Travel health service
Traveller's diarrhoea
The most common illness travellers pick up abroad — and one of the easiest to prepare for. Altrincham Travel Clinic in Timperley can advise on prevention, supply a self-treatment kit and, where appropriate, prescribe a standby antibiotic.
What it is
Don't let an upset stomach ruin your trip
Traveller's diarrhoea (often shortened to TD) is the most common health problem people experience abroad. It means passing three or more loose, unformed stools in 24 hours, often with cramps, nausea, vomiting or a mild fever, usually starting within the first week of travel. Depending on where you go, anywhere from around 1 in 5 to more than half of travellers to lower-income regions are affected, and although most cases settle within three to four days, they can easily cost you a couple of days of your holiday or business trip.
The good news is that a little planning makes a real difference. This page is general information drawn from the NHS and TravelHealthPro (NaTHNaC) to help you travel prepared — it is not personalised medical advice or a prescription. Before you go, our pharmacist at Altrincham Travel Clinic in Timperley can talk through your destination, put together the right self-care kit and confirm whether a standby antibiotic is suitable for you.
Plan ahead
See us a few weeks before you fly
A short pre-travel appointment lets us tailor everything to your trip: the right food and water advice for your destination, any vaccines like hepatitis A and typhoid that take time to work, and a self-treatment kit you can rely on. For higher-risk or remote travel, we can also assess whether a standby antibiotic is suitable.
Pop into Altrincham Travel Clinic in Timperley, near Manchester Airport, or book online. Even if you're travelling soon, it's worth a quick visit — we can usually sort your kit and advice the same day.
The basics
What causes it and where you're most at risk
Traveller's diarrhoea is caught by swallowing food or water contaminated with germs — usually bacteria, but sometimes viruses or parasites. Bacteria such as E. coli (the most common cause), Campylobacter, Salmonella and Shigella account for most cases; norovirus and parasites like Cryptosporidium and Giardia can also be responsible. Your risk is shaped mostly by your destination and where you choose to eat.
- Higher-risk regions: most of South Asia, Africa, the Middle East and much of Latin America and South-East Asia
- Intermediate risk: southern Europe, the Caribbean, southern Africa and Pacific islands
- Lower risk: western Europe, North America, Australia, New Zealand and Japan
- Risk is highest in the first week and where sanitation and food handling are poor
- Even careful eaters can be caught out — food hygiene reduces risk but does not remove it
Prevention
Safe food and water: boil it, cook it, peel it or forget it
Most cases are picked up through contaminated food, drinks or ice, so sensible food and water choices are your first line of defence. The familiar traveller's rule — "boil it, cook it, peel it or forget it" — is a good shorthand. These steps lower your risk considerably, even if they can't guarantee you'll stay well.
- Eat food that's freshly prepared, thoroughly cooked and served piping hot
- Drink only sealed bottled, boiled or properly treated water — and use it to brush your teeth too
- Avoid ice unless you know it's made from safe water
- Skip salads, unpeeled raw fruit and veg, and food left uncovered in the warmth
- Steer clear of unpasteurised dairy and raw or undercooked meat, fish and shellfish
Hand hygiene
Wash your hands — gel when you can't
Germs spread easily from hands to mouth, so good hand hygiene matters as much as what you eat. Wash thoroughly with soap and water after using the toilet and always before preparing or eating food. When a sink isn't available, an alcohol-based hand sanitiser is a useful stand-in — though it isn't fully effective against every germ, so soap and water is still best when you can.
- Wash with soap and water after the toilet and before eating
- Carry a small bottle of alcohol hand gel (at least 60% alcohol) for when washing isn't possible
- Be extra careful around buffets, street food and shared serving utensils
- Avoid swallowing water when swimming in pools, lakes or the sea
- We can supply travel-sized hand sanitiser at the pharmacy
Vaccines
How hepatitis A and typhoid vaccines fit in
There's no single vaccine that prevents traveller's diarrhoea, but vaccination is still part of the bigger picture. Hepatitis A and typhoid are both spread through contaminated food and water in many of the same destinations, and they can cause far more serious illness than ordinary TD. Getting protected against them before you travel covers off two of the most important food- and water-borne risks.
- Hepatitis A vaccine — recommended for most travellers to higher-risk regions
- Typhoid vaccine — advised for South Asia, parts of Africa and other higher-risk areas
- Neither prevents everyday traveller's diarrhoea, but both protect against serious food- and water-borne illness
- The oral cholera vaccine (Dukoral) may offer limited, short-term protection against some E. coli strains for selected travellers — our pharmacist can advise
- Best given a few weeks before you fly so they have time to work
Your self-treatment kit
What to pack — rehydration first, symptom relief second
If you do get caught out, having a small kit with you means you can start looking after yourself straight away. Replacing lost fluids and salts is by far the most important thing, especially in hot climates. We can put together a travel-health kit for you at our Timperley pharmacy and explain how and when to use each item.
- Oral rehydration salts (e.g. Dioralyte) — the single most important item, to prevent dehydration
- Loperamide (e.g. Imodium) — for adults to control symptoms on a long journey, when there's no blood or high fever
- Alcohol hand sanitiser and a few resealable bags for hygiene on the move
- A thermometer so you can check for fever
- For some higher-risk trips, a standby antibiotic — prescription-only, decided at consultation
Standby antibiotics
When a standby antibiotic makes sense
Antibiotics are not routine for traveller's diarrhoea — most cases settle on their own with rehydration. But for some travellers, a "standby" course to carry and start only if symptoms become severe can be sensible. This is a prescription-only medicine, so we'd assess whether it's right for you and choose a suitable standby antibiotic at consultation, with clear instructions on when and how to use it.
- Most useful for remote trips far from medical care, or for travellers more vulnerable to severe illness
- Carried in advance and started only if diarrhoea becomes severe or disabling
- The specific antibiotic and dose are decided at consultation — never self-prescribed
- Not a substitute for rehydration, which remains the priority
- Available on a private prescription only — not on the NHS for this purpose
Know the warning signs
Red flags — when to seek medical help
Most traveller's diarrhoea is mild and self-limiting. But some symptoms mean you should get medical advice promptly rather than treating yourself — and loperamide should be avoided in these situations.
Blood or mucus in your stool
This can point to a more serious bacterial infection. Don't take loperamide (Imodium) — seek medical advice instead.
High fever
A temperature of 38°C or above, especially with severe tummy pain, needs assessment rather than self-treatment.
Severe or lasting symptoms
If diarrhoea is severe, or hasn't settled after about three days, get medical help — particularly if you can't keep fluids down.
Signs of dehydration
Extreme thirst, passing little urine, dizziness, sunken eyes or dry, less-elastic skin all mean you need fluids and advice quickly.
Vulnerable travellers
Infants and young children, older adults, pregnant women and anyone with a weakened immune system should seek advice early.
After you get home
See your GP or come in to us if diarrhoea persists or returns after travel — lingering cases can be due to parasites such as Giardia.
FAQ
Traveller's diarrhoea — frequently asked questions
Travelling soon? Get prepared for traveller's diarrhoea
Pick up a tailored self-treatment kit, get safe food and water advice, and ask about standby antibiotics at our Timperley clinic near Manchester.