Concerns About Gastrointestinal Infections After Southeast Asia Travel

Q: Concerns About Gastrointestinal Infections After Southeast Asia Travel

Hello, sir： It is recommended to first visit a gastroenterology clinic to check your stool in order to determine if there are any issues. <br>Additionally, when traveling to mainland China or Southeast Asia, please consume only cooked food and avoid drinking untreated water. <br>

Concerns regarding infection issues in epidemic areas?

In May, I traveled to Southeast Asia, and upon returning around mid-July, I noticed that my stools were softer than usual and contained what appeared to be dark brown mucus.
This condition lasted for about 3 to 4 weeks, after which the color and shape of my stools returned to normal.
I have a regular bowel movement once every morning after waking up.
Aside from this bowel issue, I have not experienced any other discomfort.
I undergo regular colonoscopy examinations, with my last one being around July or August of last year.
The doctor mentioned that there were no abnormalities, only hemorrhoid issues.

I would like to consult with a physician regarding my previous travel to an endemic area.
Should I be tested for amoebic dysentery due to my symptoms? I read an article stating that the incubation period for this condition can range from weeks to years, and most people are asymptomatic after infection.
Is it possible that I am currently an asymptomatic carrier? I am particularly concerned because I have a young child at home and fear that if I am infected, I might transmit it to my family.
Additionally, as a carrier of hepatitis B, I am worried that if I were to become infected, it could lead to complications such as liver abscesses.
I would appreciate your guidance on this matter.

Mr. Huang, 40~49 year old female. Ask Date: 2015/12/25

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, sir: It is recommended to first visit a gastroenterology clinic to check your stool in order to determine if there are any issues.
Additionally, when traveling to mainland China or Southeast Asia, please consume only cooked food and avoid drinking untreated water.
Changhua Hospital cares about your health.
Chen Shih-Dian

Reply Date: 2015/12/25

More Info

Traveling to Southeast Asia can expose travelers to various gastrointestinal infections, including those caused by bacteria, viruses, and parasites. Your concerns about the changes in your bowel movements after returning from such a trip are valid, especially given the potential for infections like dysentery or amoebiasis, which can have long incubation periods and may sometimes present with mild or no symptoms at all.

Based on your description, you experienced soft stools mixed with what appeared to be dark brown mucus for about 3 to 4 weeks, which later normalized. This could indicate a transient gastrointestinal disturbance, possibly related to your travel. While the absence of other symptoms is reassuring, it is still prudent to consider further evaluation, especially since you have a history of travel to an endemic area.

1. Testing for Dysentery or Amoebiasis: Given your travel history and the symptoms you experienced, it would be wise to consult a gastroenterologist for a thorough evaluation. Testing your stool for pathogens, including Shigella (which causes bacillary dysentery) and Entamoeba histolytica (which causes amoebic dysentery), can provide clarity. While many infections can resolve on their own, identifying a specific pathogen can guide appropriate treatment and management.

2. Asymptomatic Carriers: It is indeed possible to be an asymptomatic carrier of certain infections, including amoebiasis. Some individuals may harbor the parasite without showing any symptoms, which can pose a risk of transmission to others, particularly in households with young children or immunocompromised individuals. If you are concerned about being a carrier, stool testing is essential to rule out any infections.

3. Concerns Regarding Hepatitis B: Your concern about the potential complications of being a Hepatitis B carrier is also valid. While Hepatitis B itself does not directly cause gastrointestinal symptoms like diarrhea, it can lead to liver complications, including liver abscesses, if there is a concurrent infection. Regular monitoring of your liver function and viral load is crucial, especially if you have a history of gastrointestinal issues.

4. Dietary Considerations: In terms of dietary management, while you are experiencing gastrointestinal symptoms, it is advisable to follow a bland diet that is low in fat and high in easily digestible foods. Foods like bananas, rice, applesauce, and toast (the BRAT diet) can be soothing. Staying hydrated is also critical, especially if you have experienced any diarrhea. Electrolyte solutions can help replenish lost fluids and minerals.

5. Preventive Measures for Future Travel: For future travels, consider taking precautions such as avoiding raw or undercooked foods, drinking bottled or boiled water, and practicing good hand hygiene. These measures can significantly reduce the risk of gastrointestinal infections.

In summary, while your symptoms have resolved, it is prudent to consult a healthcare provider for stool testing to rule out any lingering infections, especially given your travel history and concerns about potential transmission to your family. Regular follow-ups regarding your Hepatitis B status and maintaining a healthy diet will also contribute to your overall well-being.

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