Symptoms of travellers' diarrhoea

A change in food, water or local microbes can upset the bowel during or after travel. Food poisoning and gastroenteritis can cause a sudden illness with cramps, vomiting or fever. Persistent or recurring loose stools may have other explanations, including giardiasis, food intolerance, coeliac disease, irritable bowel syndrome, Crohn's disease or an overactive thyroid. The timing, duration, travel location, stool appearance and accompanying symptoms help a clinician decide what to investigate.

Replace fluid with frequent drinks; an oral rehydration solution can help replace water and salts. Eat small, plain meals when able and avoid alcohol until you are recovering. Wash hands thoroughly after using the toilet and before handling food. Avoid preparing meals for other people while diarrhoea continues. Ask a pharmacist about suitable symptom relief, particularly for children, pregnancy, fever or blood in the stool. Keep a note of onset, travel exposures and any vomiting.

Seek urgent care for blood or black stool, severe abdominal pain, confusion, fainting, repeated vomiting or marked dehydration such as very little urine and unusual sleepiness. Arrange prompt review for high fever, symptoms that persist after returning home, or diarrhoea after recent antibiotics. Babies, older adults, pregnant people and people with weakened immunity may need earlier advice because fluid loss can become serious.

Ask whether testing, rehydration treatment or medicine is appropriate, and when it is safe to return to work or prepare food. Tell the clinician where you travelled, what you ate or drank, whether anyone else became ill, and whether there is fever, blood, pain or weight loss.