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Traveler’s Diarrhea: The Basics

This is a guest post by Dr. Erik McLaughlin.

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Traveler’s Diarrhea: The Basics

Known around the world by many names including “Montezuma’s revenge,” “Delhi belly” and “mummy tummy,” traveler’s diarrhea (TD) is the most common illness faced by travelers. Nothing can slow down a fun trip as easily as TD — and it can also have serious health implications. TD typically lasts four to six days, and 90 percent of cases occur within the first two weeks of travel.

Anatomy You Need to Know

The gastrointestinal tract starts at the mouth and ends at the anus. After food enters the mouth, it passes through the esophagus to the stomach, where it sits for approximately 45 minutes. After being broken down by gastric secretions, food matter enters the small intestine (duodenum, jejunum, and ileum in order). The small intestine is the site where most nutrients are absorbed by the body. From the small intestine, food matter begins to look more like feces as it progresses to the large intestine or colon. The colon absorbs water from the food material before the material passes through the anus and exits the body as feces.

Symptoms

Recognizing the warning signs of TD, such as blood in the stool, fever, or abdominal cramping, can help a savvy traveler know when to seek medical help.

TD has many definitions; the presence of three or more loose-formed stools in one day is a good one. Abdominal cramping, nausea, vomiting and fever may also occur. The presence of blood in the stool can indicate that infection has directly damaged the intestinal wall and should be taken seriously. Read more »

This post, Traveler’s Diarrhea: The Basics, was originally published on Healthine.com by Paul Auerbach, M.D..

Drug Safety In Preventing Acute Mountain Sickness

This is a guest post by Dr. Jeremy Windsor.

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Steroids and Acute Mountain Sickness

In recent years, many attempts have been made to identify safe and effective medications to prevent acute mountain sickness (AMS). Acetazolamide (Diamox), currently the “drug of choice” for this purpose, is not perfect and occasionally causes objectionable side effects. Dexamethasone (Decadron), a powerful steroid medication, has become increasingly popular for prevention and treatment in certain circles. While there is ample evidence to suggest that dexamethasone is effective, a recent case report highlights that this drug is not without risk.

In the latest issue of the journal Wilderness & Environmental Medicine [WEM 21(4):345-348, 2010] in an article entitled ”Complications of steroid use on Mt. Everest,” Bishnu Subedi and colleagues working for the Himalayan Rescue Association (HRA) described the case of a 27 year-old man who was prescribed a course of three drugs, including dexamethasone, intended to support him during his attempt to climb Mt. Everest. After more than three weeks of taking the medications, the mountaineer noticed the appearance of a rash and decided to stop taking them. Rather than wait for the rash to subside, he chose to continue his acclimatization program and ascend to Camp 3 at 7010m altitude. The patient arrived exhausted and confused; onlookers quickly recognized that something was seriously wrong and so a rescue party was organized to help him back to safety. Read more »

This post, Drug Safety In Preventing Acute Mountain Sickness, was originally published on Healthine.com by Paul Auerbach, M.D..

Shoveling Snow? How To Protect Your Heart

After shoveling the heavy, 18-inch layer of snow that fell overnight on my sidewalk and driveway, my back hurt, my left shoulder ached, and I was tired. Was my body warning me I was having a heart attack, or were these just the aftermath of a morning spent toiling with a shovel? Now that I’m of an AARP age, it’s a question I shouldn’t ignore.

Snow shoveling is a known trigger for heart attacks. Emergency rooms in the snowbelt gear up for extra cases when enough of the white stuff has fallen to force folks out of their homes armed with shovels or snow blowers. 

What’s the connection? Many people who shovel snow rarely exercise. Picking up a shovel and moving hundreds of pounds of snow, particularly after doing nothing physical for several months, can put a big strain on the heart. Pushing a heavy snowblower can do the same thing. Cold weather is another contributor because it can boost blood pressure, interrupt blood flow to part of the heart, and make blood more likely to form clots.

When a clot forms inside a coronary artery (a vessel that nourishes the heart), it can completely block blood flow to part of the heart. Cut off from their supply of life-sustaining oxygen and nutrients, heart muscle cells begin to shut down, and then die. This is what doctors call a myocardial infarction or acute coronary syndrome. The rest of us call it a heart attack.

The so-called classic signs of a heart attack are a squeezing pain in the chest, shortness of breath, pain that radiates up to the left shoulder and down the left arm, or a cold sweat. Other signs that are equally common include jaw pain, lower back pain, unexplained fatigue or nausea, and anxiety. Read more »

*This blog post was originally published at Harvard Health Blog*

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