Q. Because many names are applied to the condition, some which cause me to blush, I am too embarrassed to discuss this with any of my friends. But I, too, suffer from severe diarrhea whenever I travel. Surely there must be an explanation for this condition and some sensible way to overcome this distressing situation. Will you please discuss this for me?
A. You could be suffering from enteritis, an inflammation of the intestine that usually manifests itself in the common traveler’s diarrhea. Travelers who now voyage to the many new destinations in undeveloped Third World countries may unwittingly be exposing themselves to a specific enteritis-causing agent on a repeated basis.
The most common cause of traveler’s diarrhea is the bacteria known as Escherichia coli, although other factors may be at root cause, including viruses and protozoa.
The condition is usually acquired from local food or water contaminated by feces: Raw leafy vegetables, unpeeled fruits, raw meat and seafood, unpasteurized milk and impure water are most often at fault. If you order bottled water while abroad, make sure the ice originates from an equally protected source.
The ways of avoiding traveler’s diarrhea vary in effort and effectiveness. Although it’s no guarantee, watch what you eat and drink, especially when venturing away from tourist or business circles.
You may also want to consider a preventative approach; a daily 2-ounce dose of bismuth subsalicylate (impractical for longer trips) greatly reduces the risk, while antibiotics such as doxcycline, trimethoprim, or trimethoprim-sulfamethoxazole can reduce the risk by between 60 percent to 90 percent. The use of antibiotics is controversial and should be restricted to individuals with underlying medical problems that may be aggravated by a case of traveler’s diarrhea.
If you should come down with the condition, try treating it by consuming sugar-containing drinks, to replace fluids you may have lost, as well as salted crackers to replenish carbohydrates and lost sodium and chloride. High fluid intake is essential in any effective treatment. Antibiotics may be necessary, particularly if nausea, vomiting, abdominal cramps or fever are present, and if bloody stools are passed in addition to the diarrhea.
Across my desk
The National Institutes of Health is seeking 19,000 women to participate in its Women’s Health Initiative, to study chronic diseases that affect women. Answers are being sought to such questions as: Can a low-fat diet prevent breast and colon cancer as well as heart disease in women; Will hormone replacement therapy prevent heart disease and fractures from osteoporosis?
If you are a woman between the ages of 50 and 79 and plan to live in the same community for at least three years, you may qualify to participate in this largest study of women’s health ever undertaken by the NIH.
Three studies are being undertaken, a dietary program, a test of hormones, and the use of calcium and Vitamin D. Participants will visit one of 40 centers around the country for a complete history, an examination and blood tests.
If you are interested, call (800) 54-WOMEN and you will be connected to the center nearest you.
———-
Write to Dr. Bruckheim in care of the Chicago Tribune, Room 400, 435 N. Michigan Ave., Chicago, Ill. 60611.
