Traveller's diarrhoea

Many people who travel from developed to developing countries experience travellers' diarrhoea. This illness can occur at any time during the trip or even afterwards, when the person gets home. It is usually a self-limiting condition that clears up after a few days. Generally, it is caused by eating contaminated food or water. Often, the micro-organisms that trigger the illness appear to be harmless to the local population, presumably because they have acquired immunity to them. The risk of travellers' diarrhoea is higher where sanitation and hygiene standards are poor, such as in developing nations of Latin America, Africa, the Middle East and Asia. Travellers' diarrhoea is more common in young adults than older adults, probably because younger people tend to choose more adventurous destinations or styles of travel, like backpacking. Other names for travellers' diarrhoea include Montezuma's revenge, Bali belly and the Rangoon runs.

Symptoms
The symptoms of travellers' diarrhoea include:

• Abdominal bloating
• Abdominal cramps
• Abdominal pains
• Nausea
• Urgency to go to the toilet
• Loose, watery stools passed frequently
• Mild temperature
• General malaise.

• Bacteria - Escherichia coli (E. coli), primarily enterotoxigenic strains (ETEC). This is one of the most common bacterial causes of travellers' diarrhoea. Other bacterial causes of travellers' diarrhoea include Campylobacter jejuni, Salmonella species and Shigella species.
• Parasites - certain parasitic infections are known to cause diarrhoea including Giardia intestinalis, Entamoeba histolytica and Cryptosporidium parvum. In these cases, the illness lasts longer than a few days and the stools may be bloody.
• Viruses - some estimates suggest that around one in three cases of travellers' diarrhoea is caused or associated with a viral infection, notably Norwalk and rotavirus.
• Unknown causes - a cause can't be found in approximately one fifth to one half of all cases of travellers' diarrhoea. It is thought that diarrhoea may be the gastrointestinal system's response to unfamiliar micro-organisms.

• Raw and peeled fruits and vegetables
• Green leafy vegetables such as spinach and lettuce
• Raw, rare or undercooked meats of any kind
• Seafood, particularly raw or inadequately cooked shellfish or fish
• Sauces and mayonnaises
• Unpasteurised milk
• Unpasteurised dairy foods
• Food from street vendors
• Any hot food that has been left long enough to cool
• Food buffets.

• If you are not sure of the water supply, avoid drinking the water or brushing your teeth with it.
• Buy bottled water to drink, preferably carbonated.
• Boil tap water for at least five minutes before drinking it.
• Avoid any drinks that contain ice.
• Avoid using tap water to wash your fruit and vegetables.

• Wash your hands with soap and water after going to the toilet, and before eating or preparing food.
• After washing your hands, make sure they are completely dry before you touch any food.
• Make sure any dishes, cups or other utensils are completely dry after they are washed.
• Eat at reputable and clean restaurants.

• Don't allow small children to crawl around on floors.
• Make sure your child doesn't put their unwashed fingers into their mouth.
• Wash their hands frequently.
• When making up formula milk, either use bottled water or thoroughly boil tap water for at least five minutes.

• Plenty of water to avoid dehydration.
• Oral rehydration drinks to replace lost salts and minerals.
• Antibiotics to kill a bacterial infection.
• Anti-nausea drugs.
• Dairy foods can worsen diarrhoea in some people, so limit consumption of these foods.
• Avoid alcohol and spicy foods.
• Avoid anti-diarrhoea drugs if you have a high fever - preventing the passage of stools will only keep a bacterial infection and its poisons inside the body for longer.

• Your doctor
• Chemist.

• Many people who travel away from home experience travellers' diarrhoea.
• It is characterised by abdominal pain, cramps and the need to urgently and frequently pass watery stools.
• Generally, the cause is consumption of contaminated food or water; in some cases, the micro-organisms that trigger the illness are quite harmless.
• It is usually a self-limiting condition that clears up after a few days.

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