Diarrhea | Johns Hopkins Medicine

What is diarrhea?

Diarrhea is when your stools are loose and watery. You may also need to go to the bathroom more often.

Diarrhea is a common problem. It may last 1 or 2 days and goes away on its own.

If diarrhea lasts more than 2 days it may mean you have a more serious problem.

Diarrhea may be either:

• Short-term (acute). Diarrhea that lasts 1 or 2 days and goes away. This may be caused by having food or water that was made unsafe by a bacterial infection. Or it may happen if you get sick from a virus.
• Long-term (chronic). Diarrhea that lasts several weeks. This may be caused by another health problem such as irritable bowel syndrome. It can also be caused by an intestinal disease such as Crohn’s disease or celiac disease. Some infections such as parasites can cause chronic diarrhea.

What causes diarrhea?

Diarrhea may be caused by many things, including:

• A bacterial infection
• A virus
• Trouble digesting certain things (food intolerance)
• Food allergy (such as celiac disease, gluten allergy)
• Parasites that enter the body through food or water
• A reaction to medicines
• An intestinal disease, such as inflammatory bowel disease
• A problem with how your stomach and bowels work (functional bowel disorder), such as irritable bowel syndrome
• A result of surgery on the stomach or gall bladder
• Recent antibiotic use
• Metabolic conditions such as thyroid problems
• Other less common reasons such as damage from radiation treatments or tumors that make too many hormones

Many people get traveler’s diarrhea. This happens when you have food or water that is not safe because of bacteria, parasites, and even food poisoning.

Severe diarrhea may mean you have a serious disease. See your healthcare provider if your symptoms don’t go away or if they keep you from doing your daily activities. It may be hard to find out what is causing your diarrhea.

What are the symptoms of diarrhea?

Each person’s symptoms may vary. Symptoms of diarrhea may include:

• Belly (abdominal) cramps
• Stomach pain
• Swelling (bloating)
• Upset stomach (nausea)
• Urgent need to go to the bathroom
• Fever
• Bloody stools
• Loss of body fluids (dehydration)
• Leaking stool and not being able to control your bowels (incontinence)

Dehydration is a serious side effect of diarrhea. Symptoms include:

• Feeling thirsty
• Not urinating as often
• Having dry skin as well as a dry mouth and nostrils (mucous membranes)
• Feeling very tired
• Feeling that you may pass out or faint (lightheaded)
• Headaches
• Fast heart rate
• Sunken fontanelle (soft spot) on baby’s head

Diarrhea symptoms may look like other health problems.   Bloody diarrhea is always a concern. Always see your doctor to be sure. Be sure to tell the doctor about any bleeding, fever, or vomiting.

How is diarrhea diagnosed?

To see if you have diarrhea, your healthcare provider will give you a physical exam and ask about your past health. You may also have lab tests to check your blood and urine.

Other tests may include:

• Stool studies including culture and other tests. This test checks for any abnormal bacteria in your digestive tract that may cause diarrhea and other problems. To do this, a small stool sample is taken and sent to a lab.

• Sigmoidoscopy. This test lets your healthcare provider check the inside of part of your large intestine. It helps to tell what is causing diarrhea. A short, flexible, lighted tube (sigmoidoscope) is put into your intestine through the rectum. This tube blows air into your intestine to make it swell. This makes it easier to see inside. A biopsy can be taken if needed.

• Colonoscopy. This test looks at the full length of your large intestine. It can help check for any abnormal growths, tissue that is red or swollen, sores (ulcers), or bleeding. A long, flexible, lighted tube (colonoscope) is put into your rectum up into the colon. This tube lets your healthcare provider see the lining of your colon and take out a tissue sample (biopsy) to test it. He or she can also treat some problems that may be found.

• Imaging tests. These tests can see if there are any problems with the way your organs are formed (structural abnormalities).

• Fasting tests. These tests show if you are unable to digest certain foods (food intolerance). They can also tell if certain foods bring on an immune system reaction (food allergy).
• Blood tests. These can look for metabolic problems like thyroid disease, anemia (low blood count), evidence of low vitamin levels suggesting poor absorption, and celiac disease, among other things.

How is diarrhea treated?

Your healthcare provider will make a care plan for you based on:

• Your age, overall health, and past health
• How serious your case is
• How well you handle certain medicines, treatments, or therapies
• If your condition is expected to get worse
• What you would like to do

In most cases you will need to replace the fluids you have lost.

You may also need a medicine that fights infection (antibiotic) if a bacterial infection is causing your diarrhea.

Complications of diarrhea

If your diarrhea is not treated you are at risk for dehydration. Severe dehydration can lead to organ damage, shock, and fainting (loss of consciousness) or coma.

Can diarrhea be prevented?

Having good personal habits can keep you from getting diarrhea caused by bacteria or a virus. It is important to:

• Wash your hands often
• Use alcohol based sanitizers
• Eat foods that have been cleaned and cooked in a safe way
• Not take any foods or liquids that may have been infected with a bacteria or virus

When you are traveling, make sure anything you eat and drink is safe. This is even more important if you travel to developing countries.

Travel safety tips for water and other liquids include:

• Not drinking tap water or using it to brush your teeth
• Not using ice made from tap water
• Not drinking milk or milk items that have not gone through a process to kill certain bacteria (pasteurization)

Travel safety tips for food include:

• Not eating any fresh or raw fruits and vegetables unless you wash and peel them yourself
• Making sure all meat and fish have been cooked to at least medium doneness
• Not eating raw or rare-cooked meat or fish
• Making sure meat and shellfish such as shrimp, crab, and scallops, are hot when served
• Not eating food from street vendors or food trucks

Living with diarrhea

In most cases diarrhea is a short-term problem. Often it only lasts for a few days. Be sure to take plenty of liquids when you’re having a bout of diarrhea.

Some health problems can make diarrhea last longer or keep coming back. These include inflammatory bowel disease and irritable bowel syndrome. If another health problem is causing your diarrhea, follow your healthcare provider’s advice for treating that problem.

When should I call my healthcare provider?

Call your healthcare provider if:

• You have diarrhea more often
• You have a greater amount of diarrhea
• You have symptoms of dehydration. You may feel thirsty, tired, or dizzy. You may also have less urine, or a dry mouth.
• You have diarrhea with rectal bleeding or black and tarry stools, a fever, or are vomiting

Key points about diarrhea

• Diarrhea is when your stools are loose and watery.
• You may also need to go to the bathroom more often.
• Short-term (acute) diarrhea lasts 1 or 2 days.
• Long-term (chronic) diarrhea lasts several weeks.
• Diarrhea symptoms may include belly cramps and an urgent need to go to the bathroom.
• Loss of fluids (dehydration) is one of the more serious side effects.
• Treatment usually involves replacing lost fluids.
• You may need an infection-fighting medicine (antibiotic) if a bacterial infection is the cause.

Next steps

Tips to help you get the most from a visit to your health care provider:

• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your provider if you have questions.

15 Common Causes and How To Treat It

Written by WebMD Editorial Contributors

• What Is Diarrhea?
• Diarrhea Causes
• Diarrhea Symptoms
• Serious Symptoms of Diarrhea
• When to See a Doctor for Diarrhea
• Diarrhea Diagnosis
• Treatment for Diarrhea
• Relief From Diarrhea Symptoms
• When Diarrhea Won’t Go Away
• More

When you have diarrhea, your bowel movements (or stools) are loose and watery. It’s common and usually not serious.

Many people get diarrhea a few times a year. It normally lasts 2 to 3 days. Some people get it more often. That could be because they have irritable bowel syndrome (IBS) or other conditions.

Usually, diarrhea happens because of a virus that gets into your gut. Some people call it “intestinal flu” or “stomach flu.”

Other causes include:

• Allergies to certain foods
• Diseases of the intestines (such as Crohn’s disease or ulcerative colitis)
• Eating foods that upset the digestive system
• Infection by bacteria (the cause of most types of food poisoning) or other organisms
• Laxative abuse
• Running (Some people get “runner’s diarrhea” for reasons that aren’t clear.)
• Some cancers
• Surgery on your digestive system
• Trouble absorbing certain nutrients, also called “malabsorption”

Diarrhea may also follow constipation, especially for people who have irritable bowel syndrome (IBS).

You may have:

• Bloating in your belly
• Thin or loose stools
• Watery stools
• An urgent feeling that you need to have a bowel movement
• Nausea and throwing up

Most cases of diarrhea are nothing more than a brief inconvenience. But sometimes, they warn of a serious condition. Talk with your doctor if your child has diarrhea for more than 24 hours. If you have it for more than 3 days, make an appointment.

Also, be sure to let your doctor know about your diarrhea if you have cancer, or have had recent treatment for it.

More serious symptoms of diarrhea include:

• Blood or mucus in your stool
• Weight loss

If you have watery stools more than three times a day and you’re not drinking enough fluids, you could become dehydrated. That can be a serious problem if it’s not treated.

Call your doctor right away if you have:

• Blood in your diarrhea or black, tarry stools
• A fever that is high (above 101 F) or that lasts more than 24 hours
• Diarrhea lasting longer than 2 days
• Nausea or throwing up that prevents you from drinking liquids to replace lost fluids
• Severe pain in your belly (especially the right lower quadrant) or rear end
• Diarrhea after coming back from a foreign country

These can be warning signs of things like:

• Infection
• Inflammatory bowel disease
• Pancreatitis
• Colon cancer

Also, call your doctor right away if you have diarrhea and any of these signs of dehydration:

• Dark urine
• Smaller than usual amounts of urine or, in a child, fewer wet diapers than usual
• Rapid heart rate
• Headaches
• Dry skin
• Crankiness
• Confusion

Your doctor will ask about your medical history and what medications you take, as well as what you’ve eaten or had to drink recently. They will give you a physical exam to look for signs of dehydration or belly pain.

Certain tests can help pinpoint the cause of your diarrhea, including:

• Blood tests to look for certain diseases or disorders
• Colonoscopy, in rare cases, in which your doctor looks inside your colon with a thin, flexible tube that holds a tiny camera and light. They can also use this device to take a small sample of tissue. Or your doctor might need to do only a sigmoidoscopy, which looks at just the lower colon.
• Stool tests to look for bacteria or parasites

If your case is mild, you may not need to take anything. Adults can take an over-the-counter medicine such as bismuth subsalicylate or loperamide, which you can get as liquids or tablets.

You also need to stay hydrated. You should drink at least six 8-ounce glasses of fluids each day. Choose electrolyte replacement drinks or soda without caffeine. Chicken broth (without the fat), tea with honey, and sports drinks are also good choices. Instead of drinking liquids with your meals, drink liquids between meals. Sip small amounts of fluids often. Liquid probiotics may also help.

Your rectal area may become sore because of all the bowel movements that diarrhea brings. You may have itching, burning, or pain when you go to the bathroom.

For relief, take a warm bath or sitz bath. Afterward, pat the area dry (don’t rub) with a clean, soft towel. You may also try using a hemorrhoid cream or petroleum jelly on the affected area. If this continues for several days, you should contact your doctor.

If you still have diarrhea after 4 weeks, then you have chronic diarrhea.

To figure out the cause, your doctor will want to know your symptoms and medical history. You’ll get the most out of your appointment if you can tell them:

• How long you’ve had diarrhea
• Whether your diarrhea comes and goes, or is continuous
• If you think certain foods and situations make things better or worse
• If your stool looks bloody, oily, fatty, or watery
• Other symptoms you have and how long you’ve had them
• If you have a family history of chronic diarrhea
• Places you’ve traveled to recently
• Unusual foods you’ve tried in the last little while
• Any medication or supplements you’re taking
• If you’ve lost a lot of weight

Top Picks

causes, symptoms, how to quickly stop

Gastroenterologist

Neronov

Vladimir Alexandrovich

Experience 25 years

Gastroenterologist, Doctor of Medical Sciences

Make an appointment

Acute diarrhea is a multifactorial syndrome included in the list of symptoms of many infectious and non-communicable diseases. The main symptom of pathology is frequent loose stools. The feces become watery or mushy. With an exacerbated course of the primary disease, undigested food residues, mucus, and foam are present in the feces. The urge to defecate becomes more frequent and occurs with an interval of 2-3 hours.

General

Each year, two billion people around the world are diagnosed with diarrhea. Stool disorder remains the most common manifestation of pathological processes of gastroenterological, proctological and infectious types.

The disease is characterized by a favorable course in the presence of adequate and timely treatment. Patients with acute intestinal infections are placed in hospitals. Diarrhea of ​​a different origin can be treated on an outpatient basis.

Causes of disease

A stool disorder develops in patients under the influence of various factors:

• Infections;
• toxins;
• medication;
• inflammatory processes in the gastrointestinal tract;
• acute diseases of the pelvic organs.

In countries with a high culture of personal hygiene, diarrhea is the result of infections entering the human body. Their pathogens are rotaviruses and adenoviruses. Bacterial infections remain an equally common cause of diarrhea. Stool disorder is provoked by salmonella, E. coli, shigella. Similarly, helminthic invasions affect the condition of children and adults.

A common form of pathology is travelers’ diarrhea. It develops in people who move between countries with strict sanitary standards and countries with low levels of sanitation.

Symptoms

The clinical picture of the pathology is determined by the type of intestinal disorder detected in the patient. The secretory form of diarrhea occurs without abdominal pain. The daily volume of loose stools exceeds 1 liter. The mild course of the disease is explained by increased secretion of water in the intestine against the background of irritation of its mucous membrane with toxins. The frequency of the urge to defecate does not depend on the diet of the patient.

The aggravated course of diarrhea is accompanied by a number of non-specific symptoms:

• abdominal pain;
• fever;
• bouts of nausea;
• episodic vomiting.

Significantly frequent stool provokes dehydration. Against this background, the patient is faced with dehydration and its manifestations in the form of desiccation of the skin, an increase in blood pressure and tachycardia. The smell and color of feces change – dark shades of green dominate. Pathological processes in the large intestine can lead to staining of the stool with blood, the appearance of mucus and foam.

Diagnostics

The patient is examined by an infectious disease specialist, proctologist or gastroenterologist. The doctor collects data for anamnesis and clarifies the list of drugs that the child or adult used before the onset of diarrhea. The main diagnostic criterion for the disease is loose stools observed in humans at least three times a day. The duration of the intestinal disorder should not exceed three days.

Confirmation of the diagnosis is carried out after laboratory tests. General blood and stool tests allow you to verify the presence of an inflammatory process in the body of a child or adult. The coprogram contains information about the concentration of leukocytes and erythrocytes in the biomaterial. Based on these data, doctors differentiate between inflammatory and non-inflammatory types of pathology. Identification of signs of inflammation involves bacteriological culture. This technique makes it possible to determine the causative agent of the pathology that caused acute diarrhea. Occasionally, microbiological studies are ineffective. In this case, the patient is referred to hardware tests that are designed to establish the cause of the stool disorder.

Therapeutic measures

Treatment of diarrhea is based on relief of the main symptoms. Patients with stool disorders are prescribed a diet, eubiotics and adsorbents. The diet includes foods that reduce intestinal motility and reduce the secretion of fluid in it. Adults and children should temporarily avoid foods that can irritate the mucous membranes of the digestive tract and damage them.

Diarrhea is often accompanied by marked loss of fluid and electrolytes. Restoration of water balance is carried out through rehydration therapy. A mild degree of dehydration is eliminated by oral administration of saline solutions. Severe forms of pathology require parenteral rehydration. Intravenous infusion of saline solutions quickly normalizes the condition of patients.

The appointment of antibacterial drugs is appropriate when pathogenic bacteria are detected in the analyzes of children or adults. Oral medication continues until the complete disappearance of traces of infection from the biomaterials of patients.

Preventive measures

Preventing the development of acute diarrhea in an adult or child is relatively simple – it is enough to eliminate the main causes of pathogens entering the body. Compliance with the rules of personal hygiene remains a key element of prevention. Particular attention should be paid to the storage of perishable products. Meat, fish, unpasteurized milk and chicken eggs must be thoroughly cooked. Products in the refrigerator need regular revision – expired products must be disposed of. The same should be done with any purchases with damaged packaging.

Questions and answers

What are the features of the diarrhea diet?

Patients should drink water, light broths, tea. With the normalization of the condition (for 2-3 days), it is permissible to include steamed meat, mucous soups in the diet. Foods with a lot of fiber should be avoided. Food should be taken in small portions with an interval of 2-2.5 hours.

How to prevent the development of diarrhea in a child of preschool age?

Parents should have a preventive conversation with the kids and talk about the need to observe the rules of personal hygiene. The child should be aware of the dangers of eating unwashed vegetables and fruits, the main ways of transmitting viral and bacterial infections. You can consolidate the acquired knowledge in game situations. Parents can show their children how easy it is to follow all the rules by personal example.

prevention and treatment of infectious diarrhea with IMODIUM®

Author, editor and medical expert – Zavgorodnyaya Ekaterina Alexandrovna.

Editor and medical expert – Harutyunyan Mariam Harutyunovna.

Number of views: 108 091

Date last updated: Contents:

Bacterial diarrhea
Food poisoning (FTI)
Viral diarrhea
Traveler’s diarrhea
How to treat bacterial and viral diarrhea in adults?
Prevention of bacterial and viral diarrhea

According to statistics, infectious diarrhea ranks second in prevalence, second only to acute inflammation of the respiratory tract ² . The causative agents of acute intestinal infection (AII) can be bacteria, viruses, parasites and protozoa ^3.6 . But more than half of cases of acute diarrhea are associated with a viral infection, less often (in 20-25%) – bacterial ¹ .

At the first sign of diarrhea, you should consult a general practitioner. The specialist will assess the severity of the condition, and most importantly, establish the cause of the disorder, which is important for prescribing the correct treatment.

What pathogens often cause acute intestinal infection, how to prevent infection and what treatment a doctor can prescribe – we will tell in the article.

Bacterial diarrhea

Among bacteria, acute diarrhea is most often caused by Salmonella (in 50% of cases), less often by Shigella, Escherichia coli, Staphylococcus aureus, Campylobacter, Yersinia and others ¹ . Usually, infection occurs through contact with a patient with an intestinal infection, neglect of personal hygiene measures, and consumption of contaminated food or water ¹ . Most often, AII occurs with the use of multi-component salads, confectionery with cream and minced meat dishes ⁹ . An increase in the incidence is noted in the summer-autumn period ⁴ .

Bacterial diarrhea usually caused by exposure to toxins produced by bacteria ⁸ . Toxins increase the release of water into the intestinal lumen, as a result of which the feces become liquid ³ .

The main symptoms of bacterial diarrhea, in addition to loose stools, include:

• fever ² ;
• impurities in the feces (mucus, blood) ¹ ;
• cramping abdominal pain ¹ .

But the diarrheal syndrome can proceed in different ways, depending on the pathogen².

Food poisoning (FTI)

Food poisoning is a separate group of acute intestinal infections, which is associated with the use of food contaminated not only with bacteria, but also with their toxins ¹⁰ . This condition is commonly referred to as food poisoning or “dirty food” disease ¹¹ . Most of the bacteria that can cause PTI are opportunistic, that is, they can live in the intestines of absolutely healthy people. But when these bacteria multiply and produce toxins in food, it leads to food spoilage ¹¹ .

Microorganism-contaminated food often does not change appearance, taste or smell ⁹ .

In people aged 17 to 35, foodborne illness is the most common cause of acute diarrhea. It does not have a pronounced seasonality ⁴ and often causes group outbreaks of diarrhea (among those who have used an inferior product) ¹¹ .

Food poisoning is characterized by:

• sudden onset ⁵ ;
• nausea ⁵ ;
• repeated vomiting with relief ⁶ ;
• watery stools, foul smelling ⁶ .

Back to top

Viral diarrhea

Its main pathogens are noroviruses and rotaviruses ¹ . Children are the most affected. The maximum rise in the incidence of viral diarrhea is observed in the winter-spring period with peaks in April (rotavirus) and February (norovirus) ⁴ .

Viruses that cause AII can remain on the surface of poorly washed fruits and vegetables ⁹ . Penetrating into the intestine, they damage the cells of its mucous membrane, causing diarrhea ³ .

Viral diarrhea is characterized by a combination of stool disorder with fever and dyspepsia – a feeling of heaviness, bloating, belching, heartburn and nausea. With rotavirus infection, upper respiratory tract infections can occur, that is, the appearance of symptoms such as nasal congestion and sore throat ^1.2 .

In contrast to bacterial diarrhea, viral stools are watery, without impurities, and pain is mild or completely absent ¹ . The duration of the infection usually does not exceed 3-5 days, and it tends to self-heal ² . Despite the relatively favorable course, consultation with a specialist is required.

Traveler’s diarrhea

Diarrhea is the most common symptom for people during the first week of travel ⁵ . Due to the prevalence, such cases are classified as a special form of acute intestinal infection – travelers’ diarrhea ² . In 80% of cases it is caused by bacteria. Approximately 15% of episodes are associated with viruses, for example, noroviruses and rotaviruses can cause outbreaks of acute diarrhea in resorts or cruise ships ⁵ .

In addition to loose stools, abdominal cramps, nausea, vomiting, or painful urge to defecate are common. Similar symptoms may also occur in those who have just returned home from a trip or have recently changed their place of residence ⁵ . Climate change, changes in diet and nervous stress are of additional importance in their development ² .

The risk of travelers’ diarrhea remains even when traveling within the country ¹³ .

How to treat bacterial and viral diarrhea in adults?

Regardless of the causative agent, acute diarrhea can cause significant damage to the gastrointestinal tract, intoxication (dysfunction of various organs) and dehydration ⁶ .

Dehydration can be manifested by the following signs ³ :

• thirst;
• restlessness, irritability;
• decreased skin elasticity and pallor;
• decreased or no urine output;
• rapid and weak pulse;
• low blood pressure.

Seek medical attention as soon as possible to prevent dehydration and other complications ³ .

Treatment of bacterial and viral diarrhea must be prescribed by a physician. Only a specialist can correctly assess the condition, identify the pathogen and recommend taking medications.

Therapy prescribed by a physician usually includes:

• Drugs directed against the pathogen. When bacteria are found, antibiotics are often required ² . Antibiotics are not prescribed to treat viral diarrhea. In addition, antibacterial drugs themselves can cause diarrhea, therefore, without consulting a specialist, they should not be taken categorically ⁸ .
• Measures to prevent and eliminate dehydration. In mild cases, it is enough to drink as much liquid as possible. It can be mineral water, tea, or a special rehydration solution prescribed by a doctor. Severe dehydration may require intravenous fluids through a ² drip.
• Diet. When diarrhea is recommended for 2-3 days to exclude from the diet of dairy and fiber-rich foods (vegetables, fruits), as well as coffee and alcohol. It is better to use boiled slimy soup with rice, toasted bread, crackers, baked potatoes and eggs ² .
• Medications to relieve symptoms. In addition to controlling the infectious agent, in some cases of bacterial or viral diarrhea, symptomatic therapy, i. e. antidiarrheal drugs, may be prescribed. They eliminate discomfort and reduce the number of bowel movements, which is especially important for diarrhea ² .

Important!

Antidiarrheals should not be used as primary therapy for acute infectious diarrhea. Also, they are not prescribed for high fever, severe intoxication and the presence of blood in the stool ² .

Imodium® Express may be prescribed as an adjuvant for acute infectious (bacterial or viral) diarrhea. Its active ingredient, loperamide, slows down the contractions of the intestines and the release of fluid into its lumen, slows down the movement of feces, and also increases the tone of the anal sphincter, helping to reduce diarrhea and better retain stool ⁷ . Imodium® Express lyophilisate tablets dissolve on the tongue in a few seconds, do not require drinking water ⁷ and help reduce diarrhea from the first use of ¹² .

The drug should not be used in children under 6 years of age, during pregnancy and breastfeeding, and also as the main therapy ⁷ :

• in patients with acute dysentery, which is characterized by bloody stools and high fever;
• in patients with bacterial enterocolitis caused by pathogens including Salmonella, Shigella and Campylobacter.

Be sure to check with your doctor before taking any medication for bacterial or viral diarrhea.

Prevention of bacterial and viral diarrhea

For the prevention of acute intestinal infections, the World Health Organization recommends ¹⁴ :

• Choose only safe foods raw, eat only well-washed vegetables and fruits, buy pasteurized milk.
• Monitor the heat treatment of food. Frozen meat products should be thoroughly thawed before being boiled or fried. It is also important that there are no moist areas left in the meat in which live bacteria can remain.
• Eat cooked food right away. As food cools, microorganisms begin to multiply, which increases the risk of food poisoning.
• Separate raw from cooked. If you put raw vegetables or fruits next to well-done meat, there is a possibility of contamination of the latter with bacteria.
• Wash your hands often – before cooking, if you take a break and return to cooking, and before eating.
• Use clean water . If you are not sure about the safety of drinking water, it is better to boil it.

If you are a frequent traveler, if possible, book accommodation with meals included – this way you are much less likely to get infected than buying groceries from street vendors or eating in various establishments ¹³ .

Compliance with these principles does not guarantee complete protection, since there are a huge number of ways for the spread of intestinal infection and the mechanisms for the development of acute diarrhea.