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Traveller's Diarrhoea

"Travel broadens the mind, but loosens the bowels". Traveller's diarrhoea is the most common illness among those who travel to tropical locations and in many parts of the world it is merely a case of when, rather than if.

What is Traveller's Diarrhoea?

Any food or water from an infected source can cause traveller's diarrhoea. Symptoms of traveller's diarrhoea usually begin about three to four days after arrival. It can continue for up to ten days after return. The risk of traveller's diarrhoea is very much related to the destination, level of accommodation and travel habits of the traveller.

Those who only go to 5* hotels will be at a lower risk of traveller's diarrhoea than those eating and living in local accommodation and restaurants. There is some evidence to suggest that those who travel frequently (at least every six months) to developing countries - do build up a limited defense against Traveller's Diarrhoea. However, this is not a life long immunity.

How to Avoid Traveller's Diarrhoea

While in some destinations traveller's diarrhoea will be inevitable to the traveller, some steps can be taken towards prevention and it is important to understand how traveller's diarrhoea is transmitted.

Make sure that meat eaten is well cooked. Avoid seafood and abide by the "cook it, boil it or peel it" rule when eating in local restaurants. Wash salads with a good source of clean water - in fact when eating out avoid salads at all costs in high-risk locations! Avoid any food that has been re-heated and left at room temperature.

Apply strict hygiene while away especially after using the bathroom and before you eat food - never use communal, damp towels in public conveniences! Use disposable paper towels, antibacterial wipes or hot air.

Care with water is essential and this includes ice in drinks at the bar. As well as drinking soft drinks from cans it is good practice in developing countries to use sealed, bottled water, not only for drinking, but also for cleaning teeth and washing fruit.

When swimming avoid swallowing water in swimming pools, lakes or the sea.

Self Treatment of Traveller's Diarrhoea

The first rule when traveller's diarrhoea attacks is to try to get some rest and drink plenty of clear fluids. It is important, especially in hot climates, that you do not become dehydrated.

If you feel like eating, good foods are bananas, salted crisps, rice or clear soups. Avoid alcohol at all costs. In most cases, traveller's diarrhoea is self-limiting and with a little rest and rehydration you can be on your way again.

Taking an over-the-counter anti-diarrhoeal medication such as Loperamide will stop the diarrhoea, especially if you have an important meeting or flight to catch. While it is important not to take more than the recommended dose, some people can feel constipated after taking this medication.

The reason people may believe they are constipated is that Loperamide works by slowing down the movements of the gut and restoring natural balance. Therefore people may then not need to go to the toilet for a while afterwards until the gut movements have been restored to 'normal'. It can take a while for food to reach the gut again (as most or all of the existing gut contents have been rapidly removed as diarrhoea).

This medication should not be taken if you are passing blood or have a history of bowel problems; in this instance you should discuss an alternative treatment with your doctor before you leave for your trip.

Antibiotics (such as Ciprofloxacin), as advised by your doctor, should be taken if the condition does not improve or worsens. Diarrhoea treatment packs can be purchased at most travel clinics and contain a single dose of antibiotic, which can be taken if a fever accompanies the problem.

For women taking the pill it is important to recognise that absorption of the pill can be affected by traveller's diarrhoea. If this occurs always use alternative protection, such as condoms, as well as continuing with your normal oral contraceptive pill.

When to Get Medical Help

If after 24-48 hours the diarrhoea does not improve or worsens it is good to seek medical attention, as the diarrhoea could indicate other conditions. This should also be done if you suffer from a preexisting condition of the bowel or immune system, if you are passing blood or have a persistent temperature.

Traveller's Diarrhoea in the Returning Traveller

The returning traveller can also suffer from diarrhoea and it is important that you seek medical attention if you suffer on return, as this could also indicate other diseases that would need to be investigated by your doctor.