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.