Butler Dominic, McLoughlin Ramona, Flaherty Gerard T
School of Medicine College of Medicine Nursing and Health Sciences University of Galway Galway Ireland.
Department of Gastroenterology University Hospital Galway Galway Ireland.
Public Health Chall. 2022 Nov 2;1(4):e30. doi: 10.1002/puh2.30. eCollection 2022 Dec.
Gastrointestinal illnesses are among the most common health problems affecting travellers returning from international travel. Its public health implications include economic healthcare costs and the risk of promoting antimicrobial resistance. This narrative review aims to critically appraise the literature concerning gastrointestinal diseases in travellers and outlines a practical approach to aid clinicians in their assessment and management.
The Medline (PubMed) and SCOPUS databases were searched for articles relating to gastrointestinal issues in returning travellers. Articles were primarily restricted to those published in the last 5 years. Only studies on human subjects were included.
Diarrhoea is the most common gastrointestinal symptom experienced by approximately 40%-60% of travellers, but abdominal pain, bloating and fatigue are also common. Diarrhoeagenic species remain the most common cause of travellers' diarrhoea (TD), with parasitic diseases predominating in those with persistent symptoms. Molecular diagnostic techniques enable highly sensitive simultaneous testing for a multitude of enteropathogens, though more research is required to confirm the pathogenic significance of organisms identified. Further research into poorly absorbable antibiotics and novel therapies such as phage treatment may help to alleviate the burden of antimicrobial resistance. There is a role for empirical anti-parasitic therapy in selected cases.
Clinicians across a range of medical specialities should be familiar with the presentation, aetiology and management of gastrointestinal illness in the returning traveller. Efforts to improve destination sanitation and hygiene infrastructure may serve to reduce the burden of preventable illness in this setting.
胃肠道疾病是影响国际旅行归来者的最常见健康问题之一。其对公共卫生的影响包括经济医疗成本以及促进抗菌药物耐药性产生的风险。本叙述性综述旨在批判性地评估有关旅行者胃肠道疾病的文献，并概述一种实用方法，以帮助临床医生进行评估和管理。
在Medline（PubMed）和SCOPUS数据库中检索与旅行归来者胃肠道问题相关的文章。文章主要限于过去5年发表的那些。仅纳入关于人类受试者的研究。
腹泻是约40%-60%旅行者最常见的胃肠道症状，但腹痛、腹胀和疲劳也很常见。致泻性物种仍然是旅行者腹泻（TD）最常见的原因，寄生虫病在持续症状患者中占主导。分子诊断技术能够对多种肠道病原体进行高度灵敏的同时检测，不过还需要更多研究来确认所鉴定生物体的致病意义。对吸收不良的抗生素和噬菌体治疗等新型疗法的进一步研究可能有助于减轻抗菌药物耐药性的负担。在某些特定情况下，经验性抗寄生虫治疗有一定作用。
各医学专科的临床医生都应熟悉旅行归来者胃肠道疾病的表现、病因和管理。改善目的地卫生和卫生基础设施的努力可能有助于减轻这种情况下可预防疾病的负担。
