Travellers' diarrhoea

Standby medication for the treatment and prevention of travellers' diarrhoea: Azithromycin antibiotic, anti-sickness and anti-diarrhoea medication.

Treatments for travellers' diarrhoea


Azithromycin 250mg

Azithromycin 1000mg (single dose)

1 course £9.90

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Loperamide

Loperamide 2mg (Imodium)

30-60 capsules from £5.50

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Avomine

Avomine 25mg (Promethazine)

10-28 tablets from £6.20

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Travellers' diarrhoea: preparing for infection

travellers diarrhoea sign

Travellers to North America, Europe, or Australasia do not generally require antibiotic for diarrhoea.

Travellers most likely to benefit from antibiotics:

  • Going to remote rural areas distant from medical help.
  • With pre-existing bowel problems such as inflammatory bowel disease where infection may trigger a relapse e.g. ulcerative colitis, Crohn's disease, coeliac disease, and previous bowel surgery.
  • with pre-existing medical conditions which may be worsened by severe infection or dehydration, e.g. poorly controlled diabetes, renal impairment, heart failure, HIV, and reduced immunity.
  • With a tendency to severe travellers' diarrhoea (on the basis of previous travel experience) or taking immunosuppressive treatment.

Between 20% and 50% of travellers from the West visiting resource-poor countries get travellers' diarrhoea. It usually starts within the first week of arrival.

As many as 5 million people from the UK suffer from travel diarrhoea each year.

Taking an antibiotic on a trip can reduce significantly the severity and duration of travellers' diarrhoea, but only if the diarrhoea is caused by bacteria - see below causes of diarrhoea.

Standby treatment

A short course of the antibiotic azithromycin together with the antidiarrhoeal Loperamide is effective in treating travellers' diarrhoea. An anti-sickness tablet such as Avomine will also relieve symptoms and help to prevent dehydration. Avomine should not be taken at the same time as the antibiotic azithromycin. Anti-diarrhoea treatments work best if taken as soon as diarrhoea starts.

Anti-diarrhoea treatment should not be taken if there is blood in the stools, or there is a high fever (38.5°C), or severe abdominal pain, which could be signs of inflammatory bowel conditions.

Causes of diarrhoea

Travellers' diarrhoea is usually caused by bacteria (80% of cases) the body is not used to. Travellers' diarrhoea can also be caused by other bacteria, such as salmonella, by giardia, viruses (15%), and toxins in food and water.

How long does travellers' diarrhoea last

Travellers' diarrhoea usually lasts 1 to 7 days during which time a small proportion of people are bed bound. Symptoms can last up to one week (10%) or two weeks (5%) or longer. In a few cases (about 1.5%) travellers' diarrhoea can lead to serious illness and even long-term bowel problems.

Seeking help

People with serious medical conditions and a history of bowel disease should seek medical help if they get severe diarrhoea. If there is blood and mucus in the diarrhoea, or diarrhoea and vomiting continues for more than 2 days, or there is high fever (38.5°C for 48 hours) and severe abdominal pain, or a rash, then medical help is required.

Drink plenty

The biggest danger with diarrhoea is dehydration. People with diarrhoea should drink plenty of fluids (3-4 litres per day), even if they are continuing to vomit. All fluid except milk will help although specialised rehydration fluid is best.

Avoiding infections

  • Avoid street food or places that appear dirty
  • Drink bottled or boiled drinks (boil for at least 1 minute).
  • Fruit that can be peeled is safe
  • Avoid shellfish and salads
  • Be careful about hand washing - using soap and water is probably better than hand gel.
  • Sometimes ice cream and ice can be contaminated

Detailed information about travellers' diarrhoea from the NHS Fit for Travel website, and travellers' diarrhoea information sheet from Travel Health Pro.

All people who are travelling should be up-to-date with the recommended vaccines - see the NHS Fit for Travel website for advice.

Dr Tony Steele

Authored 22 March 2010 by Dr Tony Steele
Last updated 27 September 2019

Reviewed by Dr B. Babor, Dr A. Wood, Dr P. Hunt
Last reviewed 07 February 2019

References

Treatments available

Azithromycin 250mg

Azithromycin 1000mg (single dose)

1 course £9.90

Start order
Loperamide

Loperamide 2mg (Imodium)

30-60 capsules from £5.50

Start order
Avomine

Avomine 25mg (Promethazine)

10-28 tablets from £6.20

Start order

The order process

Answer short medical questionnaire

Choose treatment, register, and pay

Doctor issues prescription online

Medicine posted direct from pharmacy


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