What is Traveller’s Diarrhoea?
Traveller’s diarrhoea (TD) is the most common illness affecting international travelers, especially those visiting low- and middle-income countries. It is typically caused by ingesting contaminated food or water and is most often due to bacteria such as Escherichia coli (ETEC), but viruses (e.g., norovirus) and parasites (e.g., Giardia) can also be responsible.

Symptoms

• Sudden onset of loose or watery stools (typically 3 or more in 24 hours)

• Abdominal cramps

• Nausea or vomiting

• Low-grade fever

• Occasionally, blood in stools (indicates more severe infection)

Medication for Traveller’s Diarrhoea
Treatment depends on the severity of symptoms. A combination of self-care, rehydration, and medication is usually effective.

1. Oral Rehydration Solutions (ORS)

Purpose: Prevent or treat dehydration
Use: Essential, especially for children, older adults, or in hot climates
Availability: Commercial sachets or homemade solutions (water, salt, sugar)

2. Anti-Motility Agents

Examples: Loperamide (Imodium®)
Purpose: Reduces stool frequency by slowing bowel movements
Use:

• For short-term relief of symptoms in mild to moderate diarrhoea

• Not recommended if there is fever or bloody stools (may worsen condition)

3. Antibiotics

Purpose: Treat moderate to severe bacterial diarrhoea
Use: Prescribed based on destination and risk
Common Choices:

• Azithromycin: Preferred in Southeast Asia and for children or pregnant women

• Ciprofloxacin or Levofloxacin: Often used in other regions, though resistance is rising

• Rifaximin: Non-absorbed antibiotic for non-invasive E. coli (mild to moderate cases only)

How to Take:

• Usually a single dose or short 1–3 day course

• Should be taken only if symptoms are moderate to severe, or significantly impact travel plans

4. Antiemetics (if nausea or vomiting present)

Examples: Ondansetron
Purpose: Relieve nausea to enable fluid and medication intake

When to Seek Medical Attention

• High fever (>38.5°C or 101.3°F)

• Bloody or mucous-filled stools

• Severe abdominal pain

• Symptoms lasting more than 3 days

• Signs of dehydration (dizziness, dry mouth, reduced urination)

Preventive Measures

• Eat food that is thoroughly cooked and served hot

• Avoid raw vegetables, unpeeled fruits, and street food

• Drink bottled or purified water (avoid ice)

• Wash hands or use sanitizer regularly