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Park Hyatt Hotel

Recently accepted into the prestigious Palace Hotels Group, Park Hyatt Paris-Vendome is one of the most visually stunning luxury hotels Paris has to offer. Its striking blend of contemporary architecture and classic design was conceived by renowned designer Ed Tuttle, lending the hotel a sensual, understated elegance that extends throughout - from the lavish Paris hotel rooms and suites to the captivating social areas and impressive meeting venues.

• Superb 2,953 Reviews 9.0

Le Bristol Paris

First French hotel awarded “Palace distinction”, Le Bristol Paris, built around an exquisite 13,000 sq. ft. French manicured garden, is ideally situated on the fashionable rue du Faubourg Saint-Honore, within walking distance of the Presidential House, the Champs-Elysees, the Louvre and the Grand Palais. Le Bristol’s 190 bright and spacious rooms and suites, exquisite Cafe Antonia and Epicure gourmet restaurant rated three Michelin stars provide a unique setting for guests from around the world to gather.

• Perfect 2,060 Reviews 10.0

The Peninsula Paris

Exquisitely restored spaces are complemented by contemporary art installations, furnishings and technology. Dazzling rooftop spaces and private terrace gardens offer 360° views and glamorous extras that make The Peninsula Paris a decidedly 21st century palace.As with all Peninsula Hotels, location is of prime importance and Paris is no exception. Just steps away from the Arc de Triomphe and Avenue des Champs Elysées at 19 Avenue Kléber in the heart of the elegant 16th arrondissement, The Peninsula sits close to some of the world’s most famous monuments, museums and luxury shopping districts.

• Perfect 1,097 Reviews 10.0

W Istanbul features a nightclub and puts you just a 5-minute drive from Taksim Square. Guests can grab a bite to eat at the coffee shop/cafe, or indulge in massages, facials, or body treatments. This luxurious hotel also features a bar/lounge, a 24-hour fitness center, and a fitness center. Fellow travelers love the location. The property is just a short walk to public transportation: Maçka Cable Car Station is 12 minutes away.

• Excellent 795 Reviews 8.6

Le Royal Monceau

Located on the prestigious Avenue Hoche, just a few steps from the Champs-Elysees and with views of the Arc de Triomphe, Le Royal Monceau - Raffles Paris features 149 luxurious rooms and suites, a 99-seat cinema, an art gallery, an exclusive service of Art Concierge and a private art collection. The Spa My Blend by Clarins, 1,500 sqm of ethereal white paradise, offers the ultimate urban escape for complete relaxation.

• Superb 1,564 Reviews 9.5

Le Meurice, an iconic address in the heart of Paris since 1835 Ideally located in the heart of Paris opposite the Tuileries Garden the very first Parisian palace is just steps from Place Vendome, the designer boutiques of rue Saint-Honore and minutes from the Louvre, Opera Garnier, Orsay Museum and other Parisian cultural jewels. Through the two Michelin-starred Restaurant le Meurice Alain Ducasse, with its exclusive Chef’s Table, Le Dali, which honors the famed painter and hotel guest, the very British Bar 228 and the private function rooms, the hotel proudly heralds a love of gastronomy.

• Excellent 1,344 Reviews 9.0

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Travel GI/Endo Tech Jobs

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Aya delivers:

• The most jobs in the industry. We have the largest and most reliable job database, which means the jobs you see are open, updated in real time and ready for you!
• Competitive advantage over other agencies. Front-of-the-line access through our direct facility relationships — many with quick (even same-day) offers, giving you the best chance of securing your ideal opportunity.
• Expedited licensing and streamlined compliance. An industry-leading on-time start rate and strong relationships with boards of nursing across the country to accelerate the process in all 50 states.
• Expert career guidance. A dedicated recruiter to help you achieve your dream career. Travel, per diem, permanent — we have the reach and access to get you the jobs you want, and the expertise to help you realize your long-term goals.
• A best-in-class support system and an exceptional experience. Enjoy accurate, weekly pay, and an entire team dedicated to your happiness on assignment, 24/7.

Plus, you get everything you expect from the largest healthcare staffing company in the industry:

• Exceptional benefits, including premium medical, dental, vision and life insurance beginning day one of your assignment. Want to take time off? Keep insurance coverage for up to 24 days between assignments.
• A generous 401(k) match.
• Paid company housing (we'll help you bring your pets along, too!) or a generous housing stipend.
• Paid sick time in accordance with all applicable state, federal, and local laws. Aya's general sick leave policy is that employees accrue one hour of paid sick leave for every 30 hours worked. However, to the extent any provisions of the statement above conflict with any applicable paid sick leave laws, the applicable paid sick leave laws are controlling.
• The industry's only clinical ladder program for RNs on assignment.
• Access to unlimited continuing education units online.
• Licensure, relocation and other reimbursements, when applicable.
• Pay listed above includes taxable wages and tax-free expense reimbursements.

For all employees and employee applicants, Aya is an Equal Employment Opportunity ("EEO") Employer, including Disability/Vets, and welcomes all to apply. Please click here for our EEO policy.

• Bi-weekly weekend travel home.
• A rental car and paid housing.

With Aya Locums you get:

• Access to top hospitals and healthcare systems in diverse care settings.
• Highly competitive, transparent locum tenens pay.
• Dedicated application and assignment support.
• In-house credentialing and licensing teams.
• Full coverage of licensing costs.
• Travel and lodging coverage.
• Easy timekeeping and streamlined management of documents.
• Malpractice coverage and risk management support.
• Premium medical, dental, vision and life insurance beginning day one of your assignment.
• Paid sick time. Aya provides paid sick leave in accordance with all applicable state, federal, and local laws. Aya's general sick leave policy is that employees accrue one hour of paid sick leave for every 30 hours worked. However, to the extent any provisions of the statement above conflict with any applicable paid sick leave laws, the applicable paid sick leave laws are controlling.
• Generous 401k match.
• Aya may provide other benefits where required by applicable law, including but not limited to reimbursements.
• Aya coordinates all travel and lodging accommodations.
• Travel information is received the evening prior to your scheduled departure.
• Airfare is covered and, if driving to the assignment, reimbursement is available.
• Once notice is received, communication from our team is sent via email and text to ensure you are kept in the loop as soon as information becomes available.
• Your safety is Aya's top priority. We work closely with the facility to ensure additional security measures are taken onsite so you can focus on what really matters: patient care.
• Licensure, relocation and other reimbursements.

Experience the Aya difference today

• A dedicated recruiter who advocates for you every step of the way.
• We'll ensure the hiring manager prioritizes your interest and schedules an interview quickly.
• A streamlined hiring process means offers are often presented within 24-48 hours after an interview with a hiring leader.
• Flexible start dates that work around your availability.
• We make it simple with one point of contact the entire time.
• University of Washington (UW) offers a wide range of benefits as part of your total compensation package. Choose from top medical and dental insurance programs; plan for your future with tax-deferred investing through the UW retirement options; enjoy generous vacation and sick leave policies; and protect yourself and your family with life and long-term disability insurance. For more information, follow the links shown below or explore the Benefits website at http://hr.uw.edu/benefits/

With Aya, you get:

• Higher compensation - we negotiate on your behalf.
• Work-life balance - contracts are up to 40 hours per week, with workdays ending mid-late afternoon and weekends off!
• An employee advocate - our team ensures you have the support needed to be successful in your role.
• Options post contract - extend, convert to a permanent employee or find a new job.
• Paid company housing (pets are welcome to tag along) or a generous housing stipend.
• If qualified, continued insurance coverage over the summer.
• A generous 401k match.
• A robust team to support you every step of the way.
• A credentialing specialist to streamline the entire compliance process.
• Freedom and flexibility around your current schedule.
• The easy-to-use Shifts app. Select shifts anytime, anywhere.
• Premium medical, dental, vision and life insurance.
• Front-of-the-line access to exclusive jobs at thousands of healthcare facilities nationwide.
• A robust team to support you every step of the way to ensure you start on time, have accurate payroll and an exceptional experience.
• Certification and other reimbursements, when applicable.

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• Traveling with your GI Disorder: TSA Information

When traveling with your GI disorder, it is important to know how to fly with feeding tubes, medications, and other medical supplies you need. Although it can be challenging, with proper preparation, navigating the TSA checkpoints can be easy and less stressful.

Traveling with your GI Disorder: Support from Government Agencies

Preparing for your travel:.

You can do a few things to minimize distress before traveling and arriving at your airline. TSA offers a list of things you can do to make you feel as comfortable as possible during this process.

• You can visit the Oley Foundation for a sample letter
• Prepare a detailed list of medical equipment and supplies you will be bringing on your trip. (This can be included in the letter from your healthcare provider).
• Call the airline and ask TSA if you can get an advocate to help you through security. They can have someone meet you at curbside to assist you through the entire process.
• Fill out a TSA Notification card with your condition and print it out to present at your checkpoint.
• Check the state laws regarding labeling prescription medications.

For more information on traveling with a feeding tube, visit the Feeding Tube Awareness website.

Medical Supplies and Medication Screening:

• The TSA allows larger amounts of nutrition and medications in reasonable quantities. This means you are exempt from the 3-1-1 Liquids rule.
• Inform the TSA that you have medically necessary liquids and/or medications and separate them from your other belongings before screening takes place.
• You are responsible for displaying and handling your nutrition and medications during the screening process.
• Medications can go through a visual or x-ray screening to test for traces of explosives.
• Inform TSA if you do not want the nutrition and/or juice to be X-rayed or opened. Additional steps will be taken to clear the liquid.
• You may experience additional screening including a pat-down and inspection of your carry-ons.
• If you don’t feel like your TSA agent understands your medical situation or supplies, kindly stop them and ask them to really listen to your concerns to make sure you maintain comfort during this process.

For more information or advice on traveling, you can visit the TSA website or call TSA Cares at (855) 787-2227 before arrival.

Resources for traveling with a GI disorder: TSA website The Oley Foundation Feeding Tube Awareness

Check out other talks from our 2021 virtual advocacy day, share this page, topics of this article.

• Your Healthcare Team
• GI Motility Testing: A Comprehensive Guide
• Diet & Treatment Overview
• Tips & Daily Living with GI and Motility Disorders
• Qualifying for Social Security Benefits with a GI Disorder

IFFGD is a nonprofit education and research organization. Our mission is to inform, assist, and support people affected by gastrointestinal disorders. Our original content is authored specifically for IFFGD readers, in response to your questions and concerns.

If you found this article helpful, please consider supporting IFFGD with a small tax-deductible donation.

Related Information

Restroom Access Card: We understand the difficulties of needing to use a restroom urgently, especially for patients with gastrointestinal conditions. This can be a problem

Background of IFFGD’s Travel Awards IFFGD first offered Travel Awards in 2023. To date, we have presented Awards to 23 young investigators from around the

The 2024 Virtual Digestive Health Wellness & Walk held Saturday, July 6, 2024 – Saturday, July 13, 2024 is a charitable event to raise money to support gastrointestinal illness research. 

Like a traditional walk, participants register to be active to get credit for steps taken during the event. However, this event goes beyond a step goal by also awarding points to participants for self-care, wellness, and outreach activities.

By adding these alternative activities, we hope that anyone that wants to participate, can participate. #Moves4GIhealth24

Personal Stories

This information is in no way intended to replace the guidance of your doctor.

We advise seeing a physician whenever a health problem arises requiring an expert’s care. 

© Copyright 2024 International Foundation for Gastrointestinal Disorders, Inc. (IFFGD). All Rights Reserved.

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GI Travel is expert in organizing. We take care of all your travel details! Our team is happy to be your partner for business group travel, incentives, and corporate events with the goal of letting you enjoy the trip to the fullest. 

We create unexpected experiences

GI Travel has provided customized incentives, group travel, international meetings, post-graduate course travel, staff travel, anniversary travel, and trade missions to destinations worldwide for over 40 years. Together with you, our team of experienced experts creates an unforgettable travel experience in a creative and innovative way.

Our greatest assets include versatility, flexibility, resourcefulness, knowledge, and experience. Anything goes for us, and we love the challenge of bringing your trip or event to a climax.

Besides the travel-technical part, GI Travel is happy to help you with hands-on services like participant registration, billing, and communication. We are immensely proud to have received excellent client reviews for our customized travels and events for many years.

Taking a post-graduate course in one of the most extraordinary countries the African continent has to offer, Tanzania. Who can say that they followed a refresher course among elephants, zebras, and other wildlife? To top it all off, the participants also got an impression of the breathtaking landscape from the air during a flight with 3 Cessna’s.

Taking a course in the savannah

Sylvia van Loon

Business Unit Manager GI Travel

Traveling, creating something together, taking pictures, cooking delicious food, and then having a long dinner are some of my passions. This comes together very nicely in my current work! We see a lot of the world and every time it is very satisfying to see the surprised faces of our customers when everything falls into place during the trip or event.

Terug naar overzicht

We create unexpected experiences

Specialist in het creëren van onvergetelijke ervaringen!

GI Travel is specialist in het creëren van ervaringen

GI Travel is expert in organiseren. We nemen alle details van de reis voor je uit handen! Ons team is graag jouw partner voor zakelijke groepsreizen, incentives en zakelijke events met als doel dat je zelf optimaal kunt genieten van en tijdens de reis. Ons team bestaat uit ervaringsdeskundigen die iedere gewone reisbestemming of event omtoveren tot een unieke en onvergetelijke ervaring!

Onze klanten aan het woord

Een impactvolle ervaring, dat is waar het om draait!

Reisbrancheorganisatie ANVR organiseert samen met GI Travel jaarlijks hét netwerkevent voor de Nederlandse reissector op een buitenlandse bestemming. Het organiseren van een congres brengt extra veel werk, tijd en expertise met zich mee. Voor de praktische uitvoering van dit jaarlijks terugkerende evenement werkt de ANVR al jaren naar volle tevredenheid samen met GI Travel. Ook de deelnemers prijzen GI Travel voor hun professionaliteit. Inmiddels hebben we zeer succesvolle congressen achter ons liggen op de meest uiteenlopende bestemmingen als Malta, Dresden, Cyprus, Abu Dhabi, Curaçao en Sevilla.

De Tokyo marathon reis van Marathons International is goed geregeld. Het mooie van alles is dat je nergens aan hoeft te denken behalve aan je hardloopvoorbereiding en trainingen voor deze marathon. Raad ik het iedereen aan? JA! Hotel is geweldig met een perfecte ligging voor zowel voor als na de marathon. Alles is inbegrepen en makkelijk te doen. Zeer blij dat ik weer gekozen heb voor Marathons International voor deze Japanse beleving! Sayonara! Op naar de volgende.

Al ruim twintig jaar lang organiseert GI Travel de studiereizen voor onze leden met steeds weer een andere bestemming in Europa. Ze weten iedere keer weer een verrassend en aantrekkelijk programma voor de doelgroep samen te stellen. Ze denken goed mee, zijn flexibel, deskundig en begeleiden ons uitstekend. De reisorganisatie neemt ons veel werk uit handen, altijd met een prachtig resultaat.

Een zorgeloze reis, dat is voor mij waar het om draait. We werken nu al enkele jaren met GI Travel en elk jaar zorgen ze weer voor een ontzettend leuk programma, mooie locaties en faciliteiten, maar vooral geen gedoe ter plaatse. Alles is tot in de puntjes geregeld, zodat iedereen optimaal van de reis kan genieten!

GI Travel is in één woord "Geweldig". Al 5 jaar organiseren we gezamenlijk een studiereis voor Nederlandse en buitenlandse directieleden van retailers en e-commercebedrijven. Het niveau van de deelnemers is hoog en daarmee ook de eisen en flexibiliteit die aan de reisorganisatie worden gesteld. GI Travel is altijd in staat om de hoogste verwachtingen te overtreffen. Zoals met de studiereis naar San Francisco. Naast logistiek tot in de puntjes geregeld, bevatte de reis ook veel creatieve uitspattingen die bij de deelnemers een blijvende indruk hebben achtergelaten. Ook zijn ze altijd in staat om goede kortingen te realiseren die ze zeer transparant aan ons rapporteerden. Kortom, ik raad GI Travel van harte aan.

Sinds een aantal jaren werkt Exact samen met GI Travel bij het organiseren en uitvoeren van de Exact Stars reis. Deze groep best presterende sales medewerkers en partners kijkt ieder jaar uit naar de verrassende reis die hen te wachten staat. Dankzij GI Travel voelen onze deelnemers zich echte “Stars”, door steeds weer bijzondere bestemmingen en speciale programma’s samen te stellen. Wij zijn heel blij met de samenwerking en meedenken op alle fronten.

Ik ben meegegaan op een 3-daagse ondernemersreis naar Girona. Deze reis was georganiseerd in samenwerking met ondernemersplatform nlgroeit . Ik ben meegegaan op deze reis omdat ik vaak in mijn bedrijf werk, aan mooie projecten voor onze opdrachtgevers, maar dat ik me graag ook wil ontwikkelen op het gebied van ondernemerschap. Ik ging naar huis met een concreet actieplan, heel fijn! Als je als ondernemer of organisatie twijfelt om inhoud en ontspanning te combineren tijdens een groepsreis, dan zeg ik: juist doen! Je kan hiermee in een paar dagen bereiken waar je anders misschien jaren over doet.

Al ruim 15 jaar is GI Travel een vaste partner voor het organiseren van zakelijke reizen voor KPN. De teller staat nu op zo’n 40 succesvolle reizen. Zelfs na al die jaren en al die reizen weet het ervaren GI team ons nog steeds te verrassen met het aanbieden van unieke bestemmingen en exclusieve activiteiten, die telkens weer alle verwachtingen van onze gasten overtreffen. GI Travel is professioneel en transparant, uiterst meedenkend en gaat altijd een stapje verder voor haar klanten. Absoluut een aanrader!

The Recruitee Workation 2022 to Greece was a huge success! We have you to thank for the wonderful organisation, guidance, and support throughout the course of this project. Thank you for the collaboration. We have made some wonderful memories.

Al meer dan tien jaar boeken wij naar volle tevredenheid onze reizen bij GI Travel. Dankzij onze vaste projectmanager wordt elke vraag vertaald naar een passend antwoord terwijl alle andere collega's altijd op de hoogte zijn van onze aanstaande reis. Dit is snel en prettig schakelen. Naast het feit dat GI Travel gewoon goed is in wat ze doen, is er ook altijd oog voor de warme kant. Het is persoonlijk en professioneel tegelijkertijd. Een reis die wij met GI Travel voor onze gasten organiseren voelt altijd als thuiskomen!

Al jaren organiseren wij studiereizen voor bestuurders van onze leden. Om die reizen worden we zeer gewaardeerd. GI Travel is voor ons onmisbaar. Zij zorgen ervoor dat de reizen tot in de puntjes zijn geregeld. De keuzes voor hotels en restaurants en sociale events zijn altijd uitstekend. Ter plaatse zijn er altijd ontzettend goede lokale reisbegeleiders. In de voorbereiding zijn ze prettig flexibel en pro-actief, met nuttige suggesties en tips. Door onze jarenlange samenwerking weet GI Travel precies wat belangrijk voor ons is. De samenwerking verloopt altijd ontzettend goed, met een vaste accountmanager die altijd voor ons beschikbaar is.

GI Travel organiseerde voor Thuiswinkel.org een studiereis naar Silicon Valley voor een aantal Captains of Industry. Tot in de details was alles geregeld. Alle deelnemers waren super tevreden over de kwaliteit van GI Travel.

GI Travel has arranged several times corporate tours for our Board of Directors and Business teams as well. Every trip was an unforgettable experience! The staff is professional and attentive. The schedules were well-organized. The hotels were amazing. The food was excellent. The sightseeings were wonderful.

In juni 2019 zijn wij naar Londen geweest en heb ik (net als bij de andere DGA-reizen) gebruik gemaakt van de expertise van GI Travel. GI Travel heeft ons geadviseerd in het samenstellen van het programma in Londen. Zij regelen alle reistechnische onderdelen. Door dit allemaal door een betrouwbare partner te laten regelen die aangesloten is bij verschillende garantiefondsen biedt dit zekerheid. Tijdens de reis is GI Travel ook 24/7 bereikbaar en ter plaatse zijn wij ondersteund door de lokale vertegenwoordiging van GI Travel. Het is fijn om met één contactpersoon samen te werken die meedenkt en op de hoogte is van de laatste ontwikkelingen op de bestemming.

Boek een retourtje inspiratie!

Het dagelijkse kantoorleven is vandaag de dag behoorlijk veranderd. Tegenwoordig is werken op afstand (remote working) niet alleen maar voor zelfstandig ondernemers weggelegd. Ook werknemers in loondienst ervaren de voordelen van een workation in het buitenland. Even uit je vertrouwde omgeving kan je soms een gezonde dosis inspiratie opleveren. Lees meer...

Wat kan een reis of event betekenen voor jouw organisatie?

Samen mooie ervaringen opdoen staat voor verbintenis. Het beïnvloedt de goede samenwerking, werksfeer en productiviteit op een positieve manier.

Behalve mensen verbinden en inspireren, kan een reis of event ook een specifiek doel hebben. Denk bijvoorbeeld aan een reis die aandacht trekt rondom een productlancering, voor het verhogen van de samenwerking en productiviteit van je werknemers of een mooi event om een jubileumjaar te vieren dat absoluut niet onopgemerkt voorbij mag gaan. Met creatieve ideeën laat zakelijk reisbureau GI Travel jou het meeste uit je reis of event halen.

GI Travel Amsterdam

De Lairessestraat 117 1075 HH Amsterdam +31 (0) 20 517 18 88 [email protected]

GI Travel Rotterdam

Goudsesingel 184 3011 KD Rotterdam +31 (0) 10 217 99 99 [email protected]

Onze reizen

• Personeelsreizen
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• Congresreizen
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• Handelsmissies
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• Section 11 - Respiratory Infections
• Section 11 - Dermatologic Conditions

Persistent Diarrhea in Returned Travelers

Cdc yellow book 2024.

Author(s): Bradley Connor

Although most cases of travelers’ diarrhea (TD) are acute and self-limited, a certain percentage of people afflicted will develop persistent (>14 days) gastrointestinal (GI) symptoms. Details on the management of acute TD are available in Sec. 2, Ch. 6, Travelers’ Diarrhea .

Pathogenesis

The pathogenesis of persistent diarrhea in returned travelers generally falls into one of the following broad categories: ongoing infection or co-infection with a second organism not targeted by initial therapy; previously undiagnosed GI disease unmasked by the enteric infection; or a postinfectious phenomenon.

Ongoing Infection

Most cases of TD are the result of bacterial infection and are short-lived and self-limited. In addition to immunosuppression and sequential infection with diarrheal pathogens, ongoing infection with protozoan parasites can cause prolonged diarrheal symptoms.

Individual bacterial infections rarely cause persistent symptoms, but travelers infected with Clostridioides difficile or enteroaggregative or enteropathogenic Escherichia coli (see Sec. 5, Part 1, Ch. 7, Diarrheagenic Escherichia coli ) can experience ongoing diarrhea. C. difficile –associated diarrhea can occur after treatment of a bacterial pathogen with a fluoroquinolone or other antibiotic, or after malaria chemoprophylaxis. The association between C. difficile and antimicrobial treatment is especially important to consider in patients with persistent TD that seems refractory to multiple courses of empiric antibiotic therapy. The initial work-up of persistent TD should always include a C. difficile stool toxin assay. Clinicians can prescribe oral vancomycin, fidaxomicin, or, less optimally, metronidazole to treat C. difficile .

As a group, parasites are the pathogens most likely to be isolated from patients with persistent diarrhea. The probability of a traveler having a protozoal infection, relative to a bacterial one, increases with increasing duration of symptoms. Parasites might also be the cause of persistent diarrhea in patients already treated for a bacterial pathogen.

Giardia (see Sec. 5, Part 3, Ch. 12, Giardiasis ) is the most likely parasitic pathogen to cause persistent diarrhea. Suspect giardiasis particularly in patients with upper GI–predominant symptoms. Untreated, symptoms can last for months, even in immunocompetent hosts.

PCR-based diagnostics, particularly the multiplex DNA extraction PCR, are becoming the diagnostic methods of choice to identify Giardia and other protozoal pathogens, including Cryptosporidium , Cyclospora , and Entamoeba histolytica . Diagnosis also can be made by stool microscopy, antigen detection, or immunofluorescence. In the absence of diagnostics (given the high prevalence of Giardia as a cause for persistent TD), empiric therapy is a reasonable option in the clinical setting. Rare causes of persistent symptoms include the intestinal parasites Cystoisospora , Dientamoeba fragilis , and Microsporidia .

Tropical Sprue & Brainerd Diarrhea

Persistent TD also has been associated with tropical sprue and Brainerd diarrhea. Tropical sprue is associated with deficiencies of vitamins absorbed in the proximal and distal small bowel and most commonly affects long-term travelers to tropical areas, as the name implies. The incidence of tropical sprue appears to have declined dramatically over the past 2 decades. Diagnosed only rarely in travelers, its cause is unknown.

Brainerd diarrhea is a syndrome of acute onset of watery diarrhea lasting ≥4 weeks. Symptoms include 10–20 episodes of explosive, watery diarrhea per day, fecal incontinence, abdominal cramping, gas, and fatigue. Nausea, vomiting, and fever are rare. Although the cause is believed to be infectious, a culprit pathogen has yet to be identified, and antimicrobial therapy is ineffective as treatment. Investigation of an outbreak of Brainerd diarrhea among passengers on a cruise ship to the Galápagos Islands in 1992 identified that individuals with persistent diarrhea (range: 7 to >42 months) were more likely to have consumed contaminated water or eaten raw fruits or vegetables washed with contaminated water.

Underlying Gastrointestinal Disease

Celiac disease.

In some cases, persistent symptoms relate to chronic underlying GI disease or to a susceptibility unmasked by the enteric infection. Most prominent among these is celiac disease, a systemic disease manifesting primarily with small bowel changes. In genetically susceptible people, exposure to antigens found in wheat causes villous atrophy, crypt hyperplasia, and malabsorption. Serologic tests, including tissue transglutaminase antibody testing, support the diagnosis; a small bowel biopsy showing villous atrophy confirms the diagnosis. Patients can be treated with a gluten-free diet.

Colorectal Cancer

Depending on the clinical setting and age group, clinicians might need to conduct a comprehensive search for other underlying causes of chronic diarrhea. Consider colorectal cancer in the differential diagnosis of patients passing occult or gross blood rectally or in patients with new-onset iron-deficiency anemia.

Inflammatory Bowel Disease

Idiopathic inflammatory bowel disease, including Crohn’s disease, microscopic colitis, and ulcerative colitis, can occur after acute bouts of TD. One prevailing hypothesis is that in genetically susceptible people, an initiating exogenous pathogen changes the microbiota of the gut, thereby triggering inflammatory bowel disease.

Postinfectious Phenomena

In a certain percentage of patients who present with persistent GI symptoms, clinicians will not find a specific cause. After an acute diarrheal infection, patients might experience a temporary enteropathy characterized by villous atrophy, decreased absorptive surface area, and disaccharidase deficiencies, which can lead to osmotic diarrhea, particularly after consuming large amounts of fructose, lactose, sorbitol, or sucrose. Use of antimicrobial medications during the initial days of diarrhea might also lead to alterations in intestinal flora and diarrhea symptoms.

Occasionally, onset of irritable bowel syndrome (IBS) symptoms occurs after a bout of acute gastroenteritis, known as postinfectious IBS (PI-IBS). PI-IBS symptoms can occur after an episode of gastroenteritis or TD. The clinical work-up for microbial pathogens and underlying GI disease in patients with PI-IBS will be negative. Whether using antibiotics to treat acute TD increases or decreases the likelihood of PI-IBS is unknown.

Traditional methods of microbial diagnosis rely on the use of microscopy. Examine stool specimens collected over 3 or more days for ova and parasites; include acid-fast staining for Cryptosporidium , Cyclospora , and Cystoisospora . Giardia antigen testing and a C. difficile toxin assay are appropriate elements of a work-up. In addition, a D-xylose absorption test can determine whether patients are properly absorbing nutrients. If underlying gastrointestinal disease is suspected, include serologic testing for celiac disease and consider inflammatory bowel disease during initial evaluation. Subsequently, studies to visualize both the upper and lower gastrointestinal tracts, with biopsies, might be indicated.

Diagnostic tests to determine specific microbial etiologies in cases of persistent diarrhea have advanced in the past number of years. One of the most useful tools is high-throughput multiplex DNA extraction PCR. This technology uses a single stool specimen to detect multiple bacterial, parasitic, and viral enteropathogens simultaneously. Except for Cryptosporidium , these assays have high sensitivity and specificity; the clinical ramifications and the economic impact of using these diagnostic molecular panels have not been determined fully, however. In some cases, molecular testing detects colonization rather than infection, making it difficult for clinicians to interpret and apply the results properly.

Specific treatment of identified enteropathogens is usually indicated, and appropriate management of underlying gastrointestinal disease warranted (e.g., a gluten-free diet for celiac disease, medication for inflammatory bowel disease). Dietary modifications might help patients with malabsorption. Symptomatic treatment or the use of nonabsorbable antibiotics offer potential benefit if small intestinal bacterial overgrowth accompanies the symptom complex. Additionally, chronic diarrhea might cause fluid and electrolyte imbalances requiring medical management involving oral or intravenous replacement based on clinical presentation.

The following authors contributed to the previous version of this chapter: Bradley A. Connor

Bibliography

Connor BA. Sequelae of traveler’s diarrhea: focus on postinfectious irritable bowel syndrome. Clin Infect Dis. 2005;41(Suppl 8):S577–86.

Connor BA. Chronic diarrhea in travelers. Curr Infect Dis Rep. 2013;15(3):203–10.

Connor BA, Rogova M, Whyte O. Use of a multiplex DNA extraction PCR in the identification of pathogens in travelers’ diarrhea. J Trav Med. 2018;25(1):tax087.

Duplessis CA, Gutierrez RL, Porter CK. Review: chronic and persistent diarrhea with a focus in the returning traveler. Trop Dis Travel Med Vaccines. 2017;3(9):1–17.

Hanevik K, Dizdar V, Langeland N, Hausken T. Development of functional gastrointestinal disorders after Giardia lamblia infection. BMC Gastroenterol. 2009;9:27.

Libman MD, Gyorkos TW, Kokoskin E, Maclean JD. Detection of pathogenic protozoa in the diagnostic laboratory: result reproducibility, specimen pooling, and competency assessment. J Clin Microbiol. 2008;76(7):2200–5.

Mintz ED, Weber JT, Guris D, Puhr N, Wells JG, Yashuk JC, et al. An outbreak of Brainerd diarrhea among travelers to the Galapagos Islands. J Infect Dis. 1998;177(4):1041–5.

Norman FF, Perez-Molina J, Perez de Ayala A, Jimenez BC, Navarro M, Lopez-Velez R. Clostridium difficile –associated diarrhea after antibiotic treatment for traveler’s diarrhea. Clin Infect Dis. 2008;46(7):1060–3.

Porter CK, Tribble DR, Aliaga PA, Halvorson HA, Riddle MS. Infectious gastroenteritis and risk of developing inflammatory bowel disease. Gastroenterology. 2008;135(3):781–6.

Spiller R, Garsed K. Postinfectious irritable bowel syndrome. Gastroenterology. 2009;136:1979–88.

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Endoscopy/GI Travel Nursing Jobs

Jobs listing, endoscopy/gi job description.

Endoscopy/GI Lab Registered Travel Nurses provide care to patients undergoing procedures in an endoscopy/GI Lab. Endoscopy/GI nurses assess and monitor patients during the procedures and are usually have responsibility associated with sedation and post-procedure care.

Endoscopy/GI Job Requirements

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Registered GI Endoscopy Nurse Salary

In the United States, the average endoscopy nurse income is $80,600 per year or $41.33 per hour. Starting salaries for entry-level employment start at $57,687 per year, with the highest-paid professionals earning up to $123,014 per year.

Even so, when you factor in the financial benefits of traveling, such as bonuses, insurance, and travel and housing allowances, the compensation for traveling Endoscopy/GI jobs skyrockets. Pay for endoscopy travel nurses varies depending on the geographic region, facility, education, and experience.

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Our Stability Healthcare recruiter will work with you to plan out various assignments for your travel career in advance. You get the following benefits with Stability Healthcare:

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Endoscopy/GI Travel Nurse compensation is enhanced by Stability Healthcare incentives and benefits. Such as:

• Day 1 Premium Insurance:  Starting on the first day of your assignment, you will be covered by premium insurance (medical, dental, vision, and life insurance).
• $15,000 Company-paid Life/ADD Insurance.

Travel Nurse Salary & Benefits

Yes, Travel Nurses can earn more money with various assignments. Still, the good news is that it’s not simply the money that attracts people to work as house supervisor travel nurses. With bonuses, extra shift compensation, stipends, and above-average compensation, travel nurses can significantly improve their earnings in a short period of time.

Stability Healthcare’s incentives and advantages help endoscopy travel nurses earn more money. Such as the following:

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If you apply to position yourself as a strong candidate for an endoscopy  travel nurse career you will get many benefits. Stability Healthcare’s  Endoscopy Travel Nurse jobs offer many benefits, such as:

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Are you looking for an Endoscopy Travel Nursing career option? Check our job opportunities at Stability Healthcare and start a new step in your career!

Travel Nursing Reviews

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The response time from my recruiter and nurse specialist is amazing! They both have been so great to work with on my first assignment out in California!!! Chad and Samantha both are super caring and very responsive! I already extended my contract with the hospital because of the smooth process. They made the transition from Florida to California a lot loss stressful than I imagined. Would definitely recommend them both!!!

My recruiter, and other staff I have had the pleasure of interacting with, are all so friendly and helpful. My recruiter is responsive, and even reached out while she was on vacation to check on me! I’ve worked with other agencies in the past, but Stability is next level when it comes to making your travel nursing experience as seamless as possible! Special shout out to Lindsay (best recruiter ever) and Tracy. Amazing people to work with.

Brittany J.

My recruiter is very responsive and personable. I have NEVER had any issues with them!! This agency even has PTO! None of my co workers with other agencies have this benefit!! Also the rates are equal or higher than most other agencies!! Everything feels more like family than business and for that I would choose stability over any other agency!! I am so happy I chose to work with them!

Sopheare C.

My recruiter Amanda is amazing and always timely with her responses. Debbie who is my nurse experience specialist who is with me all times of the contract is truly awesome. Love how responsive she is and will answer any and all my questions. Big thanks to Jesse my compliance coordinator for making all the appointments and getting me travel ready. Can’t thank my team enough for all they do. Any question or issue I have they resolve right away. And I love that they breakdown each contract into a spread so you know exactly what your getting for the terms of the contract.

I have been incredibly impressed by the professionalism, ease of communication, ability to have all requirements for onboarding fulfilled in a timely manner, and just overall outstanding service. Lindsay Hernandez is my particular recruiter and she has been a pleasure to work with, as well as all the team members at Stability. I’m looking forward to staying with them for my next assignment. I highly recommend them to my nursing friends, and anyone looking to travel as a nurse!

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