Montezuma's Revenge, Delhi Belly, the Aztec Two-Step, the Tokyo Trots, King Tut Gut, Turista, or simply Travelers' Diarrhea. It has been called so many names in so many languages and in so many cultures all over the world because it is the most common gastrointestinal ailment among travelers. In fact, there's an old saying that "travel broadens the mind but loosens the bowel!" Although all these names may sound funny, travelers' diarrhea is no joke. About a third of its victims must take a bed rest, and almost half must change their plans to accommodate the symptoms, resulting to a major inconvenience. Teenagers and young adults are more prone to get travelers' diarrhea than older travelers, maybe because they are more adventurous, daring, and sometimes careless about sampling the local cuisine, or perhaps because they haven't developed immunity yet.

The culprit
There are various causes of travelers’ diarrhea, such as viruses, bacteria, and protozoa. An estimated 40 to 70 percent of most cases are caused by Escherichia coli, a toxin-producing bacteria that is normally found in the digestive tract. Other culprits share the limelight, such as Vibrio parahaemolyticus, Shigella, Campylobacter jejuni, Salmonella, Norwalk-like virus, rotaviruses and Giardia, which usually enter our body via food, drinking water, and sometimes ice cubes, but there are other possible transmission agents like contaminated lakes, streams, and rivers in which tourists swim.

The defense
Travelers should follow a very conservative food and water safety guideline (see the TRAVELERS' STOMACH) to prevent travelers' diarrhea, but it can also be prevented with medications. There are available over-the-counter medications, and prescription drugs to minimize the possibility of getting it.

But the wise traveler should always consult a doctor before taking the medication, because some of these drugs have known side effects. Some even cause the diarrhea they were trying to prevent. Most doctors will advise against using these drugs routinely because some of the microorganisms that cause diarrhea have developed resistance to some types of drugs. It is usually more an uncomfortable problem than a dangerous one that taking preventive medications are for those who want to remain well while away. Some businessmen cannot afford to take a rest that taking preventive medications is more advantageous. And in those situations where you will be traveling to remote areas where safe food and water and medical help is not accessible, it is wise to take preventive medications. But it is always wiser to consult a doctor first.

However, no preparation is foolproof. But it also does not have to ruin your whole trip. You can usually get rid of the problem and be up-and-out in a day or two if you treat the problem immediately. Most cases will subside in three to five days if left untreated, because diarrhea is actually the body's way of ridding itself of invading organisms. But if you're on that perfect island paradise with the perfect companion, spending most of your vacation feeling weak is not an option.

A mild case of diarrhea is usually defined as one or two stools over an eight-hour period, also accompanied by abdominal cramps, nausea and cold sweating. It can be remedied by taking antimotility drug such as loperamide (Imodium), or Pepto-Bismol. Both are proven to be effective against travelers' diarrhea, but Immodium will relieve symptoms more quickly. If you have nothing else available, taking plain aspirin alone is worth a try. It has shown in some studies that it can reduce stool volume.