Traveller?s Diarrhoea Traveller?s Enemy

The place is ideal for your preference, all the things you need are packed and with you, camera is full-charged and so ready to capture special moments and other important events, and the whole vibe is great, but the only factor in bad shape is YOU. Travelling is a great experience for anyone; it can be a venture to be audacious and discover new things, get in touch with new environment and people, a very important affair, or anything that is worth spending your time for, but in the event that there a big wall of hindrance blocks your productivity and enjoyment, it will surely ruin everything.

Say for an example, the traveller’s diarrhoea, it is the most common illness attacking backpackers from developed countries spending a matter of days or weeks in developing parts of the world, and regarded as every traveller’s enemy, thinking that the risk is very high (estimates vary from 30 to 80% of travelers).

So, what is diarrhoea or traveller’s diarrhoea in the first place? Well basically, this condition is characterized by increased frequency of loose bowel movements or stools in 24-hour period matched with abdominal cramps, bloating, toilet urgencies, nausea, vomiting, mild fever and even blood in stools for some serious cases (or dysentery). It is acquired through ingestion of contaminated food or drinks that is spread by poor hygiene. The microorganisms responsible for traveller’s diarrhoea range from bacteria to viruses to parasites, and they are the following: Escherichia coli (E. coli)—which is the primary cause of this illness approximates 40% of all cases, Salmonella, Shigella, Campylobacter, Rotavirus, Norovirus and Giardia.

The reason why travelers from industrialized or developed countries are more prone to this illness is because of the drastic and rapid change in the type of organisms in their gastrointestinal tract, wherein these organisms responsible for TD is basically alien to them since they are not present in the environment they are used to. Meanwhile, developing countries, which are the high-risk areas, such as Asia, the Middle East, Africa and Central and Southern America find these organisms harmless, which can be presumably because they have gained immunity on them.

Because of this kind of case, remember that prevention is your best weapon. Equip yourself with enough knowledge you’ll need to protect yourself, practice the basics yet important principle of good hygiene, and see to it to cook your food properly especially the meats, poultry and seafood, handle and prepare the foods properly, and avoid risky foods and risky areas to eat. It is also important that you pack antimotility medications, oral rehydration solutions and antibiotics along with you just to prepare when the sudden onset of traveller’s diarrhoea occurs.

How Can Traveller?s Diarrhoea Affect Your Travel

Each travel is important, it can be a vacation trip you have planned for months, a very important business affair, something you need to do to accomplish an important task or you are representing your country for a special event. But when a sudden onset of various inconvenience brought by traveller’s diarrhoea gets into the way, you only have two choices: let it ruin your trip and everything you have traded for that, or strike back and prevent things before it breaks you. And for most cases, everyone will definitely choose the latter option.

Diarrhoea or traveller’s diarrhoea (TD) is considered the most common enemy of travelers from industrialized or developed countries spending days or weeks in developing countries, as the sudden change in their gastrointestinal environment is attacked by microorganisms generally found in these countries, which includes, Asia, the Middle East, Africa and Latin America. This condition is also known as bali belly, delhi belly, Montezuma’s revenge and Rangoon runs, among other names, is basically caused by ingestion of food or water contaminated with traveller’s diarrhoea causing microorganisms. Even though it is a self-limiting condition and usually clears up after 3 to 4 days, the inconveniences of this illness is just an utter nuisance of your trip (or right after you went home). The symptoms of diarrhea or diarrhoea in UK, includes the following:
• Frequent loose bowel movements in 24-hour period
• Abdominal cramps
• Abdominal bloating
• Urgency to go to the toilet
• Nausea
• Vomiting
• Mild fever
• Blood in stools (in some cases)

Because of these said symptoms, that may occur 1 or 2 weeks after the arrival to the developing country, getting paralyzed all throughout your travel is a great hindrance from you accomplishing all your tasks or enjoying the vacation. Luckily if these occur when you got home, but the case is just downright hassling at any point you look at it. Since traveller’s diarrhoea is characterized by frequent bowel movements and vomiting, lots of fluid gets off your body, and as most people know, dehydration can be fatal once ignored. The feeling of lack of energy due to dehydration caused by diarrhea or diarrhoea can stop you from accomplishing tasks. Aside from that, when dysentery occurs, which is marked as bloody diarrhoea with fever that occurs to 10% of all cases of this illness, there is a high risk that you might get confined to bed or be advised to curtail your activities until your condition improve.

With these simple facts alone, there is no question that traveller’s diarrhoea should not be disregarded, as it can strip off every ounce of enjoyment and productivity in you during your travel. Be informed, be safe and be responsible for yourself.

What Cause Traveller?s Diarrhoea?

Just so you think your most-awaited, important-than-nothing-else travel abroad is perfect, you then experience along your vacation some sort of inconvenience—abdominal bloating and cramps, urgency to go to the toilet, frequent loose or unformed bowel movements (stools), nausea, vomiting, and mild fever—in an instant you became a victim of Traveller’s Diarrhoea. This condition or illness is regarded the most common nemesis of every backpackers from developed countries—a whopping 50% of traveller’s have their rips ruined—spending 2 to 3 weeks to developing parts of the globe.

Traveller’s Diarrhoea is generally acquired by consumption or ingestion of faecally contaminated food or water, or both. These food or drinks contaminated with microorganisms that spread to the body when ingested. These microorganisms that can cause diarrhoea or traveller’s diarrhoea range from bacteria, viruses, parasites and even some unidentified causes.

As for bacteria-causing diarrhoea (80-85% of cases), the Enterotoxigenic (ETEC) forming Escherichia coli (E. coli) is one of the most common reasons of this illness; studies shown that approximately 40-75% of all cases are blamed to this, and they can be found in undercooked beef and unpasteurized milk. Meanwhile, other bacterial causes of traveller’s diarrhoea are Campylobacter jejuni, found in raw meat and poultry, unclean water and unpasteurized milk; Salmonella species, bacteria found in raw meat and poultry and dairy products; Shigella species, bacteria spread through poor hygiene and found in undercooked or raw food.

While bacterial cause is the top reason of acquiring diarrhoea, or more particularly traveller’s diarrhoea, viral infection has been found the reason in every one in every three cases (or 10-15% of all cases), notably rotavirus and Norwalk, which are passed between humans due to poor hygiene. On the other hand, Giardia intestinalis, found in contaminated water and spread through poor hygiene; Cryptosporidium parvum and Cyclospora, both parasites found in contaminated food and water; and Entamoeba hystolytica, are the parasitic infections (2-10% of all cases) that cause traveller’s diarrhoea. Although TD can be caused by either bacteria, virus or parasites, there is 1/5 to ½ of all diarrhoea cases that is unknown and thought to be gastrointestinal response to basically unfamiliar microorganisms transmitted inside the individual’s system.

So once and for all, where can travelers possibly acquire these micro organisms responsible for diarrhoea? The answer is, those totally risky foods which include the following:
• Undercooked, raw or rare meats and seafood
• Raw and peeled fruits and vegetables (most especially if the travelers did not peel them personally)
• Green leafy vegetables such as spinach and lettuce (because of possible harmful pesticides and/ or fertilizers used on them)
• Unpasteurized milk and other dairy products
• Sauces and mayonnaise
• Foods bought from street vendors
• Food buffets
• Any hot food that has been left long enough at room temperature and has already cooled, and;
• Contaminated water and other drinks

In essence, traveller’s diarrhoea can be acquired in any country but the regarded high-risk areas for people from developed countries are the most places in Asia, the Middle East, Africa, and Central and Southern part of America, where 50% of attack rates have been reported.

Treatment for Traveller?s Diarrhoea

When the going gets tough, and when Traveller’s Diarrhoea already attacked your system, which is marked by increased frequency of loose bowel movements, abdominal pain, urgency to go to the toilet, nausea and vomiting, there is no place for disregard, instead immediate treatment must be done to ease the inconveniences and see to it that your trip—whether it’s a casual vacation or an important travel affair—would not be ruined.

Keep in mind that there is no vaccine intended for traveller’s diarrhoea or diarrhoea available today, but there are measures that you can take when you acquire it. Basically, people suffering from traveller’s diarrhoea (TD) have two major complaints which are abdominal cramps and diarrhoea, and diarrhoea treatment aims to kill the agents of infection, ease some symptoms that bring inconveniences and prevent serious case of dehydration, which is very dangerous to human’s system especially to young children, elderly and those with pre-existing medical conditions. Since traveller’s diarrhoea is self-limiting and generally clears up after few days, here are the things that you must do while experiencing this condition:

AVOID DEHYDRATION

Because of too many fluid lost due to frequent bowel movements and events of vomiting, it is vital that those must be replaced. It is best to drink plenty of water (at least 3 to 4 liters a day), fruit juices such as apple and carrot, and soups. There is actually a formula recommended by World Health Organization (WHO) to prevent dehydration: 1 teaspoon salt combined with 8 teaspoons of sugar in 1 liter of potable water. for fluid replacement, WHO also recommend this simple formulation for fluid replacement: In glass A: 200 ml of orange, apple or other fruit juice + ½ teaspoon of honey + 1 pinch of salt; in glass B: 200 ml of water + ¼ teaspoon of baking soda. Then alternately drink from each glass until thirst is already quenched. They are good since they combine the goodness of potassium, glucose/ sugar, sodium and bicarbonate which are lost and needed to prevent dehydration.

Oral Rehydration Solutions or ORS are good supplements to replace lost salts and minerals in the body. ORS are important to children, elderly and those with cholera-like diarrhoea case because of their electrolytes and sterility. However, adults usually don’t get the benefits of the solution and have little influence on them, so soups and juices rich with salt and sugar are recommended. ORS such as Electolade, Dioralyte and Rehidrat are available in sachets and can be purchased at stores and pharmacies in almost all countries around the world. But, bear in mind that oral rehydration are not diarrhoea treatment, instead, they are just helping to get the fluid back into the body, replace salt, glucose and other important minerals lost.

TAKE ANTIMOTILITY OR ANTI-DIARRHOEAL MEDICATION

Taking antimotility drugs such as loperamide or codeine for initial treatment diarrhoea as it provides immediate symptomatic but temporary relief of traveller’s diarrhoea by inhibiting intestinal movements. These anti-diarrhoeal medications are deem helpful in long journey or embarrassing situations, by diminishing diarrhoea and cut down its duration thus reducing fluid loss, and also increasing fluid absorption by normalizing the transit through the gut and restoring normal stools.

However, it should not be used by person with active ulcerative colitis, bloody diarrhoea and fever (as it prevent the passage of bowel movements that will only keep bacterial infection and its toxic inside the body for longer period). Also, this diarrhoea treatment should be used with extreme precaution and not recommended for young children under the age of 12. In essence, antimotility agents are best used for people over 12 and under 75 years old and were previously in good health condition and not suffering from any grave illness.

ANTIBIOTICS

For serious cases of traveller’s diarrhoea, one can depend on anti-microbial or antibiotics. When the TD case is associated with nausea, vomiting, abdominal cramps, fever, and/ or blood in the stools, antibiotic treatment is best applied. In addition, those people who have serious medical condition and does not need any disruption during the travel (say, business trip or an athlete) will benefit from antibiotics are diarrhoea treatment since they kill bacterial or even protozoan infection immediately.

However, it is advised to consult a doctor first before taking antibiotics such as ciprofloxacin (best for bacterial infection) and metronidazole (effective for protozoan infection). And if you want rapid improvement for moderate traveller’s diarrhoea, combining antimotility (loperamide) with antibiotic is the answer.