Traveller’s Diarrhoea
Traveller’s diarrhoea is a digestive infection from contaminated food or water, affecting up to 50% of visitors to high-risk regions.
Traveller’s diarrhoea is a digestive infection from contaminated food or water, affecting up to 50% of visitors to high-risk regions.
Also known as
Delhi belly, Montezuma's revenge, Bali belly, Pharaoh's revenge, Gastroenteritis, TD
Why travellers need to know
TD is the most common travel illness worldwide. It's caused by bacteria (usually E. coli), viruses, or parasites in contaminated food or water. Most cases resolve in 1-3 days with hydration alone. The danger is dehydration, which is more serious in hot climates and at altitude. Carrying oral rehydration salts and knowing when to escalate to a doctor (bloody stool, high fever, symptoms lasting more than 3 days) is practical preparation.
Real-world example
On day 3 of your trip to Marrakech, you develop sudden watery diarrhoea, stomach cramps, and nausea after eating from a food stall. You use oral rehydration salts from a pharmacy, stay hydrated, and rest for 24 hours. By day 5 you're recovered. If symptoms had included blood or fever above 38.5°C, you'd have needed antibiotics from a doctor.
Country-specific notes
🇮🇳 India
Highest risk globally; 30-50% of visitors affected
India has the highest traveller's diarrhoea rates worldwide. Avoid tap water (including ice), raw salads washed in tap water, and street food that hasn't been freshly cooked at high heat. Bottled water is safe; check the seal is intact.
🇲🇽 Mexico
15-25% of visitors affected; improving in tourist areas
Mexico's tourist infrastructure has improved water safety significantly, but risk remains in smaller towns and from street food. Resort areas have generally safe food and water. Pharmacies everywhere stock electrolyte solutions (Pedialyte/Electrolit) and loperamide.
🇪🇬 Egypt
Egypt has persistently high rates of travellers' diarrhoea — 40–70% of first-time visitors are affected within the first week
ETEC (enterotoxigenic E. coli) and other intestinal pathogens are prevalent across Egypt, including in luxury hotels. "Pharaoh's revenge" is among the most commonly reported travel illnesses globally.
In Egypt, drink only bottled water — including for brushing teeth — and avoid salads, unpeeled fruit, and ice at all establishments, including hotel restaurants.
Frequently asked questions
When should I see a doctor for traveller’s diarrhoea?
See a doctor if: you have blood in your stool, fever above 38.5°C, symptoms lasting more than 3 days, severe dehydration (dizziness, dark urine, inability to keep fluids down), or if you're taking immunosuppressant medication. Otherwise, manage with fluids and ORS.
When should travellers' diarrhoea be treated with antibiotics?
For mild cases, oral rehydration and rest are sufficient. Antibiotics (typically azithromycin or ciprofloxacin) are warranted if diarrhoea is severe, bloody, or lasts more than 48 hours without improvement. A travel doctor can prescribe a standby antibiotic course before departure for high-risk destinations.
Your Nomedic record includes any medications you take that affect dehydration risk or interact with common TD treatments, so a local doctor can prescribe safely.