serious and which are not. Infectious agents are the primary cause of TD. Bacterial enteropathogens cause approximately 80% of TD cases. The most common causative agent isolated in countries surveyed has been enterotoxigenic Escherichia coli (ETEC). In infants and children it is estimated that nearly 70% of diarrhea is due to viruses
Epidemiology and Demographics
Each year 20%-50% of international travelers, an estimated 10 million people, develop diarrhea. There are a number of colloquialisms for travelers' diarrhea contracted in various localities, such as Montezuma's revenge for travelers' diarrhea contracted in Mexico. Attack rates are similar for men and women.
Risk Factors
Risk factors for development of traveler's diarrhea are travel to developing countries, young adults, immunosuppressed persons, persons with inflammatory bowel disease or diabetes and persons taking H-2 blockers or antacids.
Natural History, Complications and Prognosis
TD usually is a self-limited disorder and often resolves without specific treatment. Dehydration is a serious consequence, with death occurring in as quickly as 24 hours with cholera.
Diagnosis
History and Symptoms
The illness usually results in increased frequency, volume, and weight of stool with altered stool consistency. Other commonly associated symptoms are nausea,vomiting, diarrhea, abdominal cramping, bloating, low fever, urgency, and malaise, and usually the appetite is low or non-existent.
Treatment
Medical Therapy
TD usually is a self-limited disorder and often resolves without specific treatment; however, oral rehydration therapy is often beneficial to replace lost fluids and electrolytes. Antibiotics are used in those who develop three or more loose stools in a 24-hour period — especially if associated with nausea, vomiting, abdominal cramps, fever or blood in stools
Primary Prevention
Primary measures to prevent gastrointestinal illness are keeping good hygiene, getting specific vaccines and prophylactic medications. It is not recommend to take antimicrobial drugs to prevent traveler's diarrhea.