Traveller’s diarrhoea affects many travellers going to destinations in Africa, Asia and South America. Antibiotics are fast and effective treatment for traveller’s diarrhoea. Travellers going to a risk area can take a course of antibiotics with them, in case they contract the infection are far from medical help.
To order an antibiotic for traveller’s diarrhoea you need to fill in a brief questionnaire. Our doctor will review your answers and approve appropriate treatment.
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Diarrhoea is when you are passing stools more frequently than is normal for you or passing looser stools than usual. You can get diarrhoea as a result of stress or drinking too much caffeine or alcohol, but often it is caused by an infection in the bowel known as gastroenteritis. Gastroenteritis can be caused by a virus, bacteria or a parasite. It is very common for people travelling to other parts of the world, i.e. Asia, the Middle East, Africa and Latin America, to get bacterial or viral diarrhoea, also known as travellers’ diarrhoea. Normally, traveller's diarrhoea will go away by itself within about 3 days. In some cases, you might find it lasts for a week (particularly in children, who often take longer to bounce back). If the diarrhoea is frequent or severe, it can lead to dehydration, so you need to make sure you drink plenty of water.
Normally traveller's diarrhoea will pass by itself within about 3-7 days. About 10% of cases last over a week and about 2% for more than a month, according to the British Medical Journal. If you have diarrhoea, you can dehydrate quite quickly, especially if you are also vomiting – drink plenty of fluids to rehydrate. Taking small sips of water frequently can help. You can also take an oral rehydration solution – this is a sachet of powder that you dissolve in water and drink to replace salt, glucose and other minerals that are lost when your body is dehydrating. You can ask your pharmacist about this.
You need to be especially careful to avoid dehydration in children.
Medical opinion is divided over whether you should eat if you’ve got diarrhoea. Most specialists say that if you can eat and feel like eating, you should try to have a small light meal of solid foods. Avoid eating anything spicy or heavy. If you don’t feel like eating, you don't need to force yourself. Just drink plenty of fluids and start to eat when you feel up to it.
Azithromycin is a macrolide antibiotic used to treat bacterial infections. It works by containing the infection, which means the infection cannot spread and your body’s immune system can fight it off.
Ciprofloxacin is a broad spectrum antibiotic. This means, that it is effective against various types of bacteria. Ciprofloxacin works by killing these bacteria and is effective against most common infections which cause traveller’s diarrhoea.
Lopermide works by slowing down muscle movements in the gut. This means that a greater amount of water is absorbed from the stools, so the stools are less loose and passed less frequently.
20-60% of people who travel to high risk parts of the world, i.e. Asia, the Middle East, Africa and Latin America, get travellers’ diarrhoea. Annually about 100 million people travel from developed countries to these areas, resulting in up to 40 million cases of traveller's diarrhoea each year, according to a recent research paper by the National Centre for Biology Information.
Symptoms may vary depending on the severity of the diarrhoea. If you have mild diarrhoea, you might have a slight upset stomach for a short while, with stools that are a bit watery. If you have more severe diarrhoea, you might have very watery stools over a prolonged period of time. If you’ve got diarrhoea caused by a bacterial infection, you might have a fever, headache, stomach cramps, loss of appetite, nausea and/or be vomiting, as well as having diarrhoea.
Usually, severe traveller's diarrhoea is caused by bacterial and viral infections. The season can affect the risk – you are more likely to pick up diarrhoea caused by bacteria in the rainy season (or diarrhoea caused by a virus in the dry season). The type of travel also influences this – camping and backpacking put you at a higher risk than business travel.
You also can pick up a viral infection by direct contact, so you need to wash your hands regularly to prevent it (especially after going to the bathroom, before you eat, after coming into contact with animals, or after contact with another person who has diarrhoea.) If you can’t wash your hands with soap and water, use a hand sanitiser.
You can also catch bacterial diarrhoea by eating contaminated food or drinking contaminated water. Bacterial diarrhoea is often severe and comes with cramps, headache, fever and loss of appetite, as well as nausea and vomiting. There are several things you can do to prevent getting it:
Drink bottled or sterilised water (use this for everything you might eat or drink, e.g. to wash fruit, clean your teeth or make ice). Don’t eat salads (the ingredients may have been washed in contaminated water).
Be careful when eating dairy products. They may be unpasteurised.
Only eat food that is piping hot and hasn’t been left out at room temperature. Hot food should have been kept hot and cold food should have been kept cold.
Don’t eat raw egg.
Cook carefully. Wash all vegetables and fruit. Separate cooked and uncooked food. Cleanall worktops and utensils with care. Don’t make food for others if you’ve got diarrhoea.
Anyone can get travellers’ diarrhoea. High-risk parts of the world include Asia (particularly Southern Asia), the Middle East, Africa and Latin America. 20-60% of travellers visiting these areas get travellers’ diarrhoea.
You should see a doctor if:
- Your baby has six or more episodes of diarrhoea in 24 hours
- Your child has six or more episodes of diarrhoea, has blood in their stools, has diarrhoea and vomiting at the same time, has very watery stools, has diarrhoea that lasts two weeks.
As an adult, you should see a doctor if you have diarrhoea and were in hospital recently, if you’ve been treated with antibiotics lately, if your diarrhoea has blood in it, if you are vomiting a lot as well as having diarrhoea, if you are losing weight, if your rectum is bleeding, if you have diarrhoea at night that is disturbing your sleep, if you’ve passed a great quantity of very watery diarrhoea, or if you’ve had diarrhoea for more than 7 days.
About 10% of cases of travellers’ diarrhoea last over a week and about 2% for more than a month, according to a paper published by the British Medical Journal. If you have had continuous symptoms for longer than 10 days, see a doctor so that your stools can be checked for parasites, such as Giardia and Cryptosporidium. Between 5 and 10% of people who have had travellers’ diarrhoea later fulfil the criteria for irritable bowel syndrome. This is referred to as post-infection irritable bowel syndrome.
It can take up to 48 hours for Loperamide to improve your symptoms. Keep taking the medication as directed and speak to a doctor if it does not help within two days. Like all antibiotics, you need to complete the course for Azithromycin to work. Azihromycin will start working on the first day, but you may need to wait three days until you notice an improvement. With Ciprofloxacin you may only need to take it for 24 hours if your symptoms resolve. Otherwise, you would need to take the full 3 day course (continue one tablet, twice daily).
You can get Loperamide and oral rehydration solution from the pharmacy. You need a prescription to get Azithromycin or Coprofloxacin.
Yes. Speak to your GP about getting Azithromycin or Ciprofloxacin as a standby to take abroad with you.
You can reduce the frequency of the diarrhoea by taking an antidiarrhoeal medicine such as Loperamide. This will make the stools firmer, so you’ll need to pass them less frequently. It can take up to 48 hours for Loperamide to improve your symptoms. Keep taking the medication as directed and speak to a doctor if it does not help within two days. Severe cases of diarrhoea may need to be treated with an antibiotic, such as Azithromycin. If you are going abroad, you might like to ask your doctor for Azithromycin or Ciprofloxacin, depending on where you are travelling to take with you just in case you fall ill and need it.
If you have got a fever or a headache you could consider taking painkillers, such as paracetamol or ibuprofen. Antibotics are effective in most cases of Travellers’ Diarrhoea, according to a recent article published by the Centre for Disease Control and Prevention. Studies suggest, that Loperamide is as effective as other anti-diarrhoeal medications.
If you would like to take a traveller's diarrhoea treatment with you on your next trip, you can order online from Zava. We offer free prescription and delivery and will provide you with either azithromycin or ciprofloxacin (depending on your destination) to take if you fall ill with diarrhoea while abroad.
Loperamide is not suitable for everyone. Don’t take Loperamide if you are pregnant or breastfeeding. You should consult your doctor before taking Loperamide if you:
- are allergic to any of the ingredients
- have AIDS
- have dysentery
- have problems with your liver
- have conditions such as megacolon, colitis, ileus, slow gastrointestinal movements, constipation, abdominal distension
- if the medicine is for a child under 12 years old
If you bought Loperamide without a prescription, you should also consult your doctor if you:
- are older than 40 and it is a while since you last had a bout of irritable bowel syndrome
- have recently passed blood in your stool
- have constipation, feel sick or are vomiting
- have lost your appetite
- have lost weight
- have recently been abroad
- have a fever
- have difficulty urinating (or if urinating hurts)
Lopermide’s most common side effects are: flatulence, headache, nausea and constipation.
Less common side effects are: dry mouth, dizziness, indigestion, a rash, sleepiness, stomach ache, vomiting. For rare side effects, please read the patient information leaflet.
Azithromycin is not suitable for everyone. You should consult your doctor before taking it if you:
- are allergic to macrolides, or any of the ingredients in the medicine
- have a slow heart rate
- have problems with your kidneys
- have liver disease
- have metabolic problems
- have neurological problems
- have or are at risk of a heart problem
- have psychiatric problems
Speak to your doctor about taking azithromycin if you are pregnant or breastfeeding.
Azithromycin’s most common side effects are: diarrhoea, stomach cramps, feeling nauseous and vomiting. Less common are: change in sense of smell, allergic reactions, convulsions, dizziness, flatulence, headaches, itching, jointpain, decreased appetite, a rash, sleepiness, taste changes, problems with the vagina, watery stools. For rare side effects, please read the patient information leaflet.
Ciprofloxacin can cause side effects.
- diarrhoea or nausea
- pain in joints (in children)
- skin problems such as itching and rash
- feeling agitated or hyperactive
- pain in your muscles and bones
- fever and feeling unwell
- poor kidney function
- joint pain
- decrease in appetite
- taste disorders
- fungal superinfections
- sleeping problems
- headaches and dizziness
- digestive problems (such as an upset stomach, vomiting or indigestion)
- abdominal pain and flatulence
- changes affecting your blood levels of certain substances
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