Traveller's Diarrhoea: Prevention & Treatment
Traveller's diarrhoea is the most common illness affecting international travellers. Here's how to avoid it, treat it when it happens, and when it's actually serious.
Traveller's diarrhoea — the most common travel illness, sorted properly.
The modern approach to traveller's diarrhoea has shifted in recent years. We used to recommend immediate antibiotics for almost anyone. Now — because of antibiotic resistance and the discovery that mild cases often resolve faster without antibiotics — we suggest a more graduated approach: oral rehydration for everyone, anti-diarrhoeals like loperamide for symptom control, and antibiotics held in reserve for moderate-to-severe cases.
This guide covers prevention strategies, how to recognise different severity levels, what to take with you, when to seek help abroad, and when post-trip symptoms need investigating. Most TD is annoying but manageable — the goal is to keep it that way.
Why traveller's diarrhoea matters
Traveller's diarrhoea is the single most common illness affecting international travellers. Of UK travellers visiting South Asia, parts of Africa, or Latin America, between 30% and 70% will develop TD within their first two weeks. The figure for travellers to North America, Europe and Australia is far lower.
Most cases are mild — a few days of loose stools, sometimes nausea, settling within 2–5 days. But a meaningful minority become severe enough to disrupt itineraries, require medical attention, or progress into longer-lasting infections that need post-trip testing.
What causes TD
Around 80% of cases are bacterial:
- Enterotoxigenic E. coli (ETEC) — most common
- Campylobacter
- Salmonella
- Shigella
Viruses (norovirus, rotavirus) cause around 10–20%. Parasites (Giardia, Cryptosporidium, Entamoeba) cause a small percentage but tend to produce longer-lasting symptoms.
The route of transmission is almost always contaminated food or water. Direct person-to-person spread is rare.
Prevention: food and water hygiene
The classic 'boil it, cook it, peel it, or forget it' captures the spirit. Practical version:
Water
- Drink bottled water with sealed caps, or boiled water
- Avoid tap water, even for brushing teeth in high-risk countries
- Avoid ice unless you know it's from clean water
- Hot drinks (tea, coffee) are usually safe
- Beer, wine and spirits are generally safe — but cocktails with ice or fruit garnish may not be
Food
- Eat hot, freshly cooked food. Buffets that have been sitting out are higher risk
- Avoid undercooked meat, fish, eggs and shellfish
- Avoid salads and uncooked vegetables (washed in tap water)
- Peel fruit yourself — don't eat pre-peeled fruit
- Avoid soft cheeses and unpasteurised dairy
- Street food can be safer than it looks if you choose busy stalls cooking food fresh in front of you
Hands
- Wash hands frequently with soap and water
- Carry alcohol gel for situations without sinks
- Wash before eating, after using toilets, and after public transport
Vaccination: what's available
No vaccine prevents all causes of TD. But several vaccinations reduce the risk of more serious causes:
- Hepatitis A. Spread the same way as TD. Highly effective vaccine.
- Typhoid. Caused by Salmonella Typhi. Single dose lasts 3 years.
- Cholera. Oral vaccine considered for some high-risk trips. Also offers partial cross-protection against some E. coli strains.
We administer all three at Preston Clinic same-day where appropriate.
Stand-by treatment kit
What to pack in your travel medicine kit:
Always
- Oral rehydration salts (ORS). Sachets like Dioralyte. Reconstitute with clean water. The foundation of TD treatment.
- Loperamide (Imodium). Controls symptoms by slowing gut motility. Useful when you need to travel or attend a meeting. Don't use if you have bloody diarrhoea or high fever.
- Paracetamol and/or ibuprofen. For aches and fever.
Often appropriate
- Stand-by antibiotic. Azithromycin is now first choice for many destinations (resistance has reduced effectiveness of older options like ciprofloxacin). Single-dose or 3-day course depending on the regimen. Prescribed at consultation based on your destination and trip type.
Sometimes appropriate
- Bismuth subsalicylate (Pepto-Bismol). Some travellers use as both prevention and treatment. Less common in UK kits.
- Probiotics. Evidence mixed. Some patients find helpful.
Recognising severity
Most TD is mild and self-limiting. The thresholds for escalating care:
Mild TD (no antibiotics needed)
Loose stools 1–2 times per day, no blood, no fever, no severe pain. Stay hydrated, eat bland foods if able, use loperamide for symptom control.
Moderate TD (consider antibiotics)
Multiple loose stools per day, mild dehydration, some abdominal cramping but no blood or high fever. ORS plus loperamide; consider stand-by antibiotic if available.
Severe TD (medical attention recommended)
Six or more loose stools per day, blood in stool, high fever (>38°C), severe abdominal pain, signs of significant dehydration (dizziness, very dark urine, confusion). Seek medical help — most major destinations have private clinics that will see travellers.
Special groups
Children
Dehydration develops faster in young children. Lower threshold for medical attention. Pack child-appropriate ORS.
Pregnancy
Some antibiotics and loperamide are not recommended in pregnancy. Vaccinations and prevention matter more. Discuss at consultation.
Older travellers
Dehydration risks are higher. Stand-by antibiotic threshold may be lower. Hydrate proactively.
Patients on chronic medication
Some medications (diuretics, ACE inhibitors, lithium) interact with dehydration. Plan ahead.
After your trip
Most TD resolves within 5–7 days. Symptoms that persist need investigation:
- Diarrhoea lasting more than 2 weeks. Giardia and other parasites can persist and need specific testing
- Bloody diarrhoea at any point. Could indicate amoebic dysentery or other bacterial infection
- Fever with diarrhoea after returning. Could indicate typhoid or other systemic infection
- Weight loss, fatigue, ongoing GI symptoms. Worth a GP visit and stool testing
Always mention recent travel to your GP — it changes what they test for.
Book your travel consultation
Every Preston Clinic travel consultation includes TD prevention advice, kit recommendations, and where appropriate, stand-by antibiotic prescriptions. Vaccines administered same-day. Book online or walk in to Frenchwood Pharmacy on Ruskin Street — no GP referral.
Traveller's diarrhoea prevention from Preston's local travel clinic.
Roughly 30–70% of UK travellers visiting high-risk destinations develop traveller's diarrhoea (TD) within the first two weeks of their trip. Most cases are mild and self-limiting, resolving within 2–5 days. A small minority become severe enough to need medical attention.
The two things that matter most are <strong>prevention</strong> and <strong>preparation</strong>. Prevention is about food and water choices that are sometimes more nuanced than the standard 'boil it, peel it, forget it' rules suggest. Preparation is about carrying a small kit that lets you manage symptoms quickly when they hit — because most travellers don't want their itinerary ruined by a few bad meals.
Every appointment is led by Hamza Ali Khan, a registered pharmacist.
Travel vaccinations at Preston Clinic are conducted by a GPhC-registered pharmacist who reviews your itinerary, health background, and vaccine history before anything is prescribed or given.
Hamza Ali Khan
Hamza is the named pharmacist responsible for travel consultations at Preston Clinic. Every appointment is conducted by a registered pharmacist — never delegated to a non-pharmacist — so the person discussing your itinerary is also the person administering the vaccines.
Independent verification: both registrations above can be checked directly on the GPhC public register. Call 01772 491185 with any questions before booking.
NaTHNaC-designated · Yellow Fever CentreEverything you need to stay well abroad.
Travel kit and prescriptions sorted in one visit — no follow-ups required.
Destination-specific advice
TD risk varies hugely by country. We tailor advice to where you're actually going.
Travel vaccines in stock
Hep A, Typhoid and Cholera vaccines all available same-day if recommended.
NaTHNaC-designated
Yellow Fever Centre and pharmacist-led clinic following official guidance.
Travel kit advice
Practical guidance on what to pack — oral rehydration salts, loperamide, antibiotics if appropriate.
Standby antibiotics
Independent Prescriber can supply stand-by antibiotics (e.g. azithromycin) for some destinations.
Post-trip support
Returned ill? We can advise on next steps and signpost to GP or A&E where needed.
Three steps to a stomach-safe trip.
Consultation, vaccines, kit — usually one visit.
Book your travel consultation
Pick a slot. Tell us your destination, length of stay and any health conditions.
Come to Ruskin Street
1 Ruskin Street, just off Fishergate. We'll discuss prevention, vaccines and stand-by kit.
Leave kit-ready
Vaccines administered same-day if needed. Prescription items dispensed alongside.
Traveller's diarrhoea — the questions we get most often.
Still have a question? Call the clinic on 01772 491185 and a pharmacist will get back to you.
- TravelHealthPro — Travellers' diarrhoea· accessed 2026-05-18
- NHS — Travellers' diarrhoea· accessed 2026-05-18
- WHO — Travellers' diarrhoea — international travel and health· accessed 2026-05-18
- UK Health Security Agency — Gastrointestinal infections· accessed 2026-05-18
- GPhC — Register entry — Hamza Ali Khan (Reg. 2233681) at Frenchwood Pharmacy· accessed 2026-05-18
General travel health guidance. Individual circumstances vary — your travel consultation tailors advice to your destination, health and trip type.
On Ruskin Street, just off Fishergate. Free patient parking.
Right in the city centre on Ruskin Street, just off Fishergate.
Travelling somewhere risky? Get prevention advice plus stand-by kit at Preston's travel clinic.
Traveller's diarrhoea affects 30–70% of UK travellers to high-risk areas. Pharmacist-led prevention, treatment and travel kit advice from Preston Clinic.
