Diarrhea is the change in normal stool pattern, in which the stool becomes more frequent and less formed (more watery and softer). It may also be presented along with abdominal cramps, bloating, nausea, vomiting and fever.

Diarrhea is defined as three or more loose stools in an 8 hour period, especially when accompanied with nausea, vomiting, cramps and fever.


Infection with bacterial, protozoa or viruses that are ingested by eating contaminated food or water, and even a change in diet may cause diarrhea.

How to prevent Diarrhea

  • Abide by the ‘Cook it, boil it and peel it’ rule if you are traveling to a place where hygiene and public sanitation is poor.
  • Drink bottled water, or water treated with purifying tablets.
  • Use bottled water for washing salad and fruits, even for mouth washing and cleaning teeth.
  • Avoid eating ice cream, seafood, fruit and vegetables from street hawkers, and ice cubes in the drink.
  • Food should be well-cooked. Avoid eating left-overs, re-heated or under cooked food.
  • Practice strict hygiene especially after using the bathroom and before you eat. Never use communal, damp towels in public conveniences. Instead, use disposable paper towels, antibacterial wipes or hot air dryer.
  • Avoid swallowing water in swimming pools, lakes, river or the sea when swimming.


Traveler’s diarrhea is self-limiting, which means that it stops itself. Get plenty of rest. Drink plenty of clear fluids. It is important to prevent dehydration in children and the elderly, especially in hot climates. If you are vomiting, small sips of liquid is necessary to prevent dehydration.

Banana, salted crisps, rice, clear soups and [plain food such as bread are good. Avoid alcohol.

Since vital salts and minerals are lost during bouts of diarrhea, the best treatment for diarrhea is to take Oral Rehydration Salts (ORS). ORS comes in sachets which should be dissolved in water for drinking. It is suitable for both children and adults. (Read instruction on the packet carefully when consume)

If ORS is not available, it can be replaced with:

  • 6 level  teaspoons of sugar
  • 1 level teaspoon of salt
  • in 1L of safe-drinking water (boiled, cooked water)

OTC medication such as loperamide can also stop diarrhea by slowing down the movement of the gut/bowel. This allows more water to be absorbed from the stools. It stops diarrhea quite quickly and is very effective in short term treatment in adults.  Loperamide should not be taken if you are passing blood or have a history of bowel problems. Please consult your doctor for alternate treament before you  leave for the trip.

For women on contraceptive pills, please note that the effectiveness of the pills may be affected by traveler’s diarrhea. Alternative protection together with your pills is necessary if this occurs.


  • ORS is the only suitable treatment recommended for children.
  • Loperamide is not recommended for children 6years and below.


If diarrhea is severe or bloody, if fever occurs with shaking chills, if abdominal pain becomes marked, or if your condition dose not improve or worsens after 24-hours, seek medical attention.

It is important to know that diarrhea could also be caused by some antibiotics or medicines. This may also indicate other conditions or diseases that require medical investigation.

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