Table of Contents
- Seek restaurants with a reputation for safety. Even then, avoiding raw foods, and fresh fruits or vegetables that do not need to be peeled, is advised.
- Heated food should be hot to the touch and eaten promptly.
- Beware of sliced fruit that may have been washed in contaminated water.
- Don't buy food from street vendors.
- Peel all fresh fruits and vegetables yourself.
- Vegetables may also be rinsed with diluted soapy water, soaked in a halide solution, and rinsed in purified water. (Certain fruits, such as strawberries, raspberries, and grapes should never be considered safe, even when washed.)
- Avoid dairy products.
- Avoid raw or undercooked meat and fish.
- Avoid cold toppings and sauces -- even bottled sauces on tables. In one study, two-thirds of tabletop sauces in Mexico were contaminated. (Forty percent of sauces on tables in Houston, Texas, were also contaminated.)
- Avoid tap water and ice cubes.
- Avoid fruit juices, fresh salads, and open buffets.
Preventive Drugs
The following drugs can reduce your chance of getting sick:
Pepto-Bismol. Taking two tablets of Pepto-Bismol four times a day before and during travel to developing countries can help prevent many cases of diarrhea. Pepto-Bismol should not be taken for more than 3 weeks. Both aspirin and Pepto-Bismol share the active ingredient salicylate, which can be harmful to children. Many medications interfere with salicylate, and people who are allergic to aspirin, pregnant women, and those with ulcers, other bleeding disorders, or gout, should not take Pepto-Bismol without consulting a doctor. Side effects of Pepto-Bismol include ringing in the ears and black stools and tongue.
Prophylactic Antibiotics. Prophylactic antibiotics are those used to prevent diarrhea while traveling. They work well, but there are many reasons that argue against their routine use. Taking prophylactic antibiotics can trigger adverse drug reactions or development of infections with resistant strains. Taking prophylactic antibiotics also contributes to the global problem of bacterial resistance. Antibiotics are also NOT effective against parasites or viruses, but their use may give travelers an unwarranted sense of security. At this time, prophylactic antibiotics are not generally recommended unless the person is at increased risk for complications of TD. People at such risk include those with chronic bowel diseases, kidney disease, diabetes, or HIV.
Lactobacilli. Taking capsules that contain protective bacteria called lactobacilli (also called probiotics), may be helpful, although the Infectious Diseases Society of American believes that evidence is insufficient to recommend them. Some studies report that a genetically engineered strain called Lactobacillus rhamnosus strain GG may prevent and reduce severity of diarrhea. In fact, lactobacilli may be used for both prevention and treatment in children without any adverse effects. The capsules can be split open and put into beverages for small children.
Treatment for Diarrhea
Fluid Replacement. If diarrhea develops, the most important steps to take are preventing dehydration and replacing lost fluids, particularly in children. In severe cases, dehydration can be life threatening. Agitation may be an early symptom of dangerous dehydration. Listlessness and a weak pulse are symptoms of severe dehydration. Parents should seek medical help immediately if the child appears to be dehydrated.
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Review Date: 01/30/2011
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine,
Harvard Medical School; Physician, Massachusetts General Hospital.
Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M.,
Inc.
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)
