3 Things Pharmacists Should Tell Patients About Traveler's Diarrhea

Before patients travel abroad, pharmacists should pass along a few must-know facts about traveler’s diarrhea.

Traveler’s diarrhea is one of the most prevalent travel-related illnesses. Instances range from 30% to 70% of all travelers, depending on the destination and time of year.

“It’s an inconvenience, it’s a nuisance, it keeps you in your hotel room…but, for most people, it is not deadly,” Jeff Goad, PharmD, MPH, explained to Pharmacy Times.

Here are some helpful facts and counseling points pharmacists should make sure to talk to their jet setting patients about.

1. Certain prevention strategies can significantly lower a patient’s risk for traveler’s diarrhea.

Patients should modify certain behaviors while traveling abroad in order to avoid traveler’s diarrhea. When traveling to a developing country, for example, patients should automatically assume that the tap water isn’t drinkable.

This rule of thumb holds true “even if you’re at a beautiful, 5-star resort,” Dr. Goad advised. “This includes ice and frozen alcoholic drinks. Ice is just frozen bacteria waiting to come alive as soon as [patients] ingest it.”

Drinking bottled water obtained from a hotel or other reputable source is a much safer bet. Using a water purifier is also helpful, and boiling water will kill everything.

2. Patients can self-diagnose and self-treat traveler’s diarrhea.

The CDC Yellow Book has an entire chapter devoted to self-treatable conditions, one of which is diarrhea. The CDC refers to traveler’s diarrhea as “the most predictable travel-related illness,” and pharmacists should make sure that patients are aware of all signs and symptoms.

According to the CDC, “Bacterial and viral [traveler’s diarrhea] presents with the sudden onset of bothersome symptoms that can range from mild cramps and urgent loose stools to severe abdominal pain, fever, vomiting, and bloody diarrhea, although with norovirus, vomiting may be more prominent. Protozoal diarrhea, such as that caused by Giardia intestinalis or E. histolytica, generally has a more gradual onset of low-grade symptoms, with 2 to 5 loose stools per day.”

As far as nonpharmacological traveler’s diarrhea treatments are concerned, patients should know that drinking safe water and replacing electrolytes is an important self-treatment method. Patients who experience diarrhea are depleted of body fluids, which can result in profound dehydration.

3. Antibiotics aren’t the only defense against traveler’s diarrhea.

In fact, OTC options are more desirable treatments for a number of reasons.

In the past, traveler’s diarrhea was treated with an antibiotic that the patient was instructed to take throughout the duration of the trip. However, treating traveler’s diarrhea with antibiotics may contribute to antibiotic resistance and spread resistant bacteria strains, particularly when travelers visit developing parts of the world.

According to Anu Kantele, MD, PhD, associate professor in infectious diseases at Helsinki University Hospital in Finland, the vast majority of all traveler’s diarrhea cases are mild and resolve on their own. For that reason, Dr. Goad recommended Pepto-Bismol as an alternative to antibiotics.

“Pepto-Bismol is bismuth subsalicylate, and it’s really the bismuth that does much of the heavy lifting for traveler’s diarrhea,” he noted. “It coats, it soothes, and it also has a little antibacterial and antacid activity.”

Because traveler’s diarrhea is a self-limiting infection, the patient’s body should be able to fight it off on its own. The true benefit of Pepto-Bismol is that it “buys the body time to treat itself,” Dr. Goad explained.

Traveler’s diarrhea is a self-limiting infection, and the patient’s body should be able to fight it off on it’s own. The true benefit of Pepto-Bismol is that it “buys the body time to treat itself,” he explained.