How to Avoid Travellers’ Diarrhoea Before You Travel
Travellers’ diarrhoea is the most common illness among travellers. It affects over one in five people visiting high-risk destinations. Fewer than 1% end up in hospital, but around 13% are confined to bed for a few days, and up to 46% have to change their plans. Most of that is avoidable.
Here’s exactly how to cut your risk, and what to do if it catches you anyway.
Table of Contents
What Is Travellers’ Diarrhoea?
Doctors define it as three or more loose, unformed stools in 24 hours, usually with at least one of fever, nausea, vomiting, cramps, or blood in your stool. It typically starts during your trip or within 10 days after you get home.
Bacteria cause most cases. A strain called enterotoxigenic E. coli is the single biggest culprit, followed by Campylobacter, Shigella, and Salmonella. In up to 40% of cases, doctors can’t find a specific cause. This is why prevention is more important than trying to treat it later.
Why Prevention Is Key to Enjoying Your Holiday
One bad stomach bug can wipe out several days of a trip you’ve looked forward to for months. Nobody remembers the sunset if they spent day three stuck in the bathroom.
Prevention isn’t complicated, and it doesn’t mean skipping the local food scene. It just means being a bit more switched on about what you eat and drink, so the rest of your holiday can go to plan.
Top Ways to Avoid Travellers’ Diarrhoea
Most cases trace back to something simple: unsafe water, risky food, or hands that haven’t been washed. Nail these basics, and your risk drops sharply.
Stick to Bottled or Boiled Water
Tap water is one of the biggest offenders in higher-risk destinations, and that includes ice cubes and the water you brush your teeth with. Stick to sealed bottled water, or water that’s been boiled or properly filtered, and check the seal hasn’t been tampered with before you buy it.
Choose Street Food and Buffets Carefully
Street food can be some of the best food on a trip. Choose stalls with a queue, where food is cooked fresh and served piping hot. Buffets are trickier, since food can sit out for hours at the wrong temperature, giving bacteria plenty of time to multiply.
Peel It Yourself or Skip It
Fresh fruit and veg are often washed in local tap water before they reach your plate. A good rule of thumb: if you can peel it yourself, it’s usually fine. Salads and pre-cut fruit are harder to judge, so treat them with a bit more caution.
Be Cautious With Dairy and Seafood
Unpasteurised dairy and raw or undercooked seafood often cause stomach issues. This is more common in hot climates, where food spoils quickly. If you’re unsure whether dairy has been pasteurised, it’s safer to skip it.
Wash Your Hands Properly and Often
Sounds obvious, but it’s one of the most effective things you can do. Wash your hands before eating and after using the toilet, and carry hand sanitiser for when soap and water aren’t around.
Check Your Destination’s Risk Level Beforehand
Risk isn’t the same everywhere. Parts of South Asia, Sub-Saharan Africa, and Central and South America tend to carry higher risk than Western Europe or North America. Knowing this in advance helps you decide how cautious to be once you land.
Pack a Simple Travel Health Kit
A small kit can save you a lot of stress. Pack oral rehydration sachets (mixed with bottled or boiled water, not tap water). Also, include hand sanitiser and any medications your pharmacist suggests before you leave. Look for rehydration sachets formulated to the standard WHO salt and sugar ratio, since these work better than water alone. It won’t take up much suitcase space, but it can make a real difference if things go wrong.
Ask a Pharmacist About Standby Antibiotics
Standby antibiotics require a Travel clinic consultation. They are unsuitable for under-18s, those under 45kg, pregnant/breastfeeding individuals, or if taking warfarin, digoxin, hydroxychloroquine, or rifabutin. If prescribed, take 500mg daily for three days with food, strictly for severe symptoms like blood or fever.
Safe vs. Risky Foods and Drinks Overview
A quick cheat sheet to keep in mind while you’re away.
| Category | Safer Choices | Higher Risk |
| Water & drinks | Sealed bottled water, hot tea/coffee | Tap water, ice, unsealed bottles |
| Food | Freshly cooked, served hot | Buffets, food left standing |
| Fruit & veg | Fruit you peel yourself | Salads, unpeeled produce |
| Dairy | Pasteurised products | Unpasteurised milk, local dairy |
| Extras | Busy stalls with high turnover | Street food stalls with no queue |
Who Needs to Be Extra Careful
Travellers’ diarrhoea hits some people harder than others.
Young children dehydrate much faster than adults, so a mild bug can quickly become serious. Older travellers may struggle more with fluid loss. This is especially true if they have other health issues. Pregnant travellers have a greater risk of dehydration complications. So, it’s important to be careful with food and water.
People with weak immune systems, like those on chemotherapy or immunosuppressants, are more likely to get severe or long-lasting infections. If you’re taking antacids or acid-reducing medication, be careful. Stomach acid helps protect against these bugs. Lowering it can make infections easier.
What to Do If You Still Get It
Even careful travellers get caught out sometimes, and that’s okay. Most cases are mild and clear up within three to four days. The main thing is staying hydrated. Oral rehydration salts work far better than plain water alone, since they replace the salts and sugars your body is losing.
Anti-diarrhoeal medicines like loperamide can help if you have plans you can’t miss. They can control symptoms for a day. However, loperamide is not recommended for children under 12.
Also, avoid anti-diarrhoeal medicines if you have a fever or blood in your stool, as they might make some infections worse. Rest when you can, stick to plain foods once you feel able to eat, and avoid alcohol and caffeine until you’re feeling better.
When to Seek Help from a Pharmacist or Doctor
Most cases don’t need medical attention, but a few warning signs mean it’s time to get help rather than wait it out.
Contact a pharmacist or GP for: blood or mucus in your stools, a fever of 38°C or above, symptoms lasting more than three days, or signs of dehydration such as dizziness and very dark urine.
Go to A&E or call 999 if you or someone with you becomes confused or drowsy, cannot keep any fluids down, or has severe abdominal pain. These are signs of serious dehydration and need urgent care.
Vaccinations to Consider
Travellers’ diarrhoea has no vaccine, but two of the more serious illnesses spread the same way do. Hepatitis A is recommended for most of Africa, Asia, the Middle East and Central and South America. Typhoid particularly matters for South Asia. Both are worth sorting at the same appointment.
Book a Pre-Travel Consultation at Your Local Erdington Pharmacy and Health Clinic
A quick chat with a pharmacist before you fly covers more ground than most people expect. We can discuss food and water safety tips. Also, we’ll look at your destination’s specific risks.
We’ll check if your travel vaccines are current, offer services like a private flu jab, and decide if you should pack standby treatment. Our travel clinic in Birmingham is set up to cover exactly this. Read more on private versus NHS travel vaccines to learn about vaccine coverage options before your trip.
Frequently Asked Questions
How long does this usually last?
Most cases clear up within three to four days without specific treatment, as long as you stay hydrated.
Is it contagious?
It can spread between people due to poor hygiene, especially in shared places. So, hand washing is important, even if you’re already sick.
Can I still take antimalarial tablets if I have diarrhoea?
Severe diarrhoea can affect how well some tablets are absorbed. Speak to a pharmacist if you’re unsure, rather than stopping your antimalarials on your own.
Do probiotics help prevent it?
Evidence is mixed, so don’t rely on them as your main defence. Food and water hygiene still matter far more.
Is it different for children travelling abroad?
Children can dehydrate faster than adults, so keep a closer eye on fluid intake and seek help sooner if symptoms don’t ease.
Conclusion
Travellers’ diarrhoea can quickly ruin a well-planned holiday, but taking a few practical precautions significantly reduces your risk. Being mindful of what you eat and drink, staying prepared with a basic travel health kit, and understanding when to seek treatment ensures you stay safe throughout your trip.
Before travelling, consult our pharmacy team in Erdington for tailored travel health advice, recommended vaccinations, and essential supplies to help you travel with confidence.
Zainab Master is the Superintendent Pharmacist and owner of Your Local Pharmacy. With extensive experience in community pharmacy and patient care, she is dedicated to helping local patients access safe, professional, and convenient healthcare services. Zainab specialises in pharmacy-led treatments, travel vaccinations, earwax removal, contraception services, blood pressure checks, and everyday health advice. Her focus is on providing trusted healthcare support with a patient-first approach.