Doctor filling out a vaccination certificate (Shutterstock: see link below)
Article Words : Dr Jane Wilson-Howarth | 19 September

How to stay healthy after you've been travelling

You’ve been away, had a great time and returned home safely – or so you thought. But what is that weird rash? And why are your bowels rumbling? Our resident doc might have the answer

Stomach gripes & aches

Symptoms: Rumbles and a dull discomfort that moves around. Pain builds, then fades – often with a fart or bowel action.

Diagnosis: Colic, due to bowels being stretched by gas or by intestinal spasms. Or it might be getting used to new foods.

Serious? Rarely; tends to settle over a week or so. Constipation also causes colic.

What to do: Understand the gastro-colic reflex: the desire to stool 15 minutes after very hot/cold drinks or a big meal. A bland, high-carb, low-fat, low-dairy diet should help.

Long-term consequences: No lasting damage, but some people develop irritable bowel syndrome after a tropical trip. Persisting pains should be taken to a doctor.

Unusual bowels

Symptoms: Unpredictable bowels: often you just get a feeling of unreliability.

Diagnosis: Rumbles suggest guts are too active, but it can also be a sign of parasites. Might be giardia, might be worms.

Serious? Rarely. Occasionally a sign of serious troubles so have a check-up if symptoms persist. Worms tend to die of old age at 12 to 18 months.

What to do: Get three separate stool samples screened by your GP.

Long-term consequences: If giardia, you’ll lose friends until you cure your sulphurous farts with a short course of metronidazole. There’s a possibility of ongoing IBS. It’s not uncommon for unusual bowels to plague you long after a tropical trip; most travellers learn to live with them.

A mystery rash

Symptoms: Weird spots.

Diagnosis: Most causes are benign. However, there is a long list of possibilities. Skin scrapings are the best way to diagnose fungal infections.

Serious? Most rashes are irritating or annoying more than health-threatening.

What to do: A medium-strength steroid such as Eumovate will often settle troublesome itchy rashes. If symptoms persist you need a diagnosis – visit your GP.

Long-term consequences: Depends on the cause. Fungal infections are probably the most common cause of an itchy flaking rash. Allergic conditions including eczema and hives are also frequent. Treatment is available once a diagnosis has been made.

Boils & bumps

Symptoms: Skin lumps.

Diagnosis: Possibly insect bites – which should fade in a couple of weeks. Or do they seem deeper or stranger? Some bites thicken and become more pigmented – especially if scratched excessively. These may never disappear but will stop itching. A few unfortunate travellers develop recurrent boils.

Serious? Depends. Leishmaniasis and skin cancers are serious and need treatment within a few weeks. These both cause a persistent lump that fails to completely heal.

What to do: If new lumps appear daily, spread your bedding out in the sun – to discourage fleas. Any lesion that appears to heal but then breaks out again needs to be checked by a doctor – but it can wait a month. GPs can take swabs and eradicate any boil-causing microbe with an appropriate antibiotic, or arrange surgical removal of any potentially malignant skin lesion. If you might have been exposed to leishmaniasis seek out specialist treatment.

Long-term consequences: There’s scope for cure or disaster. Get proper diagnosis.

Lingering cold

Symptoms: International flights are perfect incubators for respiratory viruses. The common cold lasts no more than a week, ten days tops – if it’s lingering, it isn’t a simple cold.

Diagnosis: If you’re feeling ill and feverish and have face or forehead pain, it could be sinusitis. Mucous discharge from the nose when you’re not that unwell is probably an allergic reaction.

Serious? No, but it can wear you down.

What to do: Allergic nasal discharge (aka rhinorrhoea) should stop with a steroid nasal spray or antihistamine tablets. Steam inhalations help sinusitis; you might need a course of antibiotics from a GP

Long-term consequences: Large tissue bill.

Chills & flushes

Symptoms: More than a cold, you are running a high temperature – is it over 38.5°C? Are you aching all over, feeling ill?

Diagnosis: It could be malaria. Serious? Yes, very.

What to do: Get to a good doctor within 24 hours and tell them where you’ve been over the past three months; remind them this could be malaria/another tropical infection.

Long-term consequences: Unlikely – if you survive. Having had malaria once, you are no more likely to catch it again in the future but equally you gain no immunity.

Two top tips

Eat yoghurt

Though diary products are best avoided if your guts are rumbling (bland food is best) yoghurt can be quite soothing.

Inform your GP

Malaria can hit any time from a week to a year after being bitten by an infected mosquito – if you have flu-like symptoms within this time, tell your GP where you’ve been.

Dr Jane Wilson-Howarth is a GP in East Anglia and medical director of The Travel Clinic

Main image: Doctor filling out a vaccination certificate (Shutterstock)


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