Persistent gastrointestinal symptoms in the ill-returning traveler

Persistent gastrointestinal symptoms are a common and varied clinical entity encountered in the weeks to months following travelers’ return. There is a growing appreciation for a spectrum of illnesses that can include diarrhea and nondiarrheal gastrointestinal symptoms. Beyond the infectious etiologies that are known to cause persistent symptoms, our understanding of postinfectious processes including functional bowel disorder, malabsorptive states, and small intestinal bacterial overgrowth after acute infections associated with travel is growing. Advances in diagnostics are aiding the clinician in identifying specific etiologies in which targeted therapies can be applied. However more study is needed to fundamentally understand the pathoetiology of persistent gastrointestinal syndromes, as well as safe and effective therapies for a number of protozoal infections and syndromes where no etiology is identified.