title: Development of functional diarrhea, constipation, irritable bowel syndrome, and dyspepsia during and after traveling outside the USA.
abstract: BACKGROUND
  Persistent gastrointestinal (GI) symptoms after travel abroad may be common. It remains unclear how often subjects who developed new GI symptoms while abroad have persistent symptoms on return. The objective of this retrospective study was to evaluate the prevalence of persistent GI symptoms in a healthy cohort of travelers.
  
  
  METHODS
  One hundred and eight consecutive patients, mostly returned missionaries, attending the University of Utah International Travel Clinic for any reason (but mostly GI symptoms) had data recorded about their bowel habits before, during, and after travel abroad. All subjects had standard hematological, biochemical, and microbiological tests to exclude known causes of their symptoms. Endoscopic procedures were performed when considered necessary by the treating physician. Diarrhea, constipation, irritable bowel syndrome (IBS), bloating, and dyspepsia were defined according to the Rome II Criteria.
  
  
  RESULTS
  Eighty three (82% men and 18% women, median age 21 years) completed the survey with 68 subjects completing the questionnaire about bowel habits before and during travel. Among the respondents, 55 (82.1%) did not have any symptoms before travel. During travel, 41 (63%) developed new onset diarrhea; 6 (9%) developed constipation; 16 (24%) IBS, 29 (45%) bloating; and 11 (16%) dyspepsia. Of those who developed symptoms during travel, 27 (68%) had persistent diarrhea, 3 (50%) had persistent constipation, 10 (63%) had persistent IBS, 12 (43%) had persistent bloating and 8 (73%) had persistent dyspepsia. The presence of bowel symptoms during and after travel was not associated with age, gender, travel destination, or duration of travel.
  
  
  CONCLUSIONS
  This study suggests that new onset of diarrhea, IBS, constipation, and dyspepsia are common among subjects traveling abroad. Gastrointestinal symptoms that develop during travel abroad usually persist on return.
authors.affiliation: George E Wahlen VA Medical Center, Salt Lake City, UT, USA. Ashok.Tuteja@hsc.utah.edu
authors.forename: Ashok K
authors.initials: AK
authors.lastname: Tuteja
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Talley
authors.forename: Stephanie S
authors.initials: SS
authors.lastname: Gelman
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Alder
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Adler
authors.forename: Clinton
authors.initials: C
authors.lastname: Thompson
authors.forename: Keith
authors.initials: K
authors.lastname: Tolman
authors.forename: Devon C
authors.initials: DC
authors.lastname: Hale
mesh_terms: D000328:Adult; D000368:Aged; D003248:Constipation / Q000453:epidemiology / Q000209:etiology*; D003967:Diarrhea / Q000453:epidemiology / Q000209:etiology*; D004415:Dyspepsia / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D043183:Irritable Bowel Syndrome / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D066189:Missionaries; D008921:Religious Missions; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014195:Travel; D014481:United States / Q000453:epidemiology