The cause of traveller’s diarrhoea is usually contaminated food and water. There are three types of problems, and these are important to distinguish because they have different causes and different treatments.
- Common travellers diarrhoea – This is the one most travellers to developing countries experience sooner or later, with watery diarrhoea and sometimes vomiting. It is caused by bacteria, such as E.coli, Campylobacter, Salmonella and Shigella. It is treated with rehydration, and if persistent, with an antibiotic called norfloxacin.
- Giardia – This protozoon is found in tap water in many cities around the world, as well as river water and contaminated food. It gives trouble that can drag on and on, sometimes long after returning home. Cramping stomach pain, belching, wind; all round Giardia doesn’t make the sufferer very pleasant company! It requires treatment with a different antibiotic called tinidazole.
- Dysentery – This is the severe end of the spectrum, with blood or mucus in the motions. Bacterial dysentery will usually improve with norfloxacin. Amoebic dysentery will not respond to norfloxacin but may respond to tinidazole. Dysentery can be a real medical emergency while travelling, and needs medical follow up on return home.
Treatments for Adults
All travellers to higher risk destinations are advised to take treatment for traveller’s diarrhoea with them. A good kit will contain the following treatments:
- Rehydration is the most important thing – Not eating for a day does not matter so much, but if you do not drink you can become very unwell quickly, especially in a hot country.
- Antibiotics – Such as azithromycin, norfloxacin or tinidazole depending on the type and duration of symptoms. These are very useful as they actually treat the cause of the problem, i.e. the infection.
- Loperamide – This is simply a ‘stopper’…a sort of pharmacological cork. It may be convenient to use if you are about to get on a train or plane or give an important presentation. Imodium, Lomotil, Codeine and other ‘stoppers’ all do the same thing.
- Nausea treatments – Common brands are stemetil and maxolon. These come in tablets, suppositories or injections and can help with nausea and vomiting.
- Food – If you are hungry, eat a little. There is no need to ‘rest the stomach’, but try bland foods initially, especially carbohydrates such as rice, pasta, biscuits, bread or potato. Avoid too much dairy food, alcohol, fatty or spicy food while recovering.
Other Conditions List
- Acid Reflux
- Barrett’s Oesophagus
- Bowel Cancer
- Chronic Constipation
- Coeliac Disease
- Colon Cancer
- Crohn’s Disease
- Gastroenteritis in Adults
- Helicobacter pylori
- Irritable Bowel Syndrome (IBS)
- Liver Disease
- Motility Disorders
- Peptic Ulcer Disease
- Rectal Bleeding
- Swallowing Problems (Dysphagia)
- Travellers’ Diarrhoea
- Ulcerative Colitis