What to do when holiday spoiler of traveler's diarrhea hits
What to do when holiday spoiler of traveler's diarrhea hits
By Maria Endah Hulupi
JAKARTA (JP): Those tempting images of beautiful panoramas and ways of life so different from our own are hard to resist.
But what some travelers get to experience, particularly people from developed countries visiting poorer regions of the world, is the problem of traveler's diarrhea -- and end up spending most of their vacation in their hotel room.
"The explanation is that the (traveler's) body has not yet developed the antibodies to counteract certain antigens, making them prone to contract digestive problems," said an internist with state-run Cipto Mangunkusumo General Hospital in Jakarta, Dharmika Djojoningrat.
Research found that 50 percent of travelers or tourists contracted diarrhea within the first two weeks of their stay, and 10 percent of them continued to have gastrointestinal problems after they returned home.
If a country has a reputation for people coming down with stomach problems, it will be a hard sell for tourism.
"This situation poses a challenge for authorities, especially in the tourism and health ministries, to boost the country's tourism industry," he said.
Traveler's diarrhea is a form of acute diarrhea or frequent discharge of watery stools (more than three times a day). The disease may involve other symptoms like nausea, vomiting, stomach ache, pain in the anal area and bloody stools.
"Most of the reported cases are mild digestive problems and rarely lead to dehydration or fever. However, without proper and immediate handling, traveler's diarrhea can be fatal due to significant losses of fluid and electrolytes from the body," he said.
The main causes are pathogenic bacteria, such as enterotoxin e. coli, campylobacter jejuni, shigella, salmonella and vibrio, that enter the body from contaminated food and drinking water.
Traveler's diarrhea is differentiated into two types:
* Noninflammatory diarrhea, which is commonly caused by vibrio cholerae, giardia, enterotoxin E.coli and the food poisoning germ staphylococcus aureus and c. perfringens. The bacteria release toxic matter and disturb the function of the digestive system, hindering absorption of nutrients and causing increased secretion of electrolytes from the intestine wall. Affected people usually complain of frequent discharge of watery stools.
* Inflammatory diarrhea caused by bacteria that create ulcers in the intestinal wall, which will be followed by discharge. This kind of diarrhea is caused by shigella, campylobacter, salmonella, e. histolitica and c. difficile. Affected people will complain of frequent discharge of watery stools, in some cases containing blood, accompanied by fever and intense stomach pain.
Dharmika said 70 percent of acute diarrhea cases were self- limiting, meaning they cleared up without medication, within three days to four days. This is because the bacteria has a limited ability in destroying its own environment and that the body has adequate immune defenses to fight the bacteria.
Food and drinking water are potential medium for the growth of germs, and travelers are advised to eat fresh, thoroughly cooked food and avoid drinking water from potentially unhygienic sources. They must also be careful about other sources of water, such as ice.
If a person is already affected, the most important thing to do is to prevent dehydration and restore the electrolyte elements in the body by drinking a rehydration liquid, some of which are sold over the counter at pharmacies.
People can make their own rehydration fluid by mixing a glass of water, 1/4 teaspoon of salt and baking soda and one tablespoonful of sugar as a source of easily absorbed calories and to restore electrolytes.
"Drinking a lot of water and eating salty crackers will help restore fluid and electrolyte elements in the body," Dharmika said.
He also recommended other low-residue food, such as bananas, porridge and boiled potatoes for people recovering from diarrhea.
Affected people are advised to avoid dairy products and high fiber food. The body lacks the enzyme lactose to break down lactose substances during the period of illness while high-fiber foods such as vegetables will cause a higher secretion of fluids from the intestinal wall.
He said that widely available antidiarrheal medications, such as activated charcoal, kaolin and pectin, would help soothe the problem by reducing the intestinal peristaltic movement and may kill the germs as well. The intestine will be able to absorb fluid and nutrients from food and form a normal solid stool.
"However, if the problem persists or worsens, consult a physician who may prescribe antibiotics," Dharmika said.