Travellers Diarrhea (Turista)

Travellers diarrhea is a type of gastroenteritis which usually develops during travels to places with inadequately treated water supply. The illness, characterized by diarrhea, nausea, and vomiting, is also known as turista.

  • Nausea and vomiting, as well as diarrhea accompanied by abdominal pain and cramping, are the usual symptoms, but the severity of the symptoms may vary.
  • Traveler’s diarrhea may be caused by viral or bacterial infection. Parasites also may be responsible.
  • The infection originates from food or drink consumed on a visit to developing countries with inadequate water purification measures.
  • The illness can be prevented by certain precautions such as using only carbonated drinks and bottled water for drinking purposes as well as for brushing teeth.
  • The gastroenteritis is treated with rehydration therapy and drugs to control diarrhea. Sometimes antibiotics are also used for the treatment of travellers diarrhea.

The occurrence of Traveler’s diarrhea is common in people who visit developing countries which do not have a water supply system of purified water. Lack of immunity to local microorganisms, due to lack of previous exposure, is the main reason for this type of gastroenteritis affecting visitors. Bacterial infection by Escherichia coli, or viral infection by norovirus, is the usual cause of the disease. Avoiding drinking water from local sources is not sufficient to prevent this disease. If ice cubes made from ordinary water is added to bottled water, it may get contaminated. Brushing the teeth with tap water or eating from dishes rinsed in ordinary water may lead to infection. Eating fresh fruits with skin, even after washing them, can result in infection. Occasionally, certain parasitic infestations also cause travellers diarrhea.

Symptoms and Diagnosis

Nausea and vomiting as well as diarrhea are the usual symptoms. Abdominal pain and cramping are usually present.  Rumbling of the intestines may be audible. Severity of the symptoms may vary and they usually start within 12 hours to three days after the consumption of contaminated water or food. Travellers diarrhea due to noro virus infection typically has symptoms such as headache and muscular pain in addition to vomiting. Diagnostic tests are not usually done, and the illness is often mild, with the patient recovering in about 3-5 days without any treatment.


Travellers diarrhea may be prevented by taking a number of precautionary measures on traveling to susceptible areas:

  • Eating in reputed restaurants following proper food hygiene practices
  • Drinking only bottled water and carbonated drinks
  • Eating only freshly cooked hot food
  • Eating fruits only after peeling the skin
  • Using bottled water to wash food items, cutlery, and toothbrush, and for rinsing the mouth
  • Avoiding food and drinks at roadside eateries
  • Avoiding fresh vegetables and fruits in salads
  • Not participating in buffets, open air food fests and feasts

As a preventive measure, an antibiotic drug may be taken by people with lower immunity when they visit areas known to cause travellers diarrhea. Ciprofloxacin is the antibiotic of choice in such situations.


When gastroenteritis develops, plenty of water and other liquids should be taken to compensate for the fluid loss due to diarrhea. An antidiarrheal drug like loperamide may be taken to control diarrhea. However, loperamide should not be taken if fever is present or if stools are bloody. Children below 2 years are also not treated with antidiarrheal drugs. Travelers developing fever or passing bloody stools should get medical care as soon as possible.

Antibiotic therapy is started if diarrhea persists with more than 3 bowel movements in an 8 hour period. Azithromycin, ciprofloxacin, rifaximin, or levofloxacin are given to adult patients, while children above 2 years of age are usually treated with azithromycin

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Yasser Elnahas

MD, PHD, Professor Of CardioVascular Surgery
Dr. Yasser Elnahas, Is an associate Professor of Cardiovascular Surgery. Dr. Elnahas was trained as a fellow At Texas Heart Institute And Mayo Clinic Foundation.Dr. Elnahas is dedicated to educating the general public about different disease conditions and simplifying the medical knowledge in an easy to understand terminology.

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