A guide to common post-travel health problems

It can take quite a few days to ‘get back to normal’ after a holiday, but common post-holiday health problems like jet lag and traveller’s diarrhoea can sometimes make things more difficult.

Fortunately, most post-holiday health problems are mild, which means that you should be able to treat them yourself.

In this article, you’ll find information to help you treat some of the most common post-holiday health problems, alongside information and advice on when to see a doctor.

Should I be worried?

This article aims to help you treat mild to moderate health complaints that are frequently associated with travel. If you have recently returned from a holiday and find that you’re suffering from serious symptoms like:

• an unexplained rash
• difficulty breathing
• persistent vomiting
• bruising or unusual bleeding
• fever
• paralysis
• jaundice
• pain, swelling or tenderness in your thigh or calf

then you should seek medical attention straight away. Most people return from their travels without a serious health issue, but if you’ve been travelling in Africa, Asia or South America there is always some risk that you have been exposed to a tropical disease like

, the , , or .

Jet lag

Your body uses biological clocks to regulate your sleep cycle and manage the circadian rhythms which allow your body to rest, process memories, and repair cells.

These biological clocks are synchronised to a ‘master clock’ in a region of your brain called the pineal gland, and this master clock uses external stimuli (like your local day/night cycle, body temperature, and eating habits) to tune or adjust your circadian rhythms.

Jet lag occurs when shifting day/night cycles desynchronise your biological clocks and disrupt your circadian rhythms. Travelling between different time zones can cause jet lag, and you may find that flying back from your holiday is enough to trigger the condition.

Jet lag is not an illness, but it can cause a number of unpleasant symptoms, including:

• tiredness or exhaustion
• finding it difficult to stay awake during the day
• low mood
• irritability
• poor concentration
• reduced coordination
• feelings of anxiety or jitteriness
• feeling lightheaded or spaced out
• poor appetite
• nausea or
  indigestion
• bloating
• constipation

If you are suffering from jet lag, you may find that you struggle to fall asleep at night or that your sleep is distrurbed.

Jet lag can be triggered by any journey that crosses three or more time zones, but the condition affects everyone differently.

The severity of jet lag symptoms usually depend on the number of time zones that you have crossed. Someone who flies across eight to nine time zones would normally experience more severe jet lag than someone who has only crossed five to six time zones.

Jet lag symptoms may be worse if you’re flying east. The reason for this isn’t fully understood, but it is thought it may be because flying east means you are ‘losing’ time rather than gaining it, and your body finds it harder to adapt to a shorter day.

If you’ve come home after a long holiday and feel jet lagged, try not to worry too much. The condition normally passes on its own, although it can take several days to resolve completely.

You may be able to help the recovery process by:

• shifting to your home routine as quickly as possible by eating and sleeping at the correct times, even if you don’t feel tired or hungry
• setting an alarm so you do not oversleep in the morning
• turning the lights on as soon as you wake up
• going outside during the day so your body clock recalibrates using natural light
• avoiding daytime naps as much as possible
• staying hydrated, and eating small meals

There is also some evidence to suggest that carefully-timed exercise may be able to reduce the symptoms of jet lag.

According to a study published in The Journal of Physiology, exercising early in the day helped a group of 99 adults to move their circadian rhythms forward, while exercising between 7pm to 10pm helped to move it back - altering the body’s internal clock and helping to modulate the biological processes that regulate our sleep cycle.

Note: If you are suffering from severe jet lag, you may be tempted to try melatonin tablets and/or sleeping tablets, both of which usually require prescriptions.

Sleeping tablets can help you to bypass periods of restlessness caused by jet lag, but they will not cure the condition, and sleeping tablets can be highly addictive. Melatonin tablets have not been shown to help with jet lag.

Traveller’s diarrhoea

Traveller’s diarrhoea is normally the result of eating food (or drinking water) that has been contaminated by viruses, parasites or bacteria. Traveller’s diarrheoa can develop while you are on holiday or shortly after you’ve arrived home.

If you’ve just come back from holiday and you:

• pass loose or watery stools at least three times in a 24-hour period
• have a crampy or sore tummy
• feel sick
• have a high temperature
• vomit

then you may have traveller’s diarrhoea.

If you do have traveller’s diarrhoea, try to stay hydrated and rest as much as possible. Most cases of traveler’s diarrhoea are relatively mild, and pass after three to four days. With traveller's diarrhoea, you should:

• try to stay hydrated with regular intake of water
• consider oral rehydration salts to replenish your electrolytes
• avoid fluids with a diuretic effect, such as alcohol, coffee, tea, and large quantities of overly-sweet drinks
• rest as much as possible

However, traveller’s diarrhoea can be caused by a more serious infection, so pay attention to your symptoms and seek medical attention if:

• you have a fever
• your stools contain blood
• your symptoms are no better after three to four days
• you are struggling to retain fluids
• you exhibit symptoms of dehydration, such as sunken eyes, dry skin, dizziness or confusion
• you are pregnant
• you are elderly or have a compromised immune system
• you have an underlying health problem such as diabetes,
  inflammatory bowel disease
  , or kidney disease
• your child is suffering from traveller’s diarrhoea, and they are under six months old

If you do visit a doctor, they may want to take a stool sample to help diagnose your condition.

Plantar fasciitis

Plantar fasciitis (sometimes called jogger’s heel) is a condition that causes pain in the heel or arch of your foot. Plantar fasciitis occurs when the connective tissue (plantar fascia), which connects your heels to your toes, becomes inflamed or swollen. This might be because you are overweight, your shoes don’t offer adequate support, or because you’ve recently started doing a lot of exercise.

Plantar fasciitis can also be caused by the overuse or sudden stretching of your sole. If you normally spend a lot of time sitting down, but you’ve recently started doing a lot of walking (such as on holiday), you increase the risk of damaging the plantar fascia. This is why plantar fasciitis is a relatively common post-holiday health complaint.

Plantar fasciitis will normally resolve on its own. The tissues in your foot will heal over time (usually around six months) and there’s no pressing need to book an appointment with your doctor unless:

• the pain is severe, and stops you from doing everyday activities
• the pain does not start to improve after two weeks of self-treatment
• you experience tingling or loss of feeling in the affected foot
• you have already been diagnosed with diabetes, a condition that makes many common foot problems more serious

There are things you can do to reduce or manage the symptoms of plantar fasciitis at home. These include:

• resting your feet, and keeping them raised whenever you can
• making sure your shoes have good arch and heel support
• avoiding walking barefoot, or standing or walking for long periods
• wrapping a towel around an ice pack (or a bag of frozen peas), before applying to the affected area for 20 minutes every two to three hours
• taking painkillers such as paracetamol, and/or anti-inflammatory painkillers, like ibuprofen, as required
• regular stretching exercises that are designed to loosen your Achilles tendon and remove pressure on the plantar fascia

You can also buy special insoles or foot supports for plantar fasciitis. These supports often raise the heel by one or more centimetres and support the arch of your foot to reduce the strain placed on your plantar fascia.

If you are suffering from heel pain and you would like to try some simple exercises, you may find this

from the Chartered Society of Physiotherapy useful.

Sexually transmitted infections

According to the NHS, a significant number of

(STIs) occur as a result of sexual intercourse while travelling abroad. The risks of catching an STI are particularly high if you are having sex with new partners, drinking heavily before engaging in intercourse, engaging in unprotected sex or soliciting sex workers.

If you engaged in one or more of these behaviours while on holiday, always try to get tested at a sexual health clinic. Some STIs cause symptoms like:

• pain while urinating or having sex
• rashes, sores or ulcers around your genitals, mouth or throat
• discharge from your vagina, penis or anus

But some STIs are asymptomatic, which means they do not cause any immediate symptoms. To prevent the spread of STIs, and to protect yourself from the long-term health risks posed by conditions like

or , you should err on the side of caution and make sure you are screened by a health professional.

STI testing

If you are looking for a local STI testing clinic, you may find the following links useful:

UK

If you live in the UK, you can

US

If you live in the United States, the Centers for Disease Control and Prevention (CDC) allows you to find your nearest clinic via

France

If you live in France, you can use the

to locate a nearby clinic

The rest of Europe

The aidsmap has a

that allows you to search for STI testing clinics in the European country you live in

The rest of the world

The STI Project has links to help you

in Canada, Australia, and the rest of the world

Isn’t prevention better than cure?

This article is designed to help people who have returned from holiday and discovered symptoms of a minor illness. If you would like information on how to prevent travel-related health complaints, you may find the

website useful.