Latest information about coronavirus disease (COVID-19) risks
Public Health Scotland logo

Fit for Travel Logo

Information on how to stay safe and healthy abroad. About us.

Travellers' Diarrhoea

Introduction

Travellers' diarrhoea is spread mainly through food and water but it can also spread from person to person.  It is one of the commonest health problems experienced during travel.

Travellers' diarrhoea usually gets better in 3 to 5 days.  Most cases are mild and do not need specific treatment.

  • For further information on self-treatment and when to seek medical help, see treatment section below.

Recommendations for Travellers 

Preventing travellers' diarrhoea depends mainly upon you practising good hand hygiene and food and water precautions.

  • Wash your hands regularly using soap and clean water:
    • before eating and drinking
    • before and after preparing food, particularly raw meat
    • after using the toilet or changing nappies
    • after visiting food markets
    • after touching live animals
  • If you cannot wash your hands, use alcohol based sanitiser:

It might be necessary for you to use extra preventive measures in certain situations.

Overview of Disease

Travellers' diarrhoea is one of the most common health issues experienced during travel.

It can be caused by many different germs like bacteria (E.coli, Salmonella), viruses (norovirus) and parasites (Giardia). All these germs are spread through eating and drinking contaminated food and water, or using contaminated dishes and cutlery.

Loose poo can also be caused by a change in your diet such as eating oily or spicy foods.

The Illness

  • Travellers’ diarrhoea is when you have 3 or more bouts of loose, watery poo in 24 hours.
  • Most cases are mild, but for some people it is severe.
  • Travellers' diarrhoea tends to happen in the first week of travel.
  • Symptoms last on average 3 to 5 days and usually get better without you needing specific treatment.

Treatment

Mild travellers’ diarrhoea

Travellers’ diarrhoea is mild if:

  • episodes of diarrhoea are not that frequent, they don’t disrupt your activities and any other symptoms are mild

You will usually get better with rest and without specific treatment, but you should make sure you don’t become dehydrated.

Preventing dehydration

When you have diarrhoea, you can lose a lot of water from your body and become dehydrated. Young children can dehydrate quickly.

  • You should drink plenty of clear fluids such as water, diluted fruit juices or oral rehydration salt solutions such as Dioralyte®.
    • These can be bought in pharmacies and supermarkets.
  • All rehydrating drinks must be prepared using safe water.

Anti-diarrhoeal Medicine

If diarrhoea is disrupting your plans but is not severe, you can take medicines such as Loperamide (Imodium®) or diphenoxylate plus atropine (Lomotil®).  These can help, particularly with tummy pains.

Please note:

  • these medicines are not recommended for use in children under 12 years of age
  • Imodium® does not work straight away – it might take 1 to 2 hours to help
  • taking too much of these medicines might make you constipated

If you develop the following symptoms you should not take anti-diarrhoeal medications and should instead seek medical advice:

  • blood or slime (mucous) in your diarrhoea
  • a high fever
  • severe pain in your stomach

Severe Travellers’ diarrhoea

You should seek medical attention if:

  • you cannot continue your normal activities and you have had more than 6 episodes of diarrhoea stools in a 24 hour period, OR
  • you have passed blood or mucous (slime) in your diarrhoea, OR
  • you keep vomiting, have a fever or severe tummy pain

You might need intravenous fluids to prevent you becoming dehydrated, or antibiotics if an infection is suspected.

Additional Preventive Measures

Tablets to prevent diarrhoea are not routinely recommended as their side effects may be worse than the diarrhoea.

Antibiotics are not routinely recommended to prevent travellers’ diarrhoea:

  • widespread use of antibiotics causes resistance to develop in germs, meaning that antibiotics no longer work. This is an increasing problem around the world.

Preventative antibiotics might be offered to some people with severe medical problems that could be made worse by diarrhoea or dehydration. If you feel you may require antibiotics for travel, you should discuss this with your GP or a travel health practitioner.

  • All antibiotics have side effects, and can interact with other medicines that you may be taking. You should always read the patient information leaflet that comes with the medicine.

Non-antibiotic medicines

  • Bismuth subsalicylate (Pepto-Bismol®, Pepti-calm®)
    • Can help to prevent travellers' diarrhoea.
    • Available in tablet (Pepto-bismol®) or liquid (Pepto-bismol® or Boots Pepti-calm®).
    • Can be bought in pharmacies.
    • Can cause blackening of your poo and tongue.
    • It may interact with other medicines and is not suitable for everyone.
    • You should check with the pharmacist if it is safe for you to take.
    • Always follow the dose instructions on the medicine packet.

Pre/Probiotics

Pre- and probiotics are not recommended for either prevention or treatment of travellers' diarrhoea.  There is not yet any convincing evidence that they are effective.

Vaccination

No licensed vaccines are available in the UK against travellers' diarrhoea.

back to top