General/Special Clinics
Travel Medicine Clinic
Alternative Medicine
In-Patient Department (IPD)
Laboratory Services
Nursing Administration Office
Hospital for Topical Diseases
Hospital for Topical Diseases
What’s Travelers’ diarrhea?
Travelers' diarrhea is the most common illness affecting travelers. Every countries is at risk for travelers' diarrhea. But most cases occur in developing countries of Latin America, Africa, the Middle East, and Asia. In Thailand, prevalence of travelers' diarrhea is much lower nowadays, due to better sanitary condition.
What causes travelers’ diarrhea?

Germ in the unclean food or drink can cause travelers' diarrhea. Most common causative agent is enterotoxigenic Escherichia coli (ETEC). However numerous pathogen can causes travelers' diarrhea such as campylobacter, salmonella, shigella, vibrio spp., and many kind of intestinal parasites.

What are the common symptoms of traveler’s diarrhea?

The onset of travelers' diarrhea usually occurs within the first week of travel, but it may occure at any time while traveling. It also can occur shortly after you get home.

Diarrhea usually occurs abruptly. The illness results in loosening, increased frequency, volume of stool. A travelers' diarrhea usually causes five to ten bowel movement each day. The common associated symptoms are abdominal pain, nausea, vomiting, bloating, fever. 

What is the natural course of disease?
Even without treatment, travelers' diarrhea usually subside with in 2-5 days. Most cases of traverlers' diarrhea are mild. But some severe case may have dehydration, fatique, high grade fever, that required hospitalization.
What is the treatment of travelers’ diarrhea?
Whenever possible, you should have your stool check. Because stool exam and stool culture is the key to define the causative pathogen. Most travelers' diarrhea often is treated with appropriate antibiotics and supportive treatment. Oral rehydration is recommended to replace the lost fluids and electrolytes. Some severe cases that have severe dehydration and unable to drink, will require hospitalization.
What about the antimotility drug

Antimotility agents (Imodium, Lomotil) can reduce diarrhea by slowing the bowel movement. But they must be used with cautions. Because ,some authorities believe,  diarrhea is the body’s defense mechanism to get rid of the pathogen form the gastrointestinal tract. So if we slow down the bowel movement, the clearance of the pathogen is much slower. It may cause systemic toxicity to the patient.

Antimotility agent is available over the counter, their injudicious use is of concern. Never use these drug in the patients with fever or mucous-bloody stool. Medical counselling is recommended.

Is there any prophylatic drug can be used to prevent travelers’ diarrhea?
It is not recommended to take antibiotics in order to prevent travelers' diarrhea. Routine antimicrobial prophylaxis increases the risk for adverse reactions to the travelers and may increase resistance to the organism.
Where can I seek for medical care if I have diarrhea?
All hospital in Thailand can take care travelers' diarrhea. Most of patients can be treated out patiently. But some patients will need hospitalization. In our clinic, all patients will be requested to collect their stool to check for the pathogen. You may collect your stool before attend our clinic. Use small plastic bottle or can as a collecting device. The specimen handling storage is available in our clinic.
How can I prevent travelers' diarrhea? 

Travelers' diarrhea is caused by a pathogen in unclean food or drink. Here are some useful tips.

- Avoid eating food or drinking beverage from uncertain  origin.

                         - Avoid eating raw or undercooked meat and seafood.
                         - Avoid unpasteurized dairy products.
                         - Don't drink tap water.
                         - Bottled water is probably safe, but be sure the cap
                           and seal are not broken.
                         - Bottled carbonated beveraged, canned drink is safe.


Last updated: June 9, 2011