What is travellers’ diarrhoea?

Travellers’ diarrhoea is a gastrointestinal illness that happens when you consume contaminated food or water while travelling. It’s defined by passing three or more loose stools in a 24-hour period, often alongside stomach cramps, nausea, bloating, and sometimes a fever.

Most cases are caused by bacteria, though cases caused by viruses and parasites are also common. It typically comes on suddenly and, while unpleasant, the treatment of travellers’ diarrhoea is straightforward and most people recover within a few days.

What causes travellers’ diarrhoea?

The most common cause is a bacterium called Escherichia coli (E. coli), which produces toxins that irritate the gut lining. Other bacterial culprits include Campylobacter, Salmonella, and Shigella.

You usually pick it up through contaminated food and drink, particularly water that has been contaminated with faecal matter. This is more likely to happen in countries where sanitation standards differ from the UK, including parts of Asia, Africa, the Middle East, Latin America, and some areas of Southern Europe.

Higher-risk situations include:

Eating street food or buffet food that has been left out
Drinking tap water, ice, or unpasteurised drinks
Eating raw or undercooked meat, seafood, or shellfish
Eating unwashed or peeled fruit and vegetables
Travelling during hot, humid weather when bacteria multiply faster

Who is most at risk of getting travellers’ diarrhoea?

Anyone can get travellers’ diarrhoea, but some people are more susceptible, including:

First-time travellers to high-risk regions
Young adults and backpackers eating local food in high-risk areas
People with weakened immune systems or conditions like inflammatory bowel disease or irritable bowel syndrome
Those taking medications such as antacids or proton pump inhibitors, which reduce stomach acid
Older travellers, whose immune systems may be less able to fight off unfamiliar bacteria
Travellers visiting regions with lower food hygiene standards

What are the symptoms of travellers’ diarrhoea?

Symptoms usually begin within the first few days of arriving at your destination. You might experience:

Loose or watery stools (three or more in 24 hours)
Stomach cramps or pain
Nausea or vomiting
Bloating and urgency to go to the toilet
A mild fever
Feeling generally unwell or fatigued

For most people, symptoms are uncomfortable but manageable. However, severe cases – including those involving bloody stools, signs of dehydration, or a high fever – need prompt medical attention.

How is travellers’ diarrhoea treated?

Treatment depends on how severe your symptoms are, but the main priorities are staying hydrated and, where appropriate, taking medication to speed up recovery.

Oral Rehydration Salts (ORS)

Replacing lost fluids and electrolytes is the most important step in managing travellers’ diarrhoea. Oral rehydration salts (such as Dioralyte) are dissolved in clean water and help your body absorb fluids more effectively than water alone. These are available over the counter and are an essential part of your travel kit.

Anti-Motility Medicines

Loperamide (commonly known as Imodium) can reduce the frequency of loose stools and help you function more comfortably if you need to travel or can’t easily access toilet facilities. It works by slowing down the movement of the gut. It’s not suitable for everyone, particularly if you have a high fever or blood in your stools, so check with a pharmacy before using it.

Travellers’ Diarrhoea Antibiotics

For moderate to severe cases, antibiotic treatment for travellers’ diarrhoea can significantly reduce the duration and severity of illness. Many travel health services recommend requesting standby antibiotics before you leave, so you have them ready to use if symptoms develop. The antibiotic recommended will depend on where you’re travelling and the likely cause of infection.

Azithromycin for travellers’ diarrhoea is often the first-choice antibiotic, particularly for travel to Asia, where resistance to other antibiotics is more common. It works by stopping bacterial growth and is usually taken as a short course.

Ciprofloxacin is another commonly prescribed antibiotic for travellers’ diarrhoea, particularly for travel to Latin America and Africa, though resistance in some regions means it isn’t always the best option.

How to Prevent Travellers’ Diarrhoea

There’s no guaranteed way to avoid travellers’ diarrhoea, but taking sensible precautions before and during your trip can reduce the risk of developing it significantly.

Before you travel

Speak to a pharmacist or travel health professional about whether any vaccines or preventive medications are recommended for your destination
Pack oral rehydration salts, loperamide, and any prescribed antibiotics before you leave so you’re not scrambling for treatment abroad
Research the food and water safety standards of your destination

While you’re away

Only eat and drink things you’re confident are safe – when in doubt, skip it
Drink bottled water and avoid ice in drinks unless you’re confident it’s made from safe water
Stick to food that is freshly cooked and served hot
Avoid buffet food, raw seafood, unpasteurised dairy, and salads washed in tap water
Peel fruit yourself rather than eating pre-cut fruit
Wash your hands thoroughly before eating and after using the toilet, or use hand sanitiser if soap and water aren’t available
Be cautious with street food – choose busy stalls with high turnover where food is cooked fresh in front of you

Travellers' Diarrhoea FAQs

Most cases of travellers’ diarrhoea clear up within three to five days without any treatment. With the right medication, particularly antibiotics for bacterial infections, symptoms can resolve much faster, sometimes within 24 to 48 hours. Staying hydrated throughout is important regardless of how long symptoms last, as dehydration is the main risk.

Antibiotics aren’t recommended as a preventive measure for travellers’ diarrhoea. Taking them unnecessarily can contribute to antibiotic resistance and may cause side effects. The better approach is to follow food and water hygiene advice while travelling.

Mild to moderate travellers’ diarrhoea will often clear up on its own within a few days as your body fights off the infection. The most important thing you can do in the meantime is stay well hydrated using oral rehydration salts. If symptoms are severe, persistent, or accompanied by a high fever or blood in the stools, antibiotic treatment and medical advice are recommended.

It can be but it depends on the cause. Bacterial travellers’ diarrhoea is generally spread through contaminated food and water rather than person-to-person, but some causes, like norovirus or certain bacterial infections like Shigella, can spread between people. Thorough handwashing, particularly after using the toilet and before handling food, is the best way to prevent passing it on.

The symptoms are the same – loose, watery stools, cramps, and nausea. Travellers’ diarrhoea refers specifically to diarrhoea that develops after travelling to a region with different food, water, or hygiene standards. It is usually caused by ingesting bacteria such as E. coli that your gut hasn’t encountered before and therefore has no immunity to. Regular diarrhoea can have many other causes, including viral illness, food intolerance, or medication.

Most cases of travellers’ diarrhoea resolve within a few days, but you should seek medical attention if you experience:

Blood or mucus in your stools
A high fever (above 39°C)
Symptoms of severe dehydration, such as dizziness, dark urine, or not urinating
Symptoms that don’t improve after 48 to 72 hours
Diarrhoea in a young child or infant, which can become dangerous quickly

If you’re already abroad, contact a local doctor or your travel insurer’s medical helpline. If you return to the UK with ongoing symptoms, visit your GP.