Traveller’s Diarrhoea

Traveller’s diarrhoea is a digestive infection from contaminated food or water, affecting 30 to 70% of travellers over two weeks, depending on destination and season.

Traveller’s diarrhoea is a digestive infection from contaminated food or water, affecting 30 to 70% of travellers over two weeks, depending on destination and season.

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

One of the highest-risk regions

South Asia, including India, is among the highest-risk regions for traveller's diarrhoea. 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

Moderate to high risk; lower in resort 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 is a high-risk destination for travellers' diarrhoea

ETEC (enterotoxigenic E. coli) and other intestinal pathogens are prevalent across Egypt, including in luxury hotels. Travellers' diarrhoea is the most common illness reported by visitors.

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 are for severe or bloody diarrhoea, or diarrhoea with fever. Azithromycin is usually preferred, because resistance to ciprofloxacin is widespread, especially in South and Southeast Asia. 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.

Related guides

Topics

Related terms

Sources

  1. https://www.cdc.gov/yellow-book/hcp/preparing-international-travelers/travelers-diarrhea.html