Prevention and treatment of travelers' diarrhea

This chapter focuses on the most common population at risk for travelers' diarrhea (TD), which is a traveler from an industrialized country traveling to a less developed region with higher rates of enteropathogens, particularly bacterial, than the traveler's country of origin. The clinical syndrome consists of both an increased frequency of bowel movements, along with a change in stool consistency to loose and/or liquid form. "Typical" TD represents a spectrum of illness from a fleeting mild diarrhea without associated symptoms or activity limitation to a serious dehydrating and/or febrile dysentery requiring hospitalization. Bacterial enteropathogens are the predominant etiologic agents associated with TD. The American College of Gastroenterology (ACG) guidelines classified pretravel counseling regarding high-risk food/beverage avoidance to prevent TD as a conditional recommendation, though with very low-level evidence of efficacy.