John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Travelers' diarrhea is defined by most experts as three or more unformed
stools in a 24 hour time period, passed by a person who is traveling. Travelers'
diarrhea is commonly accompanied by abdominal cramps, nausea, and bloating.
Travelers' diarrhea is a general term and does not specify any cause. Travelers' from temperate regions of the world frequently experience diarrhea four days to two weeks after arriving in certain
other areas of the world. This illness is called travelers' diarrhea. Other terms used to describe this illness include "Montezuma's Revenge," the "Aztec Two Step," and "Turista" in Mexico, the "Delhi Belly" in India, and the "Hong Kong Dog" in the Far East.
How common is travelers' diarrhea?
Twenty percent to fifty percent of travelers may develop
diarrhea depending on the region of the world they visit. Diarrhea is the most common illness of travelers,
affecting 10 million people each year, according to the Centers for Disease
Control (CDC). In general, travelers at risk for diarrhea commonly come from industrialized nations and travel to high-risk areas that are primarily within developing or less industrialized nations of the world, including Latin America, Africa, the Middle East, and Asia. Areas of lesser risk include China and some Caribbean nations. Travel to areas of the United States, Canada, Northern Europe, and Australia pose the lowest risk to travelers.
Men and women are at equal risk for developing travelers' diarrhea. Younger individuals are more commonly afflicted, perhaps because of more adventurous eating habits. People with disorders that compromise their immune system (such as
HIV, cancer, chemotherapy, steroid use),
people with diabetes, and people with underlying abdominal disorders (irritable bowel syndrome,
colitis) are more susceptible to travelers' diarrhea.
People taking acid blockers for their stomachs (for example, famotidine
esomeprazole [Nexium]) also have a higher susceptibility to travelers' diarrhea because they have less stomach acid to protect them from the bacteria that cause
Reviewed by William C. Shiel Jr., MD, FACP, FACR on 9/30/2011
Melissa Conrad Stöppler, MD Medical Editor:
Charles P. Davis, MD, PhD
Travelers' diarrhea strikes up to half of all international travelers. It is
far and away the most common travel-related illness, affecting about 10 million
people per year worldwide. Infectious agents, particularly bacteria from water
contaminated with feces, cause travelers'
diarrhea. The most commonly identified bacteria associated with travelers'
diarrhea are what are called ETEC, or enterotoxigenic
The destination is the most important risk factor for the development of
travelers' diarrhea. Developing countries all over the world represent the
highest risk, and the highest-risk destinations are the developing countries of
Latin America, Africa, the Middle East, and Asia. Certain groups of people are
also more likely to develop travelers' diarrhea. At-risk groups include: