Hill diarrhea, also known as travelers’ diarrhea, is a kind of diarrhea, common in persons traveling to destinations with limited resources resulting in an unhygienic environment. The causative agents include bacteria, viruses, and parasites.
Among bacteria, enterotoxic E coli contributes to 30% of the cases. Campylobacter jejuni, Shigella, and Salmonella are some of the other bacterial species. The non-bacterial organisms include norovirus, giardia intestinalis, cryptosporidium, and Entamoeba hystolitica.
The infection is common in areas that lack refrigeration, proper sanitation facilities, and hygienic practices in food preparation and handling.
Some of the treatment and prophylactic measures are:
- Water and electrolyte repletion: Diarrhea causes dehydration. Heat-sterilized water, electrolyte drinks, or oral rehydration salts help replace lost water and electrolytes. Pedialyte is more suitable for children. However, milk and juices worsen diarrhea.
- Loperamide: It relieves symptoms, in the case of non-inflammatory diarrhea.
- Antibiotics: Ciprofloxacin and fluoroquinolones are the common antibiotics prescribed. However, the Campylobacter species have developed resistance. Hence azithromycin is preferable for those traveling to Asia.
- Counseling: As a preventive measure, travellers should be counseled with instructions before starting. The instructions include avoiding food prepared in unhygienic manner, leafy vegetables, fruits that are kept peeled off, etc.
- Prophylactic medicines: Rifaximin and bismuth subsalicylate reduce the incidence.
Dehydration,Infection in the gastrointestinal tract,Abdominal cramps
Bismuth subsalicylate,Trimethoprim-sulfamethoxazole ,Fluoroquinolones