Dr Sarah Jarvis, MBE
Author: Dr Sarah Jarvis, MBE, General Practitioner (GP)

Dr Sarah Jarvis is the Clinical Director of the Patient Platform, an active medical writer, broadcaster, and the resident doctor for BBC Radio 2.

7 min read

Long gone are the days when most of my patients’ holidays were to Blackpool or Benidorm. These days, it’s easier than ever to jet off to exotic locations, often at the last minute.

With far-flung destinations so easy to access, it can be all too easy to forget that hygiene conditions there are very different to those we take for granted in the UK. That’s probably why traveller’s tummy (also called traveller’s diarrhoea) is the most common illness my patients complain of on their return.

So how can you ensure you spend your holiday gazing at the sights, not the walls of your hotel bathroom? And what do you do if you are unlucky enough to come down with traveller’s tummy?

Think Before You Eat

When my patients are travelling anywhere outside Western Europe, the USA or Australasia, my advice where food is concerned is almost always “Boil it, peel it, cook it or forget it”.

While you may think you’re safe with a nice salad, do remember that it may have been washed in contaminated water.  Fruit is usually fine as long as you’ve peeled it.

Food from street vendors may smell tempting, but think about how many flies have thought the same! The same principle applies to buffet food which has been standing at room temperature.

Of course, tummy bugs can happen anywhere, including the UK. Seafoods like oysters, prawns and mussels are often a culprit for upset stomachs. So while you may be tempted to indulge on your holiday, do make sure shellfish is fresh and thoroughly cooked before eating.

Watch Your Water

Many countries don’t treat their drinking water to the same standards as we expect in the UK. Tap water isn’t safe to drink in much of Asia (Japan is an exception) or Africa and South America. Even in countries in Eastern Europe, water may be safe in the cities but more risky in the countryside.

If in doubt:

  • You can drink bottled drinks, with an intact seal, safely almost anywhere in the world.
  • Alternatively, boiling water for at least a minute will get rid of harmful germs. Hot drinks should also be safe if they’re made from boiling water.
  • If you’re going to an at-risk country, consider buying water purification tablets (available from many travel equipment shops) to purify your water.
  • Use bottled or purified water to brush your teeth as well as to drink.
  • Avoid adding ice, which may have been made from contaminated water, to your drinks.

Wash Your Hands - A Lot!

Since the pandemic, we’ve all become much more aware of the risk of transmitting illness by picking up contamination on our hands. Most tummy bugs are passed on largely via the ‘faecal-oral route’ which is every bit as squirm-inducing as it sounds.

Basically, someone with a bug goes to the loo and doesn’t wash their hands thoroughly after wiping, meaning they have germs on their hands. They either touch your hands directly, or deposit the germs onto a hard surface, where you pick them up with your hands. You put your hands to your mouth (or use your hands to touch your food) and hey presto, the bugs have found another host.

Always wash your hands with soap and water after you visit the loo and before you eat or smoke. If you can’t access soap and water, hand sanitizer (containing at least 60% alcohol) is a good substitute.

Drinking Water

If You Get a Tummy Bug

Be prepared with tablets

  • You can buy medication such as Imodium from many pharmacies. Take a pack with you in case you’re caught out, and follow the instructions on the pack. If you don’t have any, you may be able to get some without prescription from local pharmacies.
  • Fill up on fluid. The biggest risk with tummy bugs is dehydration.

Know when to seek help

If you have traveller’s diarrhoea, you may also get nausea, vomiting and tummy pain. Most cases settle within a few days, but you should seek medical help if:

  • Your symptoms last for more than 5-7 days
  • You're having so much diarrhoea or vomiting that you can’t get enough fluids down to avoid dehydration. Symptoms include feeling thirsty; headaches and muscle cramps; passing small amounts of dark urine; feeling dizzy or weak.

Take Relevant Tablets With You

One of the best ways to avoid a traveller's tummy, whether this is from travel sickness or from new and unusual foods, is to make sure you have adequate tablets with you to ease the pain and soreness.

If you suffer from travel sickness, then make sure you are packing sickness tablets or travel sickness preventatives with you and taking them prior to travelling so they have time to take effect before flying or sailing.

Packing ibuprofen, paracetamol or other pain relief tablets with you in case of stomach pains is always a good idea and means you’ll never be caught short. Other tablets like Imodium are always a wise choice too to try and prevent travellers’ tummy.

Drink Plenty of Fluids

It goes without saying, but one of the best ways to stay fit and well whilst on holiday, especially if you’re in a warm climate is to make sure you’re drinking plenty of water. Guidance in the UK is to drink roughly 1.2 litres of water daily, but in warmer climes, this may be more due to excess heat and sweating.

Drinking plenty of liquids flushes toxins through the body and means that bad bacteria and viruses travel through, and out of the body much quicker, meaning the likelihood of you feeling unwell is much slimmer.

However, it is really important when you’re abroad to check the water you are drinking and whether tap water is safe, this is something that the blog Along Dusty Roads speaks about in an article:

“In many, many countries across the world, drink the water that comes out of the tap, and there's only one place you're going to end up - the bathroom. In these situations, you have two options. Spend money on dozen of plastic bottles that are slowly killing the planet, or find some way to make the water safe. Unsurprisingly, we go for option number two. Either bring with you on your travels a water bottle that has an in-built filter or uses a steripen. Some accommodations will provide filtered water, in which case, refill a quality glass water bottle each day. Do note that even in countries where the tap water is technically sanitary, mineral levels can vary quite significantly so ease your body in gently.”

Getting sick whilst on holiday is something none of us want to endure, but sometimes these things can’t be helped, which is why you must have travel medical insurance to cover you in case of emergency healthcare and the cost of treatment.

Medical Travel Compared offer travel insurance for a whole host of pre-existing conditions, so you don’t have to worry about finding cover for your condition. For more articles and inspiration like this one, make sure you head over to the blog.

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