Health Matters: Traveler's diarrhea can be curbed by caution

Q. My husband and I are planning a trip to the Caribbean in a few weeks to get away from the cold. But we're concerned about the risk of stomach problems and diarrhea. A. The bad news is that so-called traveler's diarrhea is relatively common; th...

Dr. Joshua Wynne

Q. My husband and I are planning a trip to the Caribbean in a few weeks to get away from the cold. But we're concerned about the risk of stomach problems and diarrhea. A. The bad news is that so-called traveler's diarrhea is relatively common; the good news is that usually it is self-limited and mild. There is an increased risk when traveling to most of the world; low-risk countries include the United States and Canada, much of western Europe, Israel, Japan, Australia and New Zealand. So you are traveling to an area where it is relatively common.
Most traveler's diarrhea is caused by bacteria that get into your body through the consumption of contaminated food or beverages. Accordingly, we usually recommend commonsense precautions, like frequent hand washing, choosing restaurants that appear clean, avoiding uncooked or undercooked food and raw vegetables and fruits, and using only bottled beverages.
However, the effectiveness of these measures is unclear, and part of the fun of a vacation is experiencing new and unique foods. So while I do recommend these commonsense measures, I'm also realistic that many vacationers will still get sick.
If you do, typical symptoms include diarrhea, stomach cramps and bloating. Danger signals include fever and bloody diarrhea. Self-treatment usually suffices, including hydration (tea and soup are good) and over-the-counter bismuth preparations (like Pepto-Bismol) or loperamide (Imodium).
Oral antibiotics are used in more severe cases and do shorten the duration of the disease, so asking your health care provider for a prescription for one is reasonable, especially if you are traveling to a remote area. Most of all, have fun on your trip.

Q. I've tried everything to lose weight, but I'm still very heavy. I'm considering bariatric surgery. Does it work, and what are its long-term effects? A. You have plenty of company; many of us struggle with excess weight, and far too many Americans are seriously overweight. While most successful programs to lose weight include a combination of diet, exercise and counseling, many people remain morbidly obese despite their best efforts.
Bariatric surgery has been a major advance for these people and has helped them lose considerable weight. Surgery has even more benefits, including a reduction in medical complications related to obesity and an improved quality of life.
It gets even better: A recently completed study of bariatric surgery in a large group of predominantly male patients showed a significant improvement in survival for up to 14 years after surgery. At 12 years after surgery, for example, about one out of five surgical patients had passed away, while almost one out of three control patients not undergoing surgery had died.
There are risks associated with surgery, including the chance of complications and even death, but the risks have decreased over time. When balancing the risks and benefits, it seems clear that bariatric surgery is associated with enough important beneficial outcomes that it certainly should be considered by people who remain seriously overweight despite their best efforts.


Wynne is vice president for health affairs at UND, dean of the School of Medicine and Health Sciences and a professor of medicine. He is a cardiologist by training.
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The content of this column is for informational purposes only and does not substitute for professional medical advice or care. The information provided herein should not be used for diagnosing or treating a health problem or disease. If you have or suspect you may have a health problem, you should consult your health care provider. Never disregard professional medical advice or delay in seeking it because of something you have read in this column.

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