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What is Travelers' Diarrhea? Why is it so common?

Traveling across the globe to exotic locations or even a short flight away domestically can be enough to wreak havoc on your digestive system.

Typically, when taking a trip we often tax our bodies by trying to do too much before we leave home and as a result, we are already at a sleep deficit. Add that to the changes in foods we eat, potentially not drinking enough fluids and the body often reacts unfavorably for many of us. What many of us experience may not fall into the official category of Travelers' diarrhea (or TD) but upset to the intestinal tract is common due to these changes.

Traveler's diarrhea (TD) is the most common traveled related illness, which can affect 30-70% of travelers and is a stomach and intestinal infection. It is defined as three or more unformed stools passed by a traveler within a 24-hour period, commonly accompanied by:
  • Abdominal cramps
  • Nausea
  • Bloating

When traveling to many areas around the globe, high risk destinations include:
  • Most of Asia
  • The Middle East
  • Africa
  • Mexico
  • Central and South America

Intermediate-risk countries include those in:

  • Eastern Europe
  • South Africa
  • Some of the Caribbean Islands

Traveler's diarrhea is often referred to as: Bali Belly, Montezuma's Revenge, Delhi Belly and Tourist Trot.

Causes of Travelers' Diarrhea?
Travelers' diarrhea is caused by E.coli( ETEC) as well as Shigella, Salmonella and other bacteria.

Why is Travelers' diarrhea more common in developing countries?

Some reasons include:
  • Contaminated local water supplies
  • Poor plumbing
  • Poor sewage in some areas
    • These result in higher levels of stool contamination in the environment.
  • Inadequate electrical capacity leading to frequent blackouts or poorly functioning refrigeration, resulting in unsafe food storage.
  • Inadequate water supplies and/or the absence of sinks for hand washing by restaurant staff and direct contamination of food.
  • Poor training in handling and preparation of food may lead to cross-contamination
  • Storage of cooked products at ambient temperatures for extended time
  • Use of human fecal material for fertilization of crops
  • Lack of pasteurization of milk and dairy products