How to avoid traveller’s diarrhoea

Delhi belly, the trots, the runs…whatever you prefer to call it, the vast majority of us have fallen victim to a few loose bowel movements whilst exploring pastures new.

The more politically correct term ‘Traveller’s Diarrhoea’ can be defined as three or more loose bowel movements over a 24 hour period with at least one symptom of cramps, fever, nausea or vomiting.

Traveller’s diarrhoea typically affects us in the first 1-2 weeks of travel to a foreign environment and can be caused by a range of organisms including bacteria, parasites and viruses.  These bugs are usually spread through eating contaminated food or drinking contaminated water. Travellers’ diarrhoea is caused by germs and not to be confused with the passage of a few loose stools associated with a change in diet.


Traveller’s diarrhoea typically affects people travelling from industrialised western countries to less developed areas; in particular the tropics. Your risk of contracting traveller’s diarrhoea is high in Asia, The Middle East, Africa and South America. Around 40% of travellers to these countries will experience loose motions and the vast majority of cases are caused by bacteria (up to 80%). The most common bacteria to cause symptoms is E.coli which is spread by eating contaminated food and drink, drinking from dirty cups, eating from dirty plates and general poor hygiene.


Signs and symptoms will vary slightly dependent on which bug is responsible.

Typical symptoms resolve within 72 hours. They include loose bowel motions AND one of:

  • Fever
  • Cramps
  • Nausea
  • Vomiting

Signs that you may be suffering from a nastier bug which may warrant seeking medical attention include:

  • Bloody stools
  • Mucous in stools

In any case, if you suffer from symptoms for longer than 3 days you should seek medical advice. The main risk of diarrhoea is dehydration so if you become weak, lethargic, and dizzy with a dry mouth/tongue whilst struggling to pass urine you should seek medical attention. This is especially true in the case of young children, pregnant women and anyone with any long term health problems. In these groups, medical advice may need to be sought sooner than 3 days into the illness.


As the bugs are spread by poor hygiene, the best way to avoid getting ill is to adopt strict hygiene measures. This includes:

  • Wash hands after using the toilet- not always possible in remote areas so carry alcohol hand gel as a last resort
  • Wash hands before eating
  • Eat in places which look visibly clean
  • Avoid eating fruit and vegetables which may have been washed in contaminated water


The key to feeling better is to stay hydrated.

Small frequent sips of water or diluted fruit juice will help to maintain your fluid balance. Better still, use oral rehydration sachets around 5 times a day to replenish any salts lost through the course of illness. These are good to take with you on your travels as a precautionary measure.

If you desperately need to catch a bus, plane or other form of transport then you can use tablets to prevent bowel motions such as Imodium However, these should only be used as a last resort measure and never used if you experience blood in your stools as this indicates a more invasive origin and these tablets can cause complications.

Xifaxanta is a prescription only treatment which can be used to treat diarrhoea where there are fewer than 8 loose stools every 24 hours and no associated fever or blood. Xifaxanta contains an antibacterial agent which acts locally in the gut to kill bacteria which causes symptoms of traveller’s diarrhoea. The usual dose is 200mg three times a day for a maximum of three days.  You can complete an online consultation to obtain a prescription of these tablets and take them with you as a precautionary measure. They are particularly suitable for anyone taking a very short trip which would be significantly affected by a bout of illness or those visiting a remote location where medical attention may not be available.

Happy travelling!

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