What’s the best way to prevent or treat traveler’s diarrhea? —P.S., Oberlin, Ohio
For prevention, avoid contaminated food and water. Don’t drink or brush your teeth with water that hasn’t been boiled or purified, and avoid ice cubes. In many rural areas, only canned liquids and those that are bottled and carbonated are safe. (Uncarbonated liquids often come in reused, potentially unsanitary bottles.) Also avoid raw vegetables, cold cuts, dairy ingredients, and raw fruit that you haven’t peeled yourself. Don’t buy food from street vendors, and eat meat and seafood only if they’re well-done and served hot.
If you anticipate poor sanitation, bring medication. Daily over-the-counter (OTC) bismuth subsalicylate (Pepto-Bismol) can cut your risk of developing diarrhea, and OTC loperamide (Imodium A-D) can ease a mild case. Ask your doctor for a diarrhea-fighting prescription antibiotic, such as sulfamethoxazole and trimethoprim (Bactrim DS) or ciprofloxacin (Cipro), to treat severe cases accompanied by fever.
For more information, go to the Centers for Disease Control and Prevention’s Web site. And for more on preventing traveler's sickness, read our recent blog post on staying healthy on the high seas.