Order antibiotics for traveller’s diarrhoea

Traveller’s diarrhoea can occur anywhere in the world as your gut isn't accustomed to local bacteria and hygiene standards may differ from your home country. Take some antibiotics and Imodium (Loperamide) for emergency use when

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Virginia Chachati

Reviewed by Virginia Chachati MPharm
(2013, University College London)
GPhC Registration number: 2087654

Information last reviewed 08/02/21

About

What is Traveller’s Diarrhoea?

Traveller's diarrhoea is a common symptom that can occur during or after travel and is characterised by passing three or more watery stools within 24 hours. It is often caused by bacteria present in food, water or on utensils. It can also be brought on by eating different foods outside of your normal diet, such as dishes that are spicy or oily.

Where would I be at risk of Traveller’s Diarrhoea?

There may be some places you travel to where there is a high risk of traveller's diarrhoea due to different hygiene practices. These areas include: 

  • Central and South America
  • Mexico 
  • Africa 
  • Asia 
  • The Middle East

However, keep in mind that traveller’s diarrhoea can occur anywhere in the world.

Symptoms

What are the symptoms of traveller’s diarrhoea?

 The main symptom of traveller's diarrhoea is passing watery stools at least three times within a 24 hour period. Other symptoms can include:

  • Cramps
  • An urgent need to go to the toilet
  • Nausea 
  • Fever 
  • Vomiting 

Does vomiting and diarrhoea affect any other medication you may be taking i.e. antimalarials?

Vomiting after taking a medicine may mean it hasn't been absorbed correctly by the body. In general, it takes 30 to 60 minutes for the medicine to be absorbed into the bloodstream. If you vomit after taking an antimalarial then you may not be protected against malaria. If this happens, take another dose or check with a doctor if you are unsure about what to do.

How long does Traveller’s Diarrhoea last?

Traveller's diarrhoea typically lasts for three to five days. After this, your symptoms should clear up and you'll feel well again. If they don’t, you may need to seek professional medical attention.

What is the difference between mild and severe traveller’s diarrhoea?

Mild traveller's diarrhoea is defined as having three watery stools within a 24-hour period. You may also experience stomach cramps, nausea, vomiting and fever. Severe traveller’s diarrhoea results in passing six or more watery stools in 24 hours and may include bloody stools, persistent vomiting, pain and fever.

How is traveller’s diarrhoea diagnosed?

A formal diagnosis is not required for mild traveller's diarrhoea. However, severe diarrhoea will need professional medical attention and this is defined as having passed six or more watery stools within 24 hours in addition to bloody stools, vomiting, pain or fever.

Treatment

How to prevent Traveller’s Diarrhoea

Traveller's diarrhoea can be prevented by practising good hygiene and taking precautions with food and water consumption. Wash your hands thoroughly and often, particularly after using the toilet and before eating. Only consume foods which are freshly cooked and hot, avoid high-risk foods like meat if you are unsure of the quality. Stick to drinks purchased in sealed containers, wipe the rim clean before consuming and avoid ice unless you know it has been made from clean, uncontaminated water.

How to treat traveller’s diarrhoea

If you experience traveller's diarrhoea, the first thing you should do is drink plenty of fluids to avoid dehydration. Oral rehydration salts are recommended and are available from a pharmacy. Medicine such as Loperamide can help treat mild to moderate traveller's diarrhoea. Severe diarrhoea which is accompanied by vomiting, fever, pain or bleeding will need professional medical attention. Self-treatment with prescribed antibiotics such as Ciprofloxacin is an option if you are in a rural area or unable to get to a doctor or hospital. 

What should I do if I get traveller’s diarrhoea?

If you get traveller's diarrhoea you should drink plenty of fluids to prevent dehydration. Ensure you mix oral rehydration salts with clean water and sip the mixture over time rather than trying to drink it all at once. In most cases, further treatment is not needed unless the diarrhoea is severe. This is defined as passing six or more watery stools alongside other symptoms like vomiting, fever, bleeding or pain. In this case, seek professional medical attention or take antibiotics if you are in a remote location or unable to access medical care.

Is there a vaccine for traveller’s diarrhoea?

There is no vaccine available in the UK for traveller's diarrhoea. In the majority of cases, antibiotics are not necessary to treat traveller's diarrhoea and it will resolve on its own in three to five days.

Do you need to treat traveller’s diarrhoea or will it resolve on its own?

Traveller's diarrhoea does not usually cause complications and will resolve on its own in most cases. If it is severe then you will need to seek professional medical attention or take prescribed antibiotics if you are unable to access medical assistance.

How quickly does the treatment work?

For severe traveller's diarrhoea, antibiotic treatment will take one to two days to work. Non-antibiotic treatment, such as Imodium, for mild diarrhoea, will start to work after an hour or two. Traveller's diarrhoea typically resolves on its own without treatment in three to five days.

What are the options for prevention and treatment for traveller’s diarrhoea?

Awareness of hygiene and being careful with food and drink consumption are the best ways to prevent traveller's diarrhoea. Wash your hands thoroughly, use antibacterial hand gel where handwashing facilities are not accessible, and ensure the food you are eating is hot and cooked thoroughly.  

Treatment is not usually necessary if the symptoms of traveller’s diarrhoea are mild to moderate. Imodium (Loperamide) can be taken to treat mild diarrhoea. Hospitalisation and intravenous hydration may be needed for severe traveller's diarrhoea. If you are unable to access medical assistance, you may opt for self-treatment with a prescribed emergency antibiotic such as Ciprofloxacin. If a prescribed antibiotic is ineffective after three to four days, then seek professional medical attention. 

Q&A

Is traveller’s diarrhoea a form of food poisoning?

Traveller's diarrhoea can be caused by food poisoning as a result of contaminated food or drink in locations where hygiene standards are different from what you are used to.

Can traveller’s diarrhoea be passed from person to person?

Traveller's diarrhoea is contagious and can be passed from one person to another. To avoid spreading bacteria, wash your hands regularly after going to the bathroom and before eating. Do not share food or water.

Does the time of year I travel affect how likely I am to experience traveller’s diarrhoea?

The time of year you travel does not affect your likelihood of experiencing traveller’s diarrhoea as it is present year-round. However, be aware that there may be limited supplies of freshwater in certain parts of the world when it’s summer or they experience monsoons or flooding.

Is traveller’s diarrhoea always caused by E Coli?

Traveller's diarrhoea can be caused by Escherichia coli (E Coli) but it can also be caused by Salmonella, Cholera, Typhoid, Hepatitis A, Giardia and Norovirus.

Are all E Coli dangerous?

The majority of Escherichia coli (E Coli) bacteria are not dangerous and live naturally within your gut. E Coli can live outside of the body, that’s why faecal contamination can result in illnesses such as traveller’s diarrhoea. Certain strains of E Coli produce toxins which cause serious illness.

Is traveller’s diarrhoea dangerous?

In most cases, traveller's diarrhoea is not dangerous. It will usually pass without needing further treatment other than rehydration. Traveller's diarrhoea can be dangerous if it is severe or if you have a medical condition where diarrhoea can cause complications. You should see a doctor if you have any concerns about traveller’s diarrhoea.

How difficult is it to get treatment for traveller’s diarrhoea abroad?

Treatment for traveller's diarrhoea is only necessary if it is severe. Getting access to professional medical treatment may depend on your location. In rural areas, it may be difficult to see a doctor. If this happens, you can self-treat traveller's diarrhoea with prescribed antibiotics such as Ciprofloxacin or Metronidazole.

What should I do if I get traveller’s diarrhoea and I’m pregnant?

If you get traveller's diarrhoea while you are pregnant, it is essential to stay hydrated and keep eating, even if you don't feel hungry. Seek professional medical help as soon as possible.

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