Medicines for Travellers' diarrhoea

What it is

Travellers' diarrhoea is diarrhoea that develops during or shortly after travelling, particularly to regions where food and water hygiene may differ. It is one of the most common illnesses affecting travellers. It is usually caused by consuming food or water contaminated with germs (most often bacteria, but sometimes viruses or parasites) to which the traveller is not accustomed. The main symptom is passing loose or watery stools more frequently than usual, often starting suddenly, and it may be accompanied by tummy cramps, an urgent need to go to the toilet, feeling or being sick, bloating, and sometimes a mild fever. In most cases it is mild and self-limiting, settling by itself within a few days as the body clears the infection. The main risk from any diarrhoea is dehydration — from the fluid lost — so the priority is staying hydrated, which is especially important for young children, older people, and those who are unwell. Although most cases are mild, certain features indicate a more serious illness needing medical attention: blood or mucus in the stools, a high fever, severe or persistent symptoms, signs of significant dehydration, severe tummy pain, or diarrhoea that does not settle. Simple precautions with food, water and hygiene while travelling reduce the risk, and knowing how to manage symptoms and when to seek help allows most cases to be dealt with safely.

How it is treated

Travellers' diarrhoea is usually managed with self-care focused on staying hydrated, as most cases settle by themselves within a few days. The most important measure is drinking plenty of fluids to replace those lost — clean or bottled/purified water, and oral rehydration solutions (worth carrying when travelling) to replace lost salts and sugars, which are especially useful for children, older people, and more troublesome cases. Eating can resume as appetite returns, starting with bland foods. Rest helps. Anti-diarrhoeal medicines (such as loperamide) can reduce the number of trips to the toilet and may be useful for short periods (for example when travelling), but they are generally not recommended if there is a high fever or blood in the stools, and are not suitable for young children, so it is best to use them appropriately and seek advice if unsure. Maintaining good hand hygiene helps prevent spread. Most cases resolve without antibiotics; antibiotics are reserved for more severe cases or certain situations and should be guided by a health professional. It is important to seek medical help if there is blood or mucus in the stools, a high fever, severe or persistent symptoms, signs of dehydration, severe tummy pain, or if symptoms affect a baby, young child, older or frail person, or someone with an underlying condition. Prevention while travelling — being careful with drinking water (using bottled, boiled or purified water and avoiding ice of uncertain origin), choosing food that is freshly and thoroughly cooked and served hot, avoiding high-risk foods, peeling fruit yourself, and washing hands well — reduces the risk. The reassuring message is that travellers' diarrhoea is common and usually mild and self-limiting, that staying hydrated is the key, and that simple precautions reduce the risk, while certain warning signs mean medical help should be sought.