Travel Medicine
Traveler's Diarrhea — Prepare Smart, Travel Confidently
Stomach trouble abroad is common, but it doesn't have to derail your trip. Most cases are manageable — especially when you know what to bring, what to do, and when to get help.
Start a VisitAbout traveler's diarrhea
🌍 Very common, very manageable
Traveler's diarrhea is the most common illness affecting people traveling internationally. It's caused by an infection acquired through contaminated food, water, or hands. Bacteria are common causes, but viruses and parasites can also be responsible — which is one reason symptoms alone usually can't tell you exactly what you have. Risk is highest in parts of South and Southeast Asia, sub-Saharan Africa, Central America, and some regions of the Middle East and South America, though it can happen anywhere.
The good news: many uncomplicated cases improve within a few days and respond well to simple measures — rest, hydration, and over-the-counter support. Going into your trip prepared makes a meaningful difference. Knowing what to pack, what to eat and drink carefully, and when something needs more attention means you're not caught flat-footed if it does happen.
The honest reality
Most travelers who get traveler's diarrhea do not need a prescription antibiotic. Hydration is the foundation of treatment, and OTC support handles most mild cases. Antibiotics can also cause side effects, disrupt normal gut bacteria, and increase the chance of carrying antibiotic-resistant organisms — which is why they're reserved for situations where the expected benefit outweighs those risks. Understanding the difference before you go is the goal of this page.
Prevention
🛡️ The most useful thing you can do is prepare before you go
Prevention isn't about being anxious or avoiding all local food — it's about knowing which habits meaningfully reduce your risk and building them into how you travel. None of these require a prescription.
Food and drink: the practical rules
- →Choose food that is cooked thoroughly and served steaming hot. Heat kills many of the organisms responsible for traveler's diarrhea. Avoid food that has been sitting at room temperature, whether it comes from a restaurant, buffet, or street vendor.
- →Be thoughtful with raw produce. Salads, raw vegetables, and unpeeled fruit may have been washed in local tap water. Fruit you peel yourself is generally lower risk.
- →Choose your water carefully. In higher-risk destinations, use bottled or treated water for drinking and brushing your teeth. Check that seals are intact on factory-sealed bottled or canned drinks. Avoid ice when the water source is uncertain — carbonation alone doesn't make a drink safe.
- →Avoid raw or undercooked shellfish and meat. Higher risk regardless of destination.
- →Unpasteurized dairy. Higher risk in some regions — when in doubt, choose packaged options.
Hand hygiene — simple and highly effective
- →Wash hands with soap and safe water whenever possible — especially after using the bathroom and before eating
- →Use hand sanitizer containing at least 60% alcohol when handwashing isn't available, and allow it to dry fully. Soap and water remain the preferred method.
- →Avoid touching your face and mouth when your hands haven't recently been cleaned
A realistic note on prevention
These habits meaningfully reduce your risk — they don't eliminate it. Even careful travelers sometimes get traveler's diarrhea. The point isn't to avoid every local dish; it's to go in with practical awareness and a plan if it happens.
What to bring
🎒 Pack this before you leave — most of it is OTC
You don't need to carry a pharmacy in your bag. But a few targeted items — most available at any drugstore before you go — can make a real difference if symptoms hit.
✅ Adult travel kit — OTC
What to pack from any drugstore
Oral rehydration solution (ORS) packets
The most important item in your kit. ORS formulated for diarrhea-related fluid loss replaces fluids and electrolytes more effectively than water alone. Pack packets designed for this purpose and mix only with the amount of safe water stated on the label. Commercial electrolyte drinks and powders vary and are not all equivalent.
Loperamide (Imodium)
May provide short-term relief for many otherwise healthy adults with uncomplicated, non-bloody diarrhea — useful when you need to travel and can't stay near a bathroom. Not appropriate for everyone; follow the label or your provider's instructions. See the caution below.
Bismuth subsalicylate (Pepto-Bismol)
May help selected adults with symptom relief. Not appropriate for everyone — check with a provider or pharmacist if you are pregnant or breastfeeding, have an aspirin or salicylate allergy, take blood thinners, have kidney disease or gout, or are considering it for a child or teenager. It can temporarily darken the tongue or stool, which is usually harmless.
Hand sanitizer (60%+ alcohol)
For when handwashing isn't available. A small bottle is easy to carry.
Medication choices and doses differ for children. Caregivers should not give loperamide, bismuth, or an antibiotic to a child unless a pediatric healthcare professional confirms it is appropriate. ORS and early attention to hydration are especially important for infants and children.
💊 Discuss with your provider
When a standby prescription may be worth discussing
A standby antibiotic may be considered for travelers when severe diarrhea would create substantial medical or logistical risk — such as remote travel, very limited access to medical care, or certain high-risk health conditions. It is not routinely prescribed for most healthy travelers, and it is not prescribed solely for reassurance.
A standby antibiotic is a prescription you carry and use only under specific circumstances — not at the first sign of loose stool. A traveler who receives one should have clear instructions from their provider explaining when to use it, when not to use it, and when to seek in-person care instead.
This is a reasonable conversation to have at a pre-travel consultation if you're heading somewhere remote or have underlying health conditions that could raise your risk.
Preventive antibiotics taken daily are not routinely recommended — potential side effects, microbiome disruption, and increased risk of carrying antibiotic-resistant organisms generally outweigh the benefit for most travelers.
⚠️ When NOT to use loperamide
Do not self-treat with loperamide if diarrhea is bloody, accompanied by fever, or associated with severe or worsening abdominal pain. Seek medical advice instead. Loperamide is not appropriate for every age group or medical condition — follow the label or your provider's instructions.
OTC vs. prescription
💊 How to think about what you need
The most useful way to assess traveler's diarrhea is by how much it's affecting you — not just by counting symptoms. Timing and symptoms alone usually can't identify the exact cause, so severity and warning signs are more useful guides for deciding what care you need.
| Symptoms and impact | General interpretation | Recommended next step |
|---|---|---|
| Tolerable, non-bloody loose stools without fever or severe pain — not interfering with activities | Mild, uncomplicated illness may be manageable with self-care | Fluids, ORS as needed, rest, and selected OTC symptom relief if appropriate for you. Contact a provider if symptoms are not clearly improving after several days or worsen at any point. |
| Symptoms that interfere with planned activities — you can still drink and remain alert | Moderate illness may benefit from clinical guidance | Continue frequent oral rehydration in small, tolerable amounts. Contact a provider, especially if you are higher risk or far from medical care. Testing or treatment may be recommended based on the full picture. |
| Incapacitating diarrhea, blood in the stool, black or tarry stool, high fever, severe abdominal pain, repeated vomiting, or significant dehydration | Severe illness or an invasive infection may be present — requires medical evaluation | Seek prompt in-person medical evaluation. Do not self-treat with loperamide. Testing may be needed, and antibiotic treatment — if appropriate at all — depends on the likely or confirmed cause and clinical assessment. |
| Diarrhea lasting more than 14 days, or symptoms that recur after seeming to resolve | Persistent diarrhea may have a parasitic, postinfectious, or other cause | Stool testing and provider evaluation are needed. Symptoms alone cannot identify the organism. |
Note: black or tarry stool may be caused by bismuth (a harmless effect), but it can also indicate gastrointestinal bleeding. If you have recently taken bismuth and otherwise feel well, this is likely harmless — but when uncertain, seek medical advice.
⚠️ Seek urgent in-person care for any of these
Repeated vomiting that prevents keeping fluids down, very little or no urine output, fainting or near-fainting, confusion or unusual sleepiness, severe weakness, worsening dizziness when standing, rapid heartbeat, or inability to replace fluid losses. Do not wait until no fluid can be kept down at all. Fever after travel to a malaria-risk area also requires prompt medical evaluation and a full travel history — even when gastrointestinal symptoms are present. Illness in a pregnant traveler, infant, older adult, or person with significant immune suppression warrants a lower threshold for in-person care.
Not sure if your situation needs more than OTC support? A provider can help you figure it out.
Start a VisitHow we can help
💻 Before you go, or if things don't resolve
Telehealth is useful at two points: before your trip, to discuss your destination risk and whether a standby plan makes sense for your situation — and after you're home, if symptoms haven't cleared up. Our ability to provide care depends on your physical location, so in-country evaluation may need to happen locally.
| What a telehealth visit can do | What may require in-person care |
|---|---|
| Pre-trip consultation to discuss your destination risk and whether a standby plan is appropriate for your situation | Severe dehydration requiring IV fluids |
| Evaluate symptoms that aren't improving and determine whether a prescription may be appropriate based on your clinical picture | Bloody stools, significant abdominal pain, or high fever requiring physical examination and possibly stool testing |
| OTC guidance and hydration advice for mild to moderate symptoms | Stool testing or lab workup to identify specific pathogens |
| Post-travel evaluation if symptoms continue after returning home | Fever after travel to a malaria-risk area — requires urgent evaluation with a full travel history |
| Begin assessment for higher-risk travelers to determine whether prompt in-person care is needed | Illness in pregnancy, significant immune suppression, infancy, frailty, or complex chronic disease when hydration or infection severity cannot be assessed remotely |
What to expect
🗓️ Your visit, start to finish
Whether you're preparing before a trip or dealing with symptoms that haven't resolved, here's how a visit works.
1 Share what's going onDescribe your symptoms, how long they've been going on, what you've tried, and where you traveled. For pre-trip visits, share your destination and any health conditions that may be relevant. |
2 Talk with your providerA licensed provider reviews your intake and asks follow-up questions. They'll give you a clear picture of what's going on and what makes sense next — including whether in-person care is what you actually need. |
3 Get a planYour provider recommends the right approach — whether that's OTC guidance and hydration, a prescription if clinically appropriate, or a clear recommendation to seek in-person care. |
4 Pick up at your pharmacyWhen prescription treatment is appropriate, it may be sent electronically to the pharmacy you select. Medication availability, cost, insurance requirements, and dispensing time vary. |
Prescriptions when appropriate
🏪 A prescription when you need one. Good guidance either way.
Not every case needs a prescription — and we'll tell you honestly if OTC support and hydration are what you need. When prescription treatment is clinically appropriate based on your provider's assessment, it may be sent electronically to the pharmacy you select.
- ✓Prescriptions, when clinically appropriate, may be sent electronically to your selected pharmacy
- ✓Medication availability, cost, and dispensing time vary — allow time before your departure date if preparing in advance
- ✓No required membership to access our telehealth services
- ✓Visits may be HSA/FSA eligible — check with your plan administrator
- ✓If we cannot help you through telehealth, you will not be charged
Frequently asked questions
❓ Your questions answered
Do I need a prescription antibiotic before I travel?
Most travelers don't. Preventive antibiotics taken daily are not routinely recommended — potential side effects, microbiome disruption, and the risk of carrying antibiotic-resistant organisms generally outweigh the benefit for otherwise healthy travelers. What most people benefit from is a practical OTC kit and knowing what warning signs mean you need more than self-care. A standby prescription may be worth discussing at a pre-travel consultation if you're heading somewhere remote or have specific health conditions that raise your risk — but it should come with clear instructions on when to use it and when to seek care instead.
What's the difference between traveler's diarrhea and food poisoning?
"Food poisoning" is a general term for illness caused by contaminated food or drink. It may result from bacteria, viruses, parasites, or toxins already present in food. Traveler's diarrhea describes diarrhea acquired during or shortly after travel and can have many of the same causes. Timing and symptoms alone usually can't identify the exact organism, so severity and warning signs are more useful for deciding what care you need than trying to label what you have.
Is Imodium safe to take while traveling?
Loperamide may provide short-term relief for many otherwise healthy adults with uncomplicated, non-bloody diarrhea — useful when you need to travel and can't stay near a bathroom. The important caveat: do not self-treat with it if diarrhea is bloody, accompanied by fever, or associated with severe or worsening abdominal pain. In those situations, seek care instead. It's also not appropriate for every age group or medical condition, so follow the label or your provider's guidance.
What should I drink if I get sick?
Oral rehydration solution is the preferred way to replace fluids and electrolytes when diarrhea or vomiting causes meaningful fluid loss. Pack ORS packets formulated for diarrhea-related dehydration and mix them only with the amount of safe water stated on the label. Commercial electrolyte drinks vary and are not all equivalent to a properly formulated ORS. Avoid caffeinated drinks and alcohol while symptomatic. If you develop signs of significant dehydration — very little urine, dizziness, confusion, or inability to keep up with fluid losses — seek in-person care promptly; don't wait until you can't drink at all.
How long does traveler's diarrhea usually last?
Duration varies depending on the cause. Many uncomplicated cases improve within several days with hydration and rest, but this isn't guaranteed — some infections take longer, and a few causes can persist for weeks without treatment. Seek evaluation sooner if symptoms are severe, worsening, or causing dehydration. Diarrhea that lasts more than 14 days is considered persistent and should be evaluated for parasitic, postinfectious, or other causes that may require stool testing and targeted treatment.
Can I get treated while I'm traveling abroad?
MyPhysician360's ability to provide care depends on your physical location and applicable licensure rules — a visit may not be available while you are outside the United States. The most practical approach is to prepare before you leave: pack an ORS kit and appropriate OTC items, know the warning signs that mean you need in-person care, and have a plan for accessing local medical services if needed. If you're back home and still symptomatic, a telehealth visit is a convenient way to get evaluated.
Is this visit HSA or FSA eligible?
Visits may be eligible — check with your plan administrator to confirm based on your specific plan.
Trusted resources
📚 Helpful references
🌍 Destination risk and guidance Traveler's diarrhea — risk by destination and prevention guidance CDC Travelers' Health Visit CDC Travelers' Health |
💧 Safe water and food abroad Food and water safety for international travelers World Health Organization (WHO) Visit WHO Travel Advice |
Leave prepared. A provider can help you get there.
Whether you want to talk through your trip before you go or you're dealing with symptoms that aren't clearing up, a licensed provider is here to help. Most cases don't need a prescription — but you'll leave the visit knowing exactly what you do need.
HSA & FSA eligible — check with your plan administrator | No required membership | No charge if we can't help
Medical disclaimer: The information on this page is for general educational purposes only and does not constitute medical advice. Traveler's diarrhea and foodborne illness have many causes — symptoms alone cannot identify the specific organism or determine whether antibiotic treatment is appropriate. Bloody diarrhea, black or tarry stool, high fever, significant dehydration, severe abdominal pain, or illness in pregnant, immunocompromised, pediatric, or elderly travelers requires prompt in-person medical evaluation; do not self-treat these presentations with antidiarrheal medication. Fever during or after travel to a malaria-risk area requires urgent medical evaluation and a complete travel history, even when gastrointestinal symptoms are present. Whether any prescription treatment is appropriate depends on individual health history and a licensed provider's clinical judgment; nothing on this page constitutes a guarantee of any prescription or specific treatment. Medication choices and safety profiles differ for children — caregivers should consult a pediatric healthcare professional before giving any OTC or prescription medication for diarrhea to a child. Preventive daily antibiotics are not routinely recommended for most travelers. MyPhysician360's ability to provide care depends on the patient's physical location and applicable licensure rules. A licensed MyPhysician360 provider will review your complete health history before making any clinical recommendations. Services are not currently available in Mississippi or Alaska.