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Traveller’s Diarrhoea: Why It Still Happens and How to Handle It

Spokesperson: Dr. D. Chandra Sekhar Reddy, Senior Consultant Gastroenterologist, Hepatologist and Therapeutic Endoscopist, Yashoda Hospitals, Hyderabad

Traveller’s diarrhoea continues to be one of the most common health problems affecting people visiting other countries, especially regions such as South-East Asia, Sub-Saharan Africa, the Middle East, and parts of Northern Africa. Despite better awareness and travel planning, many travellers still experience stomach infections during their trips.

For decades, the popular advice was simple: “boil it, cook it, peel it, or forget it.” While being cautious about food and water does reduce risk, it does not offer complete protection. The real issue often lies beyond individual food choices. Poor sanitation systems, contaminated water supplies, improper food handling, and inadequate hygiene practices in kitchens play a much larger role in spreading infections.

What many describe as “food poisoning” is usually an infection caused by bacteria, viruses, or toxins present in contaminated food or water. Symptoms typically include diarrhoea, vomiting, stomach cramps, and sometimes fever. In most mild cases, the illness settles within a few days with adequate rest and proper fluid intake.

In recent years, medical advice around treatment has evolved. Previously, travellers were commonly advised to carry antibiotics as a precaution. Today, antibiotics are recommended only in specific situations—such as severe diarrhoea, high fever, or blood in the stool. Unnecessary antibiotic use can lead to drug-resistant bacteria and may disturb the natural balance of healthy gut microbes. In some cases, it can even trigger more serious infections, such as C. difficile.

Environmental factors significantly increase the risk of infection. Limited access to clean drinking water, poor refrigeration, frequent power outages, and inadequate handwashing facilities all contribute to contamination. Even in developed countries, restaurant-related outbreaks can still occur.

The most important part of treatment remains hydration. Drinking safe fluids and using oral rehydration solutions helps prevent dehydration and complications. While preventive steps like proper hand hygiene and choosing freshly cooked food are helpful, they are not foolproof.

Traveller’s diarrhoea is manageable, but it requires sensible care. Knowing when to rest, rehydrate, and seek medical attention is far more important than relying on antibiotics as a quick fix.