Planning a holiday is always exciting, but there's one unpleasant surprise that can derail even the best-laid plans: travellers’ diarrhoea. Whether you’re trekking through dense forests, exploring bustling cities, or lounging on pristine beaches, understanding the causes, prevention, and treatment of this common travel ailment will help ensure your trip runs smoothly. So, before you jet off, let's ensure you're prepared to handle it should it strike during your adventures.

Travellers' diarrhoea is an intestinal infection that occurs when you consume contaminated food or water. This can cause symptoms like chronic diarrhoea, nausea, vomiting, fever, and abdominal pain. Typically, traveller's diarrhoea starts with abdominal cramps. You might feel a sudden and uncomfortable grumbling in your stomach. This is often followed by loose or watery stools, and you may find yourself making urgent trips to the bathroom. If you experience three or more bouts of diarrhoea within 24 hours, you’re likely dealing with traveller's diarrhoea. 

Other early symptoms can include nausea and vomiting. Feeling queasy or having a sudden bout of vomiting can be distressing and inconvenient, particularly when you're trying to enjoy a trip. Additional symptoms might include a mild fever and bloating, often accompanied by general malaise. 

A staggering figure shows that up to 70% of travellers might experience diarrhoea during their trips. High-risk activities such as adventure travel, hiking, camping, and even indulging in delightful street food can increase your chances of catching it. 

Travellers’ diarrhoea is typically triggered by consuming contaminated food or water. Due to varying hygiene standards and different local bacteria, your body might be exposed to pathogens it's not accustomed to fighting off. Common culprits include: 

• E. coli: One of the most common bacteria causing traveller's diarrhoea. It lurks in undercooked meats and unwashed vegetables.

• Salmonella: Found in contaminated water, poultry, and eggs. It can cause severe gastrointestinal distress.

• Shigella: Known for causing intense stomach cramps and fever, Shigella spreads through contaminated water or contact with infected persons.

• Viruses: Norovirus and rotavirus are common viral agents, often spread through person-to-person contact or contaminated food.

• Parasites: Giardia and Cryptosporidium are less common but can result in prolonged illness. They are typically contracted from untreated water sources.

The likelihood of encountering these pathogens increases in destinations with limited access to clean water or where food hygiene practices are lax. Always exercise caution and use preventive measures to reduce the risk.

Certain parts of the world pose a higher risk for travellers' diarrhoea due to lower sanitation and hygiene standards. High-risk regions include parts of Africa, South Asia, and Latin America. In these areas, water and food may be contaminated, and hygiene practices may not meet stringent standards.

In Africa, countries like Egypt, Morocco, and Kenya are often considered high-risk for travellers' diarrhoea due to contaminated water and food, especially from street vendors and local eateries with poor hygiene practices.

South Asia, including countries like India, Nepal, and Bangladesh, also poses a significant risk due to high population density, inadequate sanitation, and the prevalence of foodborne pathogens.

Latin American countries such as Mexico, Peru, and Guatemala are known for a high incidence of travellers' diarrhoea due to consumption of raw or undercooked foods, unpasteurised dairy products, and untreated water.

Southeast Asia, including countries like Thailand, Vietnam, and Indonesia, is a popular tourist destination but carries a high risk due to varying food safety standards and the tropical climate. Visitors should be cautious about eating from street food vendors and drinking tap water.

When travelling, it’s crucial to be mindful of the foods you consume to avoid any digestive disturbances. As a nutritionist, I recommend steering clear of certain foods for optimal health. Uncooked vegetables, for instance, can easily harbour harmful bacteria and are often washed with unclean water. Unpeeled fresh fruit, such as apples or grapes, might have been handled or washed improperly, posing a risk. Though seemingly healthy, salads in some regions are a common source of contamination. 

Unpasteurised dairy products can contain dangerous bacteria like E. coli or listeria, which aren’t destroyed during the pasteurisation process. Additionally, raw or undercooked meat is a significant no-no; it can harbour harmful bacteria and parasites that cause serious illness. Street food, while tempting and budget-friendly, often poses a contamination risk and should be avoided unless you are sure of its hygienic preparation. 

Tap water in many destinations may not meet safety standards, which means you should use bottled water for drinking and even for brushing your teeth. Fresh fruits and vegetables washed in tap water can be risky, as can fresh juices that might be diluted with local water. It's safer to consume fruits you can peel yourself and juices from trustworthy sources. 

Buffets may seem like a convenient option, but they can be a breeding ground for bacteria, especially if the food has been sitting out for prolonged periods. If you're at a buffet, opt for hot items over those at room temperature.

Before you embark on your journey, a little preparation can go a long way in preventing traveller's diarrhoea. Firstly, it's crucial to practise good hand hygiene. Pack a small bottle of hand sanitizer and use it frequently, especially before meals. Washing your hands with soap and water whenever possible is even better. 

Next, give serious thought to food and water precautions. In high-risk areas, avoid raw or undercooked foods, including fruits and vegetables that you haven’t peeled yourself. Stick to bottled, boiled, or treated water, and be cautious with ice cubes, as they can be a hidden source of contamination. 

Consider bringing medical supplies tailored for self-treatment. Make space in your travel kit for medications like loperamide and antibiotics, which can be lifesavers in a pinch.

I'd also recommend packing yourself rehydrating electrolytes. When you’re dealing with frequent, loose stools, your body rapidly loses fluids and essential electrolytes like sodium and potassium. This can lead to dehydration quickly, exacerbating your condition and possibly leading to more serious health issues. These minerals are vital for maintaining fluid balance, nerve function, and muscle function. Without them, you may experience symptoms like dizziness, fatigue, confusion, and muscle cramps. Oral rehydration solutions like Hydravive are specifically designed to replace lost fluids and electrolytes efficiently, making them more effective than just drinking water.

Our electrolytes powder sachets have been expertly crafted to effectively and rapidly combat dehydration, replace vital minerals and reduce fatigue during exercise. With 4 added minerals including Magnesium which contributes to electrolyte balance and supports energy-yielding metabolism, as well as Vitamin C and all 8 essential B Vitamins which are necessary for normal energy-yielding metabolism and contributing to a reduction of tiredness & fatigue (Claims supported by EFSA).

Simply mix into clean water, and you have a potent remedy that can help you bounce back more quickly. Should you begin to show signs of dehydration, acting fast by taking an ORS can prevent deterioration and keep you on your feet.

Probiotic supplements are a valuable ally in preventing travellers’ diarrhoea. These supplements contain beneficial bacteria that help maintain a healthy balance in your gut flora. When you travel, your digestive system can be disrupted by unfamiliar foods and water, potentially leading to an upset stomach. By taking probiotics, you bolster your gut’s natural defences, making it more resilient to harmful bacteria and viruses. 

Several studies suggest that certain strains of probiotics, such as Lactobacillus rhamnosus and Limosilactobacillus reuteri, are particularly effective in reducing the incidence of travellers' diarrhoea. These supplements work by strengthening the gut barrier, inhibiting the growth of pathogens, and modulating the immune system to respond more effectively to any invaders. 

Our Pro Bio Cultures Complex contain 21 live bacteria strains with an impressive 60 billion CFU per serving (2 capsules). Each bottle contains 60 capsules which is a full month’s supply. We have also included Lactospore (Bacillus coagulans), a live bacteria strain which has been subject to several clinical trials to support its effectiveness.

For best results, start taking probiotics a few days before your trip and continue throughout your journey. This proactive approach can significantly reduce the likelihood of experiencing discomfort, allowing you to enjoy your holiday with peace of mind.

Riya Lakhani-Kanji MSc ANutr is a registered nutritionist and health writer. Equipped with a Bachelor's and Master's degree in Human Nutrition, Riya leverages her scientific knowledge to create engaging content that empowers people to embrace the power of plants.