Traveler's Diarrhea: What to Eat, Drink, and Do Before Symptoms Start
Updated: 18 hours ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Quick Answer
Traveler's diarrhea is a digestive tract illness that causes loose, watery stools and stomach cramps after eating contaminated food or water, affecting 30–70% of travelers to high-risk regions. Most people recover within one to two days without treatment, but staying hydrated is essential. See a doctor if diarrhea lasts more than two days or comes with fever.
What the research says
A single antibiotic dose plus loperamide works fast. In 324 people with acute watery traveler's diarrhea, one dose of levofloxacin, azithromycin, or rifaximin with loperamide cured 81.4%, 78.3%, and 74.8% within 24 hours, and about 96% within 72 hours (Riddle et al., Clinical Infectious Diseases, 2017) [11].
Probiotics may modestly lower the risk. A review of 12 trials found that probiotics lowered the risk of traveler's diarrhea by about 15%, with no serious side effects reported (McFarland, Travel Medicine and Infectious Disease, 2007) [12].
Preventive antibiotics work in trials, which is why their risks and benefits are still debated. A meta-analysis of 9 randomized, placebo-controlled studies (4 of rifaximin, 5 of fluoroquinolones) found pooled relative risks of traveler's diarrhea of 0.33 (95% CI 0.24–0.45) with rifaximin and 0.12 (95% CI 0.07–0.20) with fluoroquinolones compared with placebo, with similar rates of treatment-emergent adverse events. The authors still called for a formal risk–benefit analysis of antibiotic chemoprophylaxis (Alajbegovic et al., Syst Rev, 2012) [13].
Bismuth subsalicylate improves the odds of both preventing and relieving infectious diarrhea. A meta-analysis of 14 clinical studies found that people taking it for up to 21 days had 3.5 times greater odds of avoiding traveler's diarrhea than those given placebo (95% CI 2.1–5.9), and people with infectious diarrhea had 3.7 times greater odds of symptom relief (95% CI 2.1–6.3). Four of the five authors list Procter & Gamble affiliations (Brum et al., Dig Dis Sci, 2021) [14].
Adding loperamide to an antibiotic speeds recovery in adults. In a meta-analysis of 6 paired studies comparing an antibiotic alone with an antibiotic plus loperamide, the odds of clinical cure favored the combination at 24 hours (OR 2.6; 95% CI 1.8–3.6) and at 48 hours (OR 2.2; 95% CI 1.5–3.1). The cautions in this guide about fever and bloody stools still apply (Riddle et al., Clin Infect Dis, 2008) [15].
What is traveler's diarrhea, exactly?
Traveler's diarrhea is a digestive tract disorder that commonly causes loose stools and stomach cramps. It happens after eating contaminated food or drinking contaminated water [1].
The good news is that in most people it is not serious — it is just unpleasant. The risk rises when you visit places where the climate or sanitary practices differ from what you are used to at home [1].
Because most episodes go away without treatment, prevention matters more than treatment. But it is a good idea to pack doctor-approved medicines before traveling to high-risk areas, so you are prepared if symptoms become severe or persist [1].
What does traveler's diarrhea feel like?
Traveler's diarrhea may begin suddenly during your trip or shortly after you return home. Most people improve within one to two days without treatment and recover completely within a week. Some travelers experience multiple episodes during a single trip [1].
The six most common symptoms are summarized below [1].
Symptom | What it looks like |
Sudden loose stools | Three or more looser, watery stools per day, appearing abruptly |
Urgency | A sudden, hard-to-delay need to pass stool |
Stomach cramps | Abdominal pain that often accompanies the loose stools |
Nausea | An unsettled, sick-to-the-stomach feeling |
Vomiting | Throwing up, sometimes repeatedly |
Fever | Elevated body temperature |
Most cases are mild and self-limiting. But some infections produce more dangerous symptoms — moderate to severe dehydration, ongoing vomiting, high fever, bloody stools, or severe pain in the belly or rectum. If any of these occur, or if diarrhea lasts longer than a few days, it is time to see a healthcare professional [1].
When should you see a doctor for traveler's diarrhea?
The dividing line is simple: mild diarrhea that improves within a day or two can usually be managed at home. Anything beyond that deserves medical evaluation [1].
For adults, the specific warning signs are [1]:
Warning sign | Why it matters |
Diarrhea lasting more than two days | Suggests a cause that is not self-resolving |
Signs of dehydration | You are losing fluids faster than you can replace them |
Severe stomach or rectal pain | May signal a more serious intestinal infection |
Bloody or black stools | Indicates bleeding in the digestive tract |
Fever above 102°F (39°C) | Points to a more aggressive infection |
If you fall ill while traveling internationally, a local embassy or consulate may be able to help you find a well-regarded medical professional who speaks your language [1].
Children need special attention because traveler's diarrhea can cause severe dehydration in a short time. Call a doctor if a sick child has any of the following [1]:
Child warning sign | What to look for |
Ongoing vomiting | Cannot keep fluids down |
Fever of 102°F (39°C) or higher | Elevated temperature that persists |
Bloody stools or severe diarrhea | Significant intestinal involvement |
Dry mouth or crying without tears | Early signs of dehydration |
Unusual sleepiness or unresponsiveness | A red flag for serious dehydration |
Decreased urine output | Fewer wet diapers in infants |
What causes traveler's diarrhea?
Traveler's diarrhea may stem from the stress of travel or a change in diet, but infectious agents — bacteria, viruses, or parasites — are usually to blame [1]. You typically develop it after ingesting food or water contaminated with organisms from feces [1].
So why are native residents of high-risk countries not affected the same way? Their bodies have usually become used to the local bacteria and have developed immunity to them [1].
Current surveillance data confirms the pattern. Bacteria account for an estimated 80–90% of cases, making them by far the dominant cause [4] [5]. The most frequently identified pathogens are diarrheagenic Escherichia coli (especially enterotoxigenic E. coli, most common in warm and rainy seasons), Shigella species, and Campylobacter [4]. Viruses and parasites account for the remainder [4].
Cause type | Share of cases | Key details |
Bacteria | ~80–90% | E. coli (especially ETEC), Shigella, Campylobacter |
Viruses | Smaller share | Often spread through contaminated food and water |
Parasites | Smaller share | Tend to cause longer-lasting symptoms |
Stress or diet change | Possible contributor | Less common than infection |
Why do some travelers get sick while others don't?
Each year, millions of international travelers experience traveler's diarrhea. Attack rates range from 30% to 70% within two weeks of arriving, depending on the destination and season of travel [3] [4].
Where you go is the single biggest factor. The destination risk tiers are [1]:
Risk level | Regions |
High | Central America, South America, Mexico, Africa, South Asia, Southeast Asia |
Some risk | Eastern Europe, South Africa, Central and East Asia, the Middle East, a few Caribbean islands |
Low | Northern and Western Europe, Japan, Canada, Singapore, Australia, New Zealand, the United States |
Your chances are mostly determined by destination, but certain groups face extra risk [1]:
Higher-risk group | Why the risk is higher |
Young adults | Slightly more common; possibly because of less acquired immunity, more adventurous eating, or less caution |
People with weakened immune systems | Illnesses or immune-suppressing medicines such as corticosteroids reduce infection defenses |
People with diabetes, inflammatory bowel disease, or severe kidney, liver, or heart disease | These conditions raise both infection risk and the chance of a more severe infection |
People who take acid blockers or antacids | Stomach acid normally destroys ingested organisms; reducing it gives bacteria a better chance to survive |
People traveling in certain seasons | Risk peaks in hot months just before monsoons in places like South Asia |
Can traveler's diarrhea cause complications?
Yes — the main danger is dehydration. Because you lose vital fluids, salts, and minerals during a bout of traveler's diarrhea, dehydration can develop, especially during the summer months. It is especially dangerous for children, older adults, and people with weakened immune systems [1].
Severe dehydration from diarrhea can cause serious complications, including organ damage, shock, or even coma [1]. Watch for these symptoms:
Dehydration symptom | What it indicates |
Very dry mouth | Fluid deficit developing |
Intense thirst | The body demanding water |
Little or no urination | Kidneys conserving fluid — a late sign |
Dizziness | Reduced blood volume affecting circulation |
Extreme weakness | Widespread fluid and electrolyte loss |
How do you prevent traveler's diarrhea?
Prevention comes down to discipline with food and water. The classic travel rule is: boil it, cook it, peel it, or forget it. But note that it is still possible to get sick even if you follow these rules [1].
Food rules
Do | Don't |
Eat foods that are well cooked and served hot | Eat food from street vendors |
Peel your own fruits (bananas, oranges, avocados) | Eat salads and unpeelable fruits (grapes, berries) |
Choose foods requiring little handling in preparation | Eat raw or undercooked meat, fish, or shellfish |
Serve dishes on clean, dry utensils | Eat moist food at room temperature (sauces, buffets) |
Consume unpasteurized milk and dairy, including ice cream |
Remember that alcohol in a drink does not protect you from contaminated water or ice [1].
Water rules
The safest drinks are sealed bottled or canned beverages — water, carbonated drinks, beer, or wine — as long as you break the seals yourself and wipe the container first [1]. Steaming-hot coffee or tea is also safe [1].
Water tip | Detail |
Avoid unsterilized water | No tap, well, or stream water |
Boil local water | Boil for three minutes, let cool naturally, store in a clean covered container |
Skip local ice | Ice cubes may be made from tap water |
Avoid tap-water fruit juices and sliced fruit | The fruit may have been washed in contaminated water |
Use bottled or boiled water for baby formula | Even small amounts of contaminated water matter for infants |
Brush teeth with bottled water | A common source of unnoticed exposure |
Avoid swimming in possibly contaminated water | |
Keep your mouth closed in the shower |
If bottled water is unavailable, purification works: a water-filter pump with a microstrainer filter removes small microorganisms, and iodine or chlorine tablets chemically disinfect water. Iodine is more effective but best reserved for short trips, since too much iodine can harm your system [1].
Hand hygiene and extras
Wash your hands often, always before eating. If washing is not possible, use an alcohol-based hand sanitizer with at least 60% alcohol [1]. Keep children from putting dirty hands or objects in their mouths, and keep infants off dirty floors [1]. One practical trick: tie a colored ribbon around the bathroom faucet as a visual reminder not to drink or brush your teeth with tap water [1].
Should you take antibiotics before you travel?
Public health experts generally do not recommend taking antibiotics to prevent traveler's diarrhea. Doing so can contribute to antibiotic-resistant bacteria [1]. Antibiotics also provide no protection against viruses and parasites, can create a false sense of security about risky foods, and cause side effects such as skin rashes, sun sensitivity, and vaginal yeast infections [1].
Some doctors suggest bismuth subsalicylate as a preventive measure — it has been shown to decrease the likelihood of diarrhea. However, do not take it for longer than three weeks, and avoid it entirely if you are pregnant or allergic to aspirin. Check with your doctor first if you take anticoagulants or certain other medicines [1]. Common harmless side effects include a black-colored tongue and dark stools; it can also cause constipation, nausea, and rarely ringing in the ears (tinnitus) [1].
How is traveler's diarrhea diagnosed?
Diagnosis is usually straightforward. A doctor takes a medical and travel history and performs a physical exam to check for signs of dehydration. A stool sample is typically reserved for cases where symptoms are serious or do not resolve on their own, to check for the specific microorganism involved [2].
Diagnostic step | What it checks |
Medical and travel history | Where you traveled, what you ate and drank, symptom timing |
Physical exam | Signs of dehydration (dry mouth, low urine output, dizziness) |
Stool sample | The specific bacteria, virus, or parasite causing the illness — only for serious or persistent cases |
What treatments work for traveler's diarrhea?
Traveler's diarrhea may get better without any treatment. While you wait for it to pass, the priority is staying hydrated with safe liquids such as bottled water or an oral rehydration solution [2].
Three categories of medication are available [2]:
Treatment | How it works | When it is NOT recommended |
Anti-motility agents (loperamide, diphenoxylate) | Reduce intestinal spasms, slow transit, and allow more fluid absorption — prompt but temporary relief | Infants; people with fever or bloody diarrhea (delays clearing the infection and can worsen illness) |
Bismuth subsalicylate | Decreases stool frequency and shortens illness length | Children, pregnant women, aspirin-allergic people |
Antibiotics | Treat the underlying bacterial infection | Only prescribed when needed: more than four loose stools per day or severe symptoms with fever, blood, pus, or mucus |
Two important cautions about anti-motility agents: stop using them after 48 hours if you have stomach pain or if symptoms worsen while diarrhea continues — you may need blood or stool tests and antibiotics instead [2]. And before leaving for your trip, talk to your doctor about carrying a prescription in case you develop a serious bout [2].
How do you stay hydrated during a bout?
Dehydration is the most likely complication of traveler's diarrhea, so hydration deserves the most attention [2].
An oral rehydration salts (ORS) solution is the best way to replace lost fluids. These solutions contain water and salts in specific proportions to replenish both fluids and electrolytes, plus glucose to enhance absorption in the intestinal tract [2].
ORS option | Availability |
Bottled ORS products | Drugstores in developed areas |
WHO-ORS powder packets | Stores, pharmacies, and health agencies in most countries; reconstitute with bottled or boiled water |
Homemade emergency solution | 3/4 teaspoon table salt + 2 tablespoons sugar + 1 quart uncontaminated bottled or boiled water; optional sugar-free flavor powder |
Drink the solution in small amounts throughout the day as a supplement to solid foods or formula, as long as dehydration persists — small amounts reduce the likelihood of vomiting. Breastfed infants can drink the solution but should continue nursing on demand [2].
If dehydration symptoms — dry mouth, intense thirst, little or no urination, dizziness, extreme weakness — do not improve, seek medical care right away. Oral rehydration solutions are intended only for urgent short-term use [2].
What should you eat while recovering?
During an episode, avoid caffeine, alcohol, and dairy products, which may worsen symptoms or increase fluid loss — but keep drinking fluids [2]. Good options include canned fruit juices, weak tea, clear soup, decaffeinated soda, and sports drinks [2].
As diarrhea improves, shift toward easy-to-eat complex carbohydrates [2]:
Recovery foods | Why they help |
Salted crackers, bland cereals, dry toast or bread | Gentle on the digestive tract |
Bananas and applesauce | Easy carbohydrates with some electrolytes |
Rice, potatoes, plain noodles | Starchy, low-fiber options that are easy to digest |
Return to your normal diet as you can tolerate it. Reintroduce dairy products, caffeinated beverages, and high-fiber foods cautiously [2].
How do you prepare for a doctor's appointment?
Call a doctor if diarrhea is severe, lasts more than a few days, or is bloody. If you are traveling, an embassy or consulate can help locate a doctor. Other reasons to seek care include a fever of 102°F (39°C) or higher, ongoing vomiting, or signs of severe dehydration such as dry mouth, muscle cramps, decreased urine output, dizziness, or fatigue [2].
If you have just returned from a trip abroad, share that trip information when you call to book [2].
Before the appointment, gather [2]:
Preparation item | What to include |
Pre-appointment instructions | Ask whether immediate self-care steps can speed recovery |
Symptom history | What you have experienced and for how long |
Medical history | Conditions being treated; all medicines, vitamins, and supplements |
Questions for the doctor | Written in advance to make the most of the visit |
The twelve questions below make a strong checklist for your appointment [2]:
# | Question to ask |
1 | What is causing my symptoms? |
2 | Are there other possible causes? |
3 | What tests do I need? |
4 | What treatment approach do you recommend? |
5 | What are the possible side effects of the medicines? |
6 | How does this interact with my other health conditions? |
7 | What is the safest way for me to rehydrate? |
8 | Do I need dietary restrictions, and for how long? |
9 | How soon will I start feeling better? |
10 | How long until full recovery? |
11 | Am I contagious, and how do I protect others? |
12 | How do I reduce the risk of this happening again? |
Your doctor will likely ask their own set of questions. Being ready to answer them saves time [2]:
What the doctor asks | Why |
Your symptoms and when they began | Establishes the timeline |
Where you traveled recently | Links symptoms to destination risk |
Recent antibiotic use | Affects which organisms are likely |
Whether symptoms are improving or worsening | Guides treatment urgency |
Blood in stools | Signals severity |
Dehydration symptoms like muscle cramps or fatigue | Checks for complications |
Treatments already tried | Avoids duplicating what failed |
Whether you can keep food or liquid down | Determines hydration needs |
Pregnancy status and other conditions | Changes treatment options |
What is the bottom line on traveler's diarrhea?
Traveler's diarrhea is the most common travel-related illness, affecting 30–70% of visitors to high-risk regions — but it is usually mild, self-limiting, and entirely manageable with the right preparation [1] [3].
The three takeaways are simple. First, prevention is the real medicine: boil it, cook it, peel it, or forget it; drink only sealed or boiled beverages; and wash your hands before every meal. Second, most cases resolve within a day or two — oral rehydration solution and bland foods are all most people need. Third, know your red flags: diarrhea lasting more than two days, fever above 102°F, bloody or black stools, or any sign of dehydration means it is time to get help, even mid-trip [1] [2].
Before your next trip to a high-risk area, have a conversation with your doctor about a travel medicine kit — including a prescription to keep in reserve for serious bouts. Travel confidently, eat carefully, and know exactly when to seek care.
Frequently Asked Questions
How common is traveler's diarrhea?
Traveler's diarrhea is the most common travel-related illness in the world. Depending on destination and season, 30–70% of travelers develop it within two weeks of arrival in a high-risk area [3] [4].
How long does traveler's diarrhea last?
Most people improve within one to two days without treatment and recover completely within a week, though some travelers have multiple episodes during a single trip [1].
Can traveler's diarrhea go away on its own?
Yes. In most people it resolves without any treatment. The priority while waiting is staying hydrated with safe liquids such as bottled water or an oral rehydration solution [2].
What is the fastest way to stop traveler's diarrhea?
Anti-motility medicines like loperamide give prompt but temporary relief by slowing the digestive tract. They are not suitable for infants or anyone with fever or bloody diarrhea, and should be stopped after 48 hours if symptoms worsen — see a doctor instead [2].
When should I take antibiotics for traveler's diarrhea?
Only when prescribed. A doctor may prescribe antibiotics if you have more than four loose stools a day or severe symptoms including fever, blood, pus, or mucus in your stools [2]. Antibiotics are not recommended as a preventive measure.
What should I drink to stay hydrated?
An oral rehydration salts (ORS) solution is the best option — bottled ORS, WHO-ORS powder packets, or a homemade emergency mix of 3/4 teaspoon salt and 2 tablespoons sugar in one quart of safe water [2].
How do I prevent traveler's diarrhea on my next trip?
Follow "boil it, cook it, peel it, or forget it." Avoid street food, raw produce you cannot peel, unpasteurized dairy, local ice, and unsealed tap water. Wash hands before eating, use purified or boiled water for brushing teeth, and consider carrying a water-purification method [1].
Can traveler's diarrhea be dangerous?
In healthy adults it is rarely serious, but severe dehydration can cause organ damage, shock, or coma — especially in children, older adults, and people with weakened immune systems [1]. Seek care promptly for persistent symptoms, high fever, bloody stools, or dehydration signs.
Is it safe to take loperamide (Imodium) for traveler's diarrhea?
Loperamide can ease symptoms for many adults, but do not use it if you have a fever or bloody diarrhea, and do not give it to infants. Stop taking it and see a doctor if stomach pain develops or symptoms get worse.
What foods should I eat while recovering?
Start with bland, easy foods such as salted crackers, dry toast, bland cereals and clear soup. Avoid caffeine, alcohol and dairy until you feel better, and keep drinking safe fluids.
References
Mayo Clinic Staff. Traveler's diarrhea - Symptoms and causes. Mayo Clinic. January 18, 2025. https://www.mayoclinic.org/diseases-conditions/travelers-diarrhea/symptoms-causes/syc-20352182
Mayo Clinic Staff. Traveler's diarrhea - Diagnosis and treatment. Mayo Clinic. January 18, 2025. https://www.mayoclinic.org/diseases-conditions/travelers-diarrhea/diagnosis-treatment/drc-20352188
Centers for Disease Control and Prevention. Travelers' Diarrhea. Centers for Disease Control and Prevention. Accessed October 29, 2026. https://wwwnc.cdc.gov/travel/page/travelers-diarrhea
Anderson MS, et al. Etiology and Epidemiology of Travelers' Diarrhea among US Military and Adult Travelers, 2018-2023. Emerging Infectious Diseases. 2024;30(14):19-25. PMID 39530798. https://doi.org/10.3201/eid3014.240308
Bento D, et al. Travelers' Diarrhea. StatPearls. June 19, 2026. https://www.ncbi.nlm.nih.gov/books/NBK459348/
Connor BA, et al. Travelers' Diarrhea. CDC Yellow Book. March 24, 2026. https://www.cdc.gov/yellow-book/hcp/preparing-international-travelers/travelers-diarrhea.html
López-Vélez R, et al. Bacterial travellers' diarrhoea: A narrative review of literature published over the past 10 years. Travel Medicine and Infectious Disease. 2022;47:102293. PMID 35247581. https://doi.org/10.1016/j.tmaid.2022.102293
Connor BA, et al. Post-Travel Diarrhea. CDC Yellow Book, 2026 edition: Health Information for International Travel. April 23, 2025. https://www.ncbi.nlm.nih.gov/books/NBK620948/
Giddings SL, et al. Traveler's Diarrhea. The Medical Clinics of North America. 2016;100(2):317-30. PMID 26900116. https://doi.org/10.1016/j.mcna.2015.08.017
National Institute of Diabetes and Digestive and Kidney Diseases. Diarrhea. National Institute of Diabetes and Digestive and Kidney Diseases. September 2024. https://www.niddk.nih.gov/health-information/digestive-diseases/diarrhea
Riddle MS, et al. Trial Evaluating Ambulatory Therapy of Travelers' Diarrhea (TrEAT TD) Study: A Randomized Controlled Trial Comparing 3 Single-Dose Antibiotic Regimens With Loperamide. Clinical Infectious Diseases. 2017;65(12):2008-2017. PMID 29029033. https://doi.org/10.1093/cid/cix693
McFarland LV. Meta-analysis of probiotics for the prevention of traveler's diarrhea. Travel Medicine and Infectious Disease. 2007;5(2):97-105. PMID 17298915. https://doi.org/10.1016/j.tmaid.2005.10.003
Alajbegovic S, Sanders JW, Atherly DE, et al. Effectiveness of rifaximin and fluoroquinolones in preventing travelers' diarrhea (TD): a systematic review and meta-analysis. Syst Rev. 2012;1:39. PMID 22929178. https://doi.org/10.1186/2046-4053-1-39
Brum JM, Gibb RD, Ramsey DL, et al. Systematic Review and Meta-Analyses Assessment of the Clinical Efficacy of Bismuth Subsalicylate for Prevention and Treatment of Infectious Diarrhea. Dig Dis Sci. 2021;66(7):2323-2335. PMID 32772204. https://doi.org/10.1007/s10620-020-06509-7
Riddle MS, Arnold S, Tribble DR. Effect of adjunctive loperamide in combination with antibiotics on treatment outcomes in traveler's diarrhea: a systematic review and meta-analysis. Clin Infect Dis. 2008;47(8):1007-1014. PMID 18781873. https://doi.org/10.1086/591703
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Medical disclaimer
The information provided in this article is for educational purposes only and should not be used as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
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