Getting the runs when you’re on holidays is no fun, but diarrhoea is a common ailment for travellers, particularly in certain high-risk destinations such as developing countries.
Avoiding the runs in the first place is best, but if you or someone you’re travelling with does get diarrhoea there are things you can do.
Diarrhoea, also called gastroenteritis, can be caused by many different types of pathogens (germs) and consequently many travellers will experience it more than once. Diarrhoea can strike within the first few hours of being exposed to a germ like a bacteria or virus (food poisoning), or up to a week after you are first exposed to it. It usually runs its own course and goes away after a few days. Often local people aren’t affected by germs they’re always exposed to as they‘ve developed immunity. But as a visitor your body hasn’t built its defences against these germs and so they’ll often cause you diarrhoea.
Diarrhoea can strike anyone, so take the following precautions to avoid it:
1. Don’t drink tap water, or ice you suspect has been made straight from tap water, especially in developing countries. Beware water in swimming pools too.
2. Wash your hands before preparing or eating food, and after going to the toilet or changing nappies. Take an alcohol hand rub with you in case you can’t wash your hands.
3. Before you drink bottled water or canned drinks, ensure the seals are not broken (they may be refilled with tap water or another contaminated drink) and the area in contact with your mouth is clean and dry.
4. Use bottled water to brush your teeth and rinse your mouth.
5. If the only water you have access to is suspect, bring it to the boil, or treat it with water purification tablets or a water purifier.
6. Check the places you may be eating in. Eat at popular restaurants as a high turnover of customers is more likely to mean a constant supply of freshly prepared food. Avoid street vendors and food buffets as these can be risky.
7. Don’t eat cooked food that has been allowed to stand under heat lamps for extended periods as this provides a fertile breeding ground for bacteria.
8. Avoid undercooked or raw meat, fish and shellfish as these can harbour germs that cause diarrhoea.
9. Don’t eat salads, unless you know they’ve been washed in boiled or bottled water.
10. Only eat fruit you’ve peeled yourself.
Two very serious infectious diseases you can get from consuming contaminated water or food are cholera (which can cause severe watery diarrhoea) and typhoid. Both these diseases are preventable if you are vaccinated before you travel. More information on cholera, typhoid and other vaccines for travellers is available from the NPS MedicineWise website.
Replacing the fluids you or your child has lost is top priority to prevent dehydration. Staying hydrated can be a challenge — as water is lost in both diarrhoea and vomit — and it’s more difficult for your body to absorb fluid due to irritation of your gut.
Clear fluids are best at rehydrating the body, such as water (although too much can result in your body losing more salts), diluted fruit juice (without pulp), and clear soup or broth. With most cases of diarrhoea that only last a few days, it’s not critical what sort of clear fluids you drink, as long as you’re drinking small amounts often and replenishing what you lose. Drinking alcohol, caffeinated drinks and undiluted fluids, especially those highly concentrated in sugar (such as energy and soft drinks), can lead to further dehydration and should be avoided.
Oral rehydration solutions (such as the brand Gastrolyte) containing sugars and salts help to restore the right balance of fluid in your body. They’re worth taking with you when you travel, especially if you are travelling with kids as they can dehydrate much more quickly than adults. Adults can also use them particularly when your diarrhoea is prolonged or severe.
These types of solutions can be bought over the counter in pharmacies. They usually come as sachets of powder that are made up with fresh drinking water (or freshly boiled and cooled water). The amount of water you add is crucial to achieve the right concentration of sugars and salts and aid the absorption of fluid into the body. Carefully follow the preparation and dosing instructions on the medicine packaging to ensure you or your child is rehydrated effectively.
If you don’t have oral rehydration solutions, here are some other ways you can rehydrate with clear fluids:
- Sugar solution: add 1 teaspoon of sugar to 1 cup of sterile water.
- Natural fruit juice or lemonade (not low calorie): dilute each tablespoon with 4 tablespoons of sterile water.
- Cordial (not low calorie): dilute half a cup with 8 cups of sterile water.
‘Antidiarrhoeal’ medicines can also be bought from pharmacies. One such commonly used medicine is loperamide (in brands such as Gastro-Stop and Imodium) which is thought to work by slowing down the movement of the bowel.
This type of medicine can be useful if you need to stop diarrhoea for a short time, such as when you’re going on a bus journey with minimal toilet stops. But it should not be used for children who’ve got a bout of the runs, or for adults with severe diarrhoea. This is because antidiarrhoeals can actually prevent you from clearing out what’s causing your diarrhoea, and they can cause side effects such as nausea or vomiting, drowsiness and stomach pain.
Antibiotics may be necessary when diarrhoea caused by bacteria persists or is severe. Only take antibiotics when they are prescribed for you and purchased from a pharmacy or other reputable source, such as a clinic.
When it comes to taking any medicine, always follow the instructions provided on the label or packaging, or given by your pharmacist, doctor or other health professional.
NPS MedicineWise advises travellers to be wary of buying medicines overseas, especially in developing countries where there is big black market in fake medicines. Particularly antidiarrhoeals.
Buying medicines overseas, especially in developing countries, can be risky. At best these fake or counterfeit medicines will contain no active ingredient (the chemical that makes a medicine work) and at worst they can contain substances banned in Australia, and which may cause serious side effects.
Buy medicines to treat diarrhoea before you leave for your trip.
You may need to seek medical attention if you have:
- Symptoms that worsen or persist for more than a couple of days.
- Blood in your stools, or if you have a high temperature.
- Babies or small children with diarrhoea, especially if they are vomiting too. Seek medical attention urgently if they are showing signs of severe dehydration, for example, they’re drowsy, not passing urine or tears when crying, have a dry mouth, rapid heart beat, or a sunken soft spot (fontanelle) on their head.
Further information on travelling with medicines is available from the NPS MedicineWise website.
This article is supplied by NPS MedicineWise, providing independent information on medicines and medical tests, funded by the Australian Government’s Department of Health and Ageing.
If you have questions about your medicines, talk to your doctor, pharmacist or call the NPS MedicinesLine 1300 MEDICINE (1300 633 424). Learn more about medicine and medical tests at their website www.nps.org.au
For more top tips about travel and medicines visit NPS MedicineWise.
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