You were so careful on your last trip abroad: You drank only bottled water and peeled every fruit. Still, you wound up with a bout of diarrhea that made you miss several tours and dinners. How can you prevent your next vacation from being similarly tainted?

A Common Ailment

If you've ever gotten a case of traveler's diarrhea, you're not alone. This dreaded gastrointestinal disorder plagues an estimated 10 million travelers a year. You should suspect traveler's diarrhea when you find yourself running to the bathroom at least three times a day. You may additionally experience stomach cramps, nausea and vomiting.

Preventive Steps

The culprit is usually water or food contaminated by an organism called E. coli, although other bacteria, viruses or parasites may be at fault. Stress and jet lag can leave you especially susceptible. Fortunately, you can take steps to avoid traveler’s diarrhea:

  • Don't eat raw or undercooked meat or seafood.
  • Steer clear of raw fruits or vegetables unless you peel them yourself.
  • Avoid tap water, ice and non-pasteurized dairy products.
  • Be especially wary about eating food from street vendors, farmer's markets and small restaurants.
  • Drink bottled beverages, hot tea or coffee, beer, wine and water that has been boiled or appropriately treated with iodine or chlorine.
  • Brush your teeth using bottled rather than tap water.
  • Use a hand sanitizer before meals.

Pills for prevention?

Following precautions to avoid contaminated food and drink is the best way to reduce the risk of traveler's diarrhea. Another possibility is talking to your doctor about taking Pepto-Bismol or Kaopectate to prevent the condition. Don’t take Pepto-Bismol or Kaopectate if you're allergic to aspirin or you're taking an anticoagulant, methotrexate or the gout drug probenecid (Probalan). You also shouldn't take them for more than three weeks.

Be aware that these drugs can cause your tongue and stool to temporarily turn black. A less-common side effect is ringing in the ears. Doctors recommend against taking antibiotics to prevent traveler’s diarrhea.

Treating Traveler's Diarrhea

Most cases of traveler's diarrhea go away on their own within a few days. In the meantime, be sure to drink plenty of clear liquids. You might also try taking Pepto-Bismol or Kaopectate.

Medication that slows down the time it takes for stool to pass through your body—the antidiarrheal agents loperamide (Imodium), diphenoxylate (Lomotil) or paregoric—can also help you feel better. Avoid these drugs, however, if you have a fever or bloody diarrhea. They may actually keep you sick longer by interfering with your body’s natural ability to get rid of whatever is making you sick. If you're feeling particularly ill or your diarrhea just won't go away, see a doctor. You may have picked up a parasite.

Source: Prepared by the Editors of The Johns Hopkins Medical Letter: Health After 50

Publication Review By: the Editorial Staff at

Published: 07 Jul 2103

Last Modified: 10 Mar 2015