3 Things to Do When Traveler’s Diarrhea Is Ruining Your Life

If you’re escaping winter and jetting off to the tropics, you’re probably banking on spending as much time as possible in the warm, fresh air. But if you’re among the unlucky vacationers who catch a case of traveler’s diarrhea (TD), which hits an estimated 20 to 50% of international travelers, you could be, well, saddled to the toilet instead.

As its name suggests, this gastrointestinal infection typically causes plenty of diarrhea and loose stools, alongside abdominal cramps and flu-like symptoms such as fever and malaise. You get TD by ingesting some sort of pathogen (a bug like norovirus, bacteria such as E. coli, or even parasites like Giardia), typically via contaminated food or water. This tends to happen during travel to developing countries with a reduced level of public sanitation in comparison to the US, Sandhya Shukla, MD, a board-certified gastroenterologist with Atlantic Coast Gastroenterology Associates, in New Jersey, tells SELF.

While abroad, you may also be exposed to germs that aren’t common in the US, Theresa Fiorito, MD, a pediatric infectious disease specialist and director of the family travel medicine center at NYU Langone Hospital—Long Island, tells SELF. Because your body rarely (if ever) encounters these bugs, it may have little ability to defend against them. Hence the infection and array of miserable symptoms that can ensue once they arrive in your gut.

Most cases of TD are mild and resolve naturally within a few days, but some can get quite serious and prevent you from going about your daily life. In any case, it’s best to check in with a primary care provider or an urgent-care physician, if possible, to get advice tailored to your situation. But in the meantime, read on for three expert tips that you can put in practice ASAP the next time you’re sidelined by the runs on vacation.

1. Think twice about taking OTC diarrhea meds.

You may have treated past bouts of diarrhea with Imodium (loperamide)—an over-the-counter antidiarrheal pill that can slow down an overactive gut—but it’s not always recommended for traveler’s diarrhea. Why? In certain cases, you actually want your body to expel the germs by pooping them out. And the fact that Imodium can decelerate the runs means it may also keep harmful organisms in your body for longer.

The decision depends on how intense your TD is and what’s causing it. If it’s mild, meaning it doesn’t majorly interrupt your daily activities, there’s a good chance you’ve been infected with a virus, like one that causes food poisoning, Dr. Fiorito says. And with these cases, OTC antidiarrheals like Imodium and Pepto-Bismol can indeed be helpful for alleviating symptoms while your body fights off the infection, Dr. Shukla says.

But if you’re dealing with a rougher case that’s causing severe diarrhea (particularly bloody poops or ones streaked with mucus) as well as belly pain and fever, it’s more likely that you’re infected by bacteria, like Campylobacter or E.coli. (A doctor can order a stool test to determine the particular culprit.) And in this scenario, you may be better off skipping the Imodium and other antimotility drugs, and letting your gut effectively flush the offenders. It’s also important to see your doctor, who can prescribe an antibiotic like azithromycin (which may come in a Z-Pack) to help kill the infection-causing bugs, Dr. Shukla says.

2. Stay hydrated by taking small sips of water.

It’s important to drink plenty of water when dealing with TD, since you’ll be losing a lot of fluids by way of diarrhea. But you don’t want to chug or gulp large quantities at once—that can worsen cramping and leave you bolting for the bathroom even more frequently.

“Take small sips so as to not overwhelm the body,” Dr. Fiorito advises. This helps your kidneys process and filter the water more effectively, too, she says, so you can avoid dehydration—which can become pretty dangerous and lead to serious issues, like organ damage or shock, that require a visit to the ER.

While we’re on the topic: Rehydration solutions with electrolytes—which you can find in Liquid IV packets, Gatorade, and Pedialyte—are solid choices. You can also make your own hydration cocktail. Here are a few options from Dr. Fiorito: Half a can of Coke or half a glass of Gatorade with equal parts water and a pinch of salt, or, the simplest bet: Six teaspoons of sugar, half a teaspoon of salt, plus four cups of water.

3. Use acetaminophen for pain instead of NSAIDs.

When you have TD, it can feel like your intestines are at war—which is why, in moderate to severe cases, you might reach for an OTC drug to ease the pain. If you do, it’s best to opt for acetaminophen (Tylenol) over ibuprofen (Advil) or other nonsteroidal anti-inflammatory drugs (NSAIDs), such as naproxen (Aleve) or aspirin. It generally has a “superior gastrointestinal safety profile,” Dr. Shukla says, meaning it’s less likely to trigger stomach upset.

Conversely, NSAIDs are known to be “irritating to the stomach,” Dr. Fiorito says, and may cause gut side effects in some people, including gas, abdominal pain, and even gastrointestinal bleeding. With TD, your stomach’s already going through the wringer, so popping ibuprofen could just add fuel to the fire, whereas acetaminophen poses less of a threat.

Other than that, you want to relax as much as possible and eat small amounts of bland foods (toast! bananas!) and salty snacks like pretzels or crackers to help replenish lost electrolytes and support hydration. And as always, if you feel really unwell and none of the above seems to be helping, talk to your doctor. More serious cases of TD, including ones that linger for a couple weeks or longer, may prompt your provider to run a stool test, and depending on the results, prescribe a course of antibiotics to get your bowels back on track.