How travellers can avoid diarrhoea, and what the NHS says helps if it happens

What is travellers' diarrhoea and why does it happen?

Travellers' diarrhoea is a bout of loose, watery stools that happens during a trip or shortly after it. It usually comes from swallowing germs in contaminated food or water. For most people it is unpleasant but mild and settles without specific treatment.

The NHS says diarrhoea in adults and children usually stops within 5 to 7 days, and any vomiting usually stops in 1 or 2 days. The NHS covers diarrhoea and vomiting together, since stomach bugs such as norovirus often cause both.

What food and drink habits help avoid it?

TravelHealthPro advises choosing food that is freshly prepared, fully cooked and served hot. NHS 111 Wales gives similar advice, suggesting salads and uncooked fruit and vegetables are best skipped unless the traveller has washed and peeled them.

Where tap water may not be safe, NHS 111 Wales recommends filtered or bottled water and advises against ice in drinks. Boiled water, hot drinks made with it, and bottled fizzy drinks with intact seals are described as generally safer choices.

How does hand washing fit in?

TravelHealthPro and Fit for Travel describe good hand hygiene, along with food and water precautions, as central to prevention. Washing hands with soap and water, for example before eating, is the usual method.

Even with careful hand washing and food and water preparation, travellers' diarrhoea remains a common travel-related illness. These precautions lower the risk but do not remove it, so TravelHealthPro advises travellers to be prepared to manage symptoms during a trip.

What helps once diarrhoea has started?

The NHS says the key step is to drink plenty of fluids, in small, frequent sips if feeling sick. A pharmacist can advise on oral rehydration powder, which replaces lost salts and sugars. TravelHealthPro notes that the water used to make it up should be safe.

The NHS says it is fine to eat when able to, and that fruit juice and fizzy drinks can make diarrhoea worse.

Can loperamide or other medicines help?

Loperamide is an anti-diarrhoeal medicine, and the NHS says a pharmacist can recommend it for short-term diarrhoea. The NHS says it can be bought without a prescription by anyone aged 12 or over, while younger children need a prescription.

The NHS lists blood in the stool and a high temperature as reasons not to take it. TravelHealthPro goes further, advising against loperamide when there is blood or mucus in the stool, a high fever or severe abdominal pain. It also advises against it for anyone with active inflammatory bowel disease.

When should a traveller get medical advice?

TravelHealthPro says medical care should be sought if symptoms have not improved within three days. It advises immediate medical care for a high fever, or for blood or mucus in the stool. Older people, children and other vulnerable travellers are advised to seek medical advice earlier if they cannot keep fluids down or show signs of dehydration.

The NHS lists feeling thirsty, headache, feeling light-headed, dark yellow strong-smelling urine and peeing less often among the signs of dehydration. It also lists a dry mouth and sunken eyes. The NHS says an urgent GP appointment or NHS 111 is advised for signs of serious dehydration, such as unusual tiredness, dizziness that does not pass on standing, dark yellow urine or peeing less than usual, or fast breathing or heartbeat. For signs of shock, the NHS says to call 999 or go to A&E, and not to drive.