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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Yes. Travellers’ diarrhoea is assessed from your symptoms, and a doctor can treat it by video.
- Usual course: most episodes settle on their own within 3 to 4 days.
- Risk in Europe: up to 7% of travellers to western Europe and 8 to 20% to southern Europe are affected; the risk is higher in parts of Asia, Africa and Latin America.
- Self-care: drink plenty of safe fluids, use oral rehydration solution if you are losing a lot, and take loperamide for mild diarrhoea if you are an adult.
- Emergency: call 112 for vomiting blood, a stiff neck with pain in bright light, a sudden severe tummy ache, or confusion.
Do not book a video appointment if you are vomiting blood or something that looks like coffee grounds, have green vomit, a stiff neck with pain when looking at bright lights, a sudden severe headache or tummy ache, blue, grey or blotchy skin or lips, or are confused or not responding as usual. Call 112.
Can an online doctor treat travellers’ diarrhoea?
Yes. Travellers’ diarrhoea is diagnosed from your symptoms and where you have been, and both work by video. The doctor checks for dehydration and the warning signs, explains how to manage fluids and which medicines suit you, and decides whether you need antibiotics. Bloody diarrhoea with a high fever, or severe dehydration, may need in-person care, and the doctor tells you where to go.
How an online consultation helps with travellers’ diarrhoea
- Dehydration checked first: Thirst, dark urine, dizziness and passing little urine tell the doctor whether drinking more is enough or you need to be seen.
- Warning signs ruled out: Blood in the stool, a high temperature and severe tummy pain change the treatment, and are checked before anything else.
- Antibiotics only when they help: Most travellers’ diarrhoea settles without antibiotics. The doctor prescribes one when the illness is severe or the signs point to it.
- A plan for the rest of the trip: What to eat and drink, when you can travel on, and how to avoid passing it on.
What the doctor checks in an online travellers’ diarrhoea consultation
The consultation follows a fixed order, and the warning signs come first. The doctor asks about:
- Warning signs: blood or mucus in the stool, a temperature of 38°C or more, severe tummy pain, yellow skin or eyes, or a rash.
- Dehydration: thirst, dark urine, passing less urine than usual, and dizziness.
- The illness: when it started, how often you go, whether you are being sick, and whether others on the trip are ill.
- The trip: where you have been, and what you ate and drank.
- Your health: pregnancy, inflammatory bowel disease, kidney or heart disease, a weakened immune system, and your medicines.
Before the call, keep a drink to hand, and note how many times you have had diarrhoea in the last day.
What is travellers’ diarrhoea?
Travellers’ diarrhoea is the most predictable illness of travel. Doctors define it as 3 or more loose stools in 24 hours, often with tummy cramps, nausea, vomiting or a fever, in someone who is travelling or has just come back. Worldwide, 30 to 70% of travellers get it during a two-week trip, depending on the destination and the season. In Europe the risk is lower: up to 7% of travellers to western Europe, and an estimated 8 to 20% to southern Europe.
Bacteria cause at least 75 to 90% of cases, especially a type of E. coli, followed by Campylobacter, Shigella and Salmonella. Viruses such as norovirus cause at least 10 to 25%, and parasites such as Giardia about 10%, mainly on longer trips. In up to 40% of cases no cause is found. It is caught from food and water contaminated with traces of stool, and poor hygiene where food is prepared adds to the risk, even in high-income countries.
Travellers’ diarrhoea or ordinary diarrhoea?
At home, a stomach bug or food poisoning is the usual cause of diarrhoea. On a trip, bacteria in food and water cause most cases. The care is the same: fluids first.
Who is more at risk?
- young adults, possibly because they are less careful with food
- people with a weakened immune system, or taking medicines such as steroids that suppress it
- people with diabetes, inflammatory bowel disease, or severe kidney, liver or heart disease
- people taking acid-reducing medicines or antacids, because less stomach acid lets more bacteria survive
Travellers’ diarrhoea symptoms
Diarrhoea, sometimes with tummy cramps, feeling sick or being sick, can start during the trip or up to 10 days after you get home. Doctors grade it by how much it affects you:
Swipe sideways to compare →
| Severity | What it means | What usually helps |
|---|---|---|
| Mild | Bearable, and it does not stop your plans | Fluids; loperamide or bismuth subsalicylate can help; antibiotics are not recommended |
| Moderate | Distressing, or it gets in the way of your plans | Fluids and loperamide; antibiotics can be used |
| Severe | It stops you doing anything, or there is blood in the stool | Antibiotics are advised; see a doctor |
Untreated bacterial diarrhoea usually lasts 3 to 7 days and viral diarrhoea 2 to 3 days. Diarrhoea caused by a parasite can go on for weeks, and about 1% of cases last more than a month.
How to treat travellers’ diarrhoea
Most travellers’ diarrhoea gets better on its own. Replacing lost fluid is the most important step:
- Drink plenty of safe fluids: sealed bottled drinks, or water that has been boiled or treated.
- Use an oral rehydration solution from a pharmacy if you are losing a lot of fluid, are older, or have a condition that makes dehydration more likely.
- Avoid fruit juice and fizzy, sugary drinks, which can make diarrhoea worse.
- Eat when you feel able, and avoid fatty or spicy food at first.
- Wash your hands with soap after the toilet and before eating; alcohol gel helps when there is no soap, but it is not fully effective.
Medicines that ease the symptoms
Mild diarrhoea usually settles with fluids alone, so letting it run its course is fine when you can stay near a toilet. Loperamide eases diarrhoea in adults, and it is useful before a long journey. Follow the pack instructions, and do not use it for more than two days on your own. Do not take it if there is blood or mucus in your stool, a high temperature or severe tummy pain. Bismuth subsalicylate can help mild diarrhoea and nausea, but it is not suitable for everyone, including people allergic to aspirin and people taking some other medicines, so ask a pharmacist.
When do you need antibiotics?
Most travellers’ diarrhoea does not need antibiotics. For moderate illness they can be used, and for severe illness, including any diarrhoea with blood, they are advised. They shorten bacterial diarrhoea by about one to two days. They also carry risks, including picking up drug-resistant bacteria and a bowel infection called C. difficile, which is why doctors keep them for when they help.
Some travellers at high risk of severe illness, or going to remote high-risk areas, carry a standby antibiotic after a risk assessment with a doctor before the trip. Antibiotics are not routinely recommended to prevent travellers’ diarrhoea.
Is travellers’ diarrhoea contagious?
It can be. The germs are passed on in traces of stool, on hands, surfaces and food, so people sharing a room or a bathroom can catch it from each other. Treat yourself as infectious until 2 days after the diarrhoea and any vomiting have stopped:
- Stay off work, and do not prepare food for others, until you have been free of diarrhoea and vomiting for at least 2 days.
- Wash your hands with soap and water often, especially after the toilet and before eating.
- Clean toilet seats, flush handles, taps and door handles every day.
- Do not share towels, flannels, cutlery or utensils.
- Do not use a swimming pool until at least 48 hours after your symptoms stop.
If norovirus is the cause, the contagious calculator works out how long you are likely to stay contagious.
How to prevent travellers’ diarrhoea
Good hygiene and careful choices lower the risk, though they cannot remove it completely:
- Wash your hands after using the toilet and before preparing or eating food.
- Where hygiene is poor, choose food that is freshly cooked and served hot, and sealed drinks. The rule of thumb is: boil it, cook it, peel it or forget it.
- Where the tap water is not safe, drink sealed bottled water or water that has been boiled or treated, avoid ice made from tap water, and brush your teeth with bottled water.
- Use an alcohol hand gel with at least 60% alcohol when you cannot wash your hands.
- Pack oral rehydration sachets before you travel.
- Do not swim while you have diarrhoea, and avoid swallowing pool water.
Even careful travellers get it: studies suggest advice on food and water alone may not lower the risk much, partly because kitchen hygiene is out of your hands. To check whether the tap water is safe at your destination, see the European Travel Health Index. No vaccine prevents travellers’ diarrhoea, probiotics have not been shown to help, and most travellers should not take antibiotics to prevent it.
Which travellers’ diarrhoea treatment might the doctor recommend?
Treatment depends on how severe the diarrhoea is and whether there are warning signs. This is the framework the doctors use, in line with UK travel health and CDC guidance.
Swipe sideways to compare →
| What you have | Likely first step | Suitable for online care? | When in-person care is needed |
|---|---|---|---|
| Mild diarrhoea that does not stop your plans | Fluids, and loperamide if you need it | Yes | Not usually needed |
| Diarrhoea that is distressing or gets in the way of your plans | Fluids, loperamide, and sometimes antibiotics | Yes | If you cannot keep fluids down |
| Blood or mucus in the stool, or a temperature of 38°C or more | Antibiotics, and an assessment for dehydration | Yes, to assess | If you are very unwell or dehydrated |
| Not improving after 3 days, or lasting more than 2 weeks | A review, and stool tests for a parasite | Partly | For stool tests |
| Vomiting blood, confusion or a sudden severe tummy ache | Emergency treatment | No | Call 112 now |
Diarrhoea spoiling your trip? A doctor can tell you in one consultation whether you need more than fluids.
See available times →Treatment options for travellers’ diarrhoea
What you can do yourself
- Drink plenty of safe fluids, and use oral rehydration solution if you are losing a lot.
- Take loperamide for up to two days if you are an adult and there is no blood in the stool and no high temperature.
- Rest, and eat when you feel able.
Prescription treatment
A prescription is never issued without a consultation. When antibiotics are needed, azithromycin is usually the first choice, especially for diarrhoea with blood or a fever, and the doctor checks your allergies and other medicines first. If the doctor prescribes, use the prescription at a pharmacy near you.
What does not help
Antibiotics do not help viral diarrhoea, and they are not needed for mild illness. Fruit juice and fizzy, sugary drinks can make diarrhoea worse. Probiotics have not been shown to prevent it.
Special situations
Diarrhoea after you get home
Symptoms can start up to 10 days after you return. Diarrhoea that lasts more than 2 weeks may be caused by a parasite and needs a stool test, so tell the doctor where you have travelled.
Pregnancy
Dehydration matters more in pregnancy. Drink plenty, use oral rehydration solution, and get medical advice early: some medicines for diarrhoea, including bismuth subsalicylate, are not suitable in pregnancy.
Long-term conditions
With inflammatory bowel disease, kidney or heart disease, or a weakened immune system, get advice early, and plan before the trip how you will manage diarrhoea.
Bowel symptoms that linger
After a bad bout, some people are left with bowel symptoms for months, known as post-infectious irritable bowel syndrome. The IBS page covers what helps. Rarely, the infection is followed by painful, swollen joints, called reactive arthritis, or by weakness from nerve inflammation, called Guillain-Barré syndrome: both need a doctor.
Food poisoning and stomach bugs
Related causes of diarrhoea and vomiting are covered on the food poisoning, norovirus and gastroenteritis pages, and other holiday health problems on the travel illnesses page.
Children
Mobi Doctor consultations are for adults aged 18 and over. A child who is unwell needs a paediatrician or a local doctor in person, and emergency signs in a child mean 112.
When travellers’ diarrhoea is treated online, and when you need in-person care
Treated online: travellers’ diarrhoea during or after a trip, rehydration advice, antibiotics when they are needed, and diarrhoea that lingers after you get home.
In-person care: severe dehydration or being unable to keep fluids down, bloody diarrhoea in someone who is very unwell, stool tests, and any emergency sign.
When to get in-person care
Call 112 or go to an emergency department now for:
- vomiting blood, or vomit that looks like ground coffee
- green vomit
- a stiff neck with pain when looking at bright lights, or a sudden, severe headache
- a sudden, severe tummy ache
- blue, grey, pale or blotchy skin, lips or tongue, or confusion
Get medical advice the same day for:
- blood or mucus in the stool
- a temperature of 38°C or more
- being sick and unable to keep fluids down
- signs of dehydration that continue after rehydration sachets
- yellow skin or eyes, or a rash
How Mobi Doctor works
- Book a time that suits you: daily 7am–11pm CEST. You can see a doctor over video, usually within 15 minutes. No subscription, and the exact price is shown before you pay.
- Speak to a licensed doctor about your symptoms: say where you have travelled, when it started, how often you go, and whether there is blood or a fever.
- Leave with a plan: what to do, what to take and for how long, and which signs mean you should be seen in person. If the doctor prescribes, use the prescription at a pharmacy near you.
No sign-up needed
Not sure it’s travellers’ diarrhoea? Tick every symptom you have to see each condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call.
Tap the body — an area or a point — to browse symptoms anywhere
Similar symptoms, different condition? Food poisoning can start the same way. Compare them, or look up any other symptom in the full symptom checker.
Frequently asked questions about travellers’ diarrhoea
How long does travellers’ diarrhoea last?
Most episodes of travellers’ diarrhoea settle on their own within 3 to 4 days. Get medical advice if it is not improving after 3 days, and see a doctor if it lasts more than 2 weeks, which can mean a parasite.
What helps travellers’ diarrhoea fastest?
Drink plenty of safe fluids, and use oral rehydration solution if you are losing a lot. Loperamide can ease the symptoms in adults for up to two days, but not if there is blood in the stool or a high temperature. Antibiotics help moderate or severe bacterial diarrhoea.
Do I need antibiotics for travellers’ diarrhoea?
Not for mild diarrhoea. Antibiotics can be used for moderate illness and are advised for severe diarrhoea or diarrhoea with blood, and they shorten bacterial diarrhoea by about one to two days. A doctor can decide whether you need them.
What is the risk of travellers’ diarrhoea in Europe?
Lower than in many other parts of the world: up to 7% of travellers to western Europe and an estimated 8 to 20% to southern Europe are affected. The risk is highest in parts of Asia, the Middle East, Africa and Latin America.
What causes travellers’ diarrhoea?
Travellers’ diarrhoea is caused by germs swallowed in food, water or ice, most often bacteria such as E. coli, Campylobacter, Salmonella and Shigella, which account for most cases, with viruses such as norovirus and parasites such as Giardia behind the rest; the gut has no immunity to strains it has not met, and poor food hygiene, undercooked meat, salads washed in tap water, unpasteurised dairy and street food are the usual sources. Symptoms start hours to a few days after the meal.
Should I take loperamide or let travellers’ diarrhoea run its course?
Either can be right. Mild diarrhoea usually settles with fluids alone. Adults can take loperamide, following the pack instructions, for up to two days, for example before a long journey, but not with blood or mucus in the stool, a high temperature or severe tummy pain.
Is travellers’ diarrhoea contagious?
It can be. The germs pass on in traces of stool, on hands, surfaces and food. Wash your hands often, do not share towels or cutlery, and stay off work and avoid preparing food for others until 2 days after the diarrhoea and any vomiting have stopped.
What is the difference between travellers’ diarrhoea and ordinary diarrhoea?
Travellers’ diarrhoea is caught on a trip, from contaminated food and water, and bacteria cause at least 75 to 90% of it. At home, a stomach bug or food poisoning is the usual cause. Both are treated with fluids first.
What should I drink with travellers’ diarrhoea?
Drink plenty of safe fluids, such as sealed bottled water or water that has been boiled, and use an oral rehydration solution if you are losing a lot of fluid. Avoid fruit juice and fizzy, sugary drinks, which can make diarrhoea worse.
Can travellers’ diarrhoea start after I get home?
Yes. Travellers’ diarrhoea can start during the trip or up to 10 days after you return. Tell the doctor where you have been, because it helps work out the cause.
How can I avoid travellers’ diarrhoea?
Wash your hands before eating and after the toilet, choose sealed or treated drinks where the tap water is not safe, and be careful with food where hygiene is poor. No vaccine prevents travellers’ diarrhoea, and probiotics have not been shown to help.
Can an online doctor treat travellers’ diarrhoea?
Yes. A doctor can assess travellers’ diarrhoea and dehydration by video, advise on fluids and medicines, and prescribe antibiotics when they are needed. Severe dehydration or emergency signs need in-person care.
- Travelers’ diarrhea, CDC Yellow Book 2026, Centers for Disease Control and Prevention (US), 24 March 2026.
- Travellers’ diarrhoea, TravelHealthPro, National Travel Health Network and Centre (NaTHNaC), UK, updated 27 February 2024.
- Diarrhoea and vomiting, NHS, National Health Service (UK), reviewed 21 December 2023.
- Traveler’s diarrhea: symptoms and causes, Mayo Clinic, 18 January 2025.
- Travellers’ diarrhoea: antimicrobial prescribing guidelines for primary care, Nottinghamshire Area Prescribing Committee (NHS), updated December 2025.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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