Nearly 50% of foreign travelers will experience diarrhea during their trip. The most common cause of travelers diarrhea is E. Coli although a number of other bacteria, viruses and parasites can cause similar symptoms. If symptoms are mild and not substantially interfering with planned activities, loperamide or bismuth subsalicylates can be used. If symptoms are moderately severe and impacting travel plans, most travelers will benefit both from anti-diarrheal medications such as loperamide as well as antibiotics. If symptoms are severe and incapacitating, anti-diarrheal medications and antibiotics should be initiated and the traveler should consider medical care for dehydration, bloody diarrhea, or fever.
Crossing more than two time zones unpleasantly disrupts the normal sleep/wake cycle. Traveling east is generally worse than traveling west, but ‘jet lag’ occurs in both directions and negatively impacts the travel experience. There are several proven strategies to minimize the effects of jet lag:
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