Traveller's diarrhoea

Diarrhoea experienced by people from developed countries when travelling to developing countries. 

It is caused in up to 90% of cases by a bacterial infection (enterotoxigenic Escherichia coli, Salmonella spp, Campylobacter jejuni and Shigella spp), although it may be of viral or parasitic origin. 

Depending on the symptoms manifested, it is classified as follows:

• Mild traveller's diarrhoea: one or two episodes in 24 hours of unformed stools, without other accompanying symptoms.
• Moderate traveller's diarrhoea: one or two episodes in 24 hours of unformed stools, plus one of the following symptoms: nausea, vomiting, abdominal pain, fever and blood in the stool. Includes cases with more than two episodes of loose stools per day without other accompanying symptoms. 
• Classic traveller's diarrhoea: three or more episodes in 24 hours of unformed stools, with at least one of the following symptoms: nausea, vomiting, abdominal pain, fever and blood in the stool.

They are usually accompanied by general malaise, loss of appetite and increased bowel movements. 

It is diagnosed by clinical questioning that reveals onset during travel or within 10 days of return. Stool culture is recommended when accompanied by fever or blood in the stool to rule out infection by more virulent micro-organisms. 
Treatment is aimed at ensuring proper hydration (preferably by mouth) and soothing symptoms with standard analgesics and antiemetics.