Definition
“Traveler's diarrhea” is defined as a particular infection affecting the digestive tract (or enteritis), typical of the inhabitants of industrialized countries who travel to developing lands, where the level of hygiene is very poor. Traveler's diarrhea is characterized by the alteration of bowel movements, in which the emission of fecal material becomes very frequent, often accompanied by abdominal cramps, which tend to resolve themselves in a few days.
Causes
Most of the time, traveler's diarrhea is the result of bacterial-borne infections (Escherichia Coli, Salmonella, Staphylococci, Campylobacter), viruses or protozoa: these pathogens, after having infected food or water, can cause damage to the subject who takes these foods, causing a sensitive or marked alteration of intestinal motility, which results in traveler's diarrhea.
Symptoms
Traveler's diarrhea begins in the same way as common acute diarrhea: after an incubation period ranging from one to two days, the beating triggers an "alteration of intestinal peristalsis, which is generally associated with weakness, low-grade fever, severe abdominal pain, watery discharges (4-8 per day), vomiting.
Diet and Nutrition
The information on Traveler's Diarrhea - Medicines for the Treatment of Traveler's Diarrhea is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Traveler's Diarrhea - Medicines to Treat Traveler's Diarrhea.
Medicines
Being so brutal and violent, traveler's diarrhea can result in dehydration, a condition in which a loss of fluids, salts and electrolytes is observed from the body. In order to avoid this complication, it is recommended to take a lot of liquids, especially sugary and rich in potassium, sodium and glucose, from the very first symptoms; in other cases, it is possible to rehydrate the patient by administering fluids into a vein.
The administration of electrolytes useful to counter dehydration is called "rehydration therapy": the intake of liquids and electrolytes may contain alkalizing substances, useful for counteracting any acidosis that accompanies traveler's diarrhea. Furthermore, rehydration therapy is indicated to increase the absorption of water and electrolytes, in addition to avoiding osmotic diarrhea and accelerating the patient's recovery.
The following are the classes of drugs most used in the therapy against traveler's diarrhea, and some examples of pharmacological specialties; it is up to the doctor to choose the most suitable active ingredient and dosage for the patient, based on the severity of the disease, the state of health of the patient and his response to treatment:
Lactic ferments: the administration of lactic ferments seems to be a very effective solution to restore the intestinal flora altered by traveler's diarrhea:
- Lactobacillus Acidophilus (eg Lacteol, Lacteol Forte): it is an antidiarrheal of microbial origin, consisting of inactivated Lactobacillus acidophilus microbes. In particular, it is indicated for the treatment of diarrhea associated with dyspepsia or colitis, especially in the newborn. For the treatment of acute diarrhea, start therapy with 2 capsules of 5 billion Lactobacillus acidophilus, three times a day; continue with 2 capsules, twice a day.
- Saccharomyces boulardii lyo: this antidiarrheal / probiotic is indicated for the treatment of acute diarrhea and for traveler's diarrhea: indicatively, the dosage is 250 mg (1 capsule), twice a day.
Spasmolytics: spasmolytic drugs do not affect the triggering cause of traveler's diarrhea, but represent a valid aid to accelerate healing and alleviate the aggressiveness of symptoms.Drugs with spasmolytic activity are particularly effective as a parallel therapy to antibiotic therapy.
- Loperamide (eg Imodium): this drug balances intestinal motility thanks to its antidiarrheal potential: the active ingredient, which can also be administered to children, decreases fecal mass, also reducing the frequency of discharges. It is recommended to start treatment for acute diarrhea with 4 mg of the drug orally, to be taken after the first bowel movement. Continue therapy with 2 mg of substance (do not exceed 16 mg in 24 hours). Generally, the disorder goes away in 48 hours. Do not take the drug for more than 5 consecutive days. For the treatment of chronic diarrhea, take 4 mg of the drug orally, followed by 2 mg of active after each bowel movement. Do not exceed 14 mg in 24 hours. The maintenance dose ranges from 4 to 8 mg. In general, the clear clinical improvement is observable after 10 days of therapy.
- Diphenoxilate: take 2 tablets or 10 ml of solution orally, 4 times a day. Maintenance therapy involves taking 2 tablets once a day. The dosage just described is indicated for the treatment of acute diarrhea in adults; for the child, the dose varies according to age (1.5-10 ml, 4 times a day). Consult your doctor.
Antibiotics: the administration of antibiotics is clearly indicated for the treatment of traveler's diarrhea, since bacteria - in most cases - represent the main trigger.
- Cipro (eg Ciprofloxac, Samper, Periactin): the drug belongs to the class of fluoroquinolones. It is recommended to take 500 mg of the drug (tablets) every 12 hours; the duration of therapy is 5-7 days. Consult your doctor.
- Levofloxacin (eg Levofloxacin, Tavanic, Aranda, Fovex): in general, the indicative dosage is 500 mg per day for 7 days; however, the dosage and duration of treatment must be determined by the doctor.
- Cotrimoxazole: drug of choice for the treatment of infantile traveler's diarrhea.
- Azithromycin (eg Azithromycin, Zitrobiotic, Rezan, Azitrocin) is a macrolide antibiotic, whose recommended dose is - also in this case - variable according to the severity of the traveler's diarrhea. Consult your doctor.
Antiprotozoans: when traveler's diarrhea depends on protozoal infections (eg intestinal Giardia), specific drugs are used, such as:
- Nitazoxanide (eg Alinia): indicated for immunocompromised subjects suffering from protozoan-dependent traveler's diarrhea. Indicatively, the dosage is 100-200 mg of the drug twice a day. Consult your doctor.
- Sulfamethoxazole / trimethoprim (eg Bactrim): it is a sulfonamide antibiotic, indicated for the treatment of traveler's diarrhea related to infections by Cryptosporidia (genus of protozoa). It is recommended to take 160-800 mg of the drug orally, every 12 hours, for 5 days, in full compliance with what is prescribed by the doctor.
- Metronidazole (eg Flagyl, Metronidazole-Same, Rozex): indicatively, take 250 mg of the drug every 8-12 hours, as established by the doctor.
Notes: some doctors hypothesize that the single administration of an antibiotic (attack dose) is effective to fight the beating responsible for traveler's diarrhea; however, this theory does not seem to report positive results, therefore it still remains an unproven hypothesis. . Effective (proven) antibiotic therapy for traveler's diarrhea should last for a few days.
Traveler's diarrhea: prevention
Before embarking on a trip, especially in developing countries, where the level of hygiene is rather poor, it is advisable to follow some important prophylaxis rules, useful for preventing traveler's diarrhea:
- Respect food hygiene rules
- Consume bottled water
- Pay particular attention to oral hygiene
- Wash the vegetables well to remove any waste
- For people who are particularly at risk (immunocompromised), it is sometimes possible to follow prophylactic therapy with antibiotics (fluoroquinolones, single dose)
- It is also possible to undergo an oral anti-cholera vaccine (eg Dujoral) for the long-term prophylaxis of traveler's diarrhea (particularly indicated for the prophylaxis of E. Coli infections)
