Precautions When Travelling

It is now known that 20 - 30% of all patients who develop severe gastrointestinal infections will go on to develop IBS symptoms. The bacteria that are responsible for causing the severe gastrointestinal infections are most commonly campylobacter jejuni, a species of salmonella shigella and Escherichia coli. With the development of accessible and cheap world travel there are reasons for believing that gut infections will be come an increasingly common cause of IBS symptoms. Results of recent research have highlighted a number of risk factors for developing IBS following gut infection. These include severity and duration of the original infection, the female sex and pre-existing anxiety and depression. IBS symptoms develop, it is thought, because the offending gut infection results in a subtle and significant inflammation in the gut wall and that in turn may result in the over production of the chemical serotonin 5-hydroxytryptamine (5-HT) from the specialised entero-chromatic cells lining the gut. It certainly follows from this discussion that existing IBS sufferers should take great care when they are travelling abroad in order not to contract gut infections that will lead to a severe and long infective illness.

Travellers' diarrhoea, as it is called, can be caused by a number of other infections. These include viruses, bacterial infections mentioned above and various parasitic infections such as giardea lamblia, amoebic dysentery (this is caused by an amoebic parasite called entamoeba histolytica). Most, if not all, of these infections are present in food and drinking water and are transmitted by infected food handlers.

IBS patients travelling abroad should therefore be scrupulously careful not to drink potentially infected tap water and should restrict themselves to drinking mineral water, cooked rather than cold food should be preferred and despite the desire to eat cold salads in hot climates IBS sufferers should remember that while they might be using care to drink bottled water it is very unlikely that salads will be washed in mineral water.

There are a number of important studies that now show that any bacterial gastrointestinal infections can be treated effectively by taking 500 mg of the antibiotic ciprofloxacin (ciproxin) as soon as it is becoming apparent that diarrhoeal symptoms are about to develop. Such an approach has been shown to markedly reduce severity and longevity of gut infections. If this approach is ineffective it is very important that IBS sufferers seek medical attention and have a stool test done to determine the cause of the gut infection. This is to ensure that the correct treatment is instituted as quickly as possible to shorten the severity and duration of the infection.

Our recommended traveller's kit would therefore include a supply of ciproxin and loperamide or Imodium for symptomatic treatment.

   


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