Preventing and Treating Travelers' Diarrhea

Frank Gillingham, MD

Avoiding Travelers' Diarrhea is difficult. A study published in the mid-1980's found that among 600 travelers who kept complete dietary journals during travel to developing countries, 98% violated the rules for safe eating at least once within the first three days of their trip! Whether they're in New York or New Guinea, most travelers find it difficult not to eat something that looks appetizing, especially when they're hungry.

While there are no vaccines to prevent TD, bismuth subsalicylate (brand name: Pepto Bismol) has been shown in well-done studies to reduce the incidence of TD by about 60%. However, you have to take it frequently (2 tablets, 4 times a day; or 2 oz. 4 times a day) and it has side effects including temporary blackening of the tongue and stools, nausea and constipation, and, sometimes, ringing in the ears. This agent contains aspirin so don't take it if you're allergic to aspirin, if you take aspirin for another reason, or if you have kidney insufficiency, gout or a history of ulcers. If you take any medications chronically check with your doctor before using it. It is not recommended for children or for extended use (>3 weeks).

If, like so many others, you fall victim to TD, here's what to do (note: recommendations for children are different—see below):