Traveller's diarrhoea is by far the most com­mon problem affecting travellers - between 30% and 50% of people will suffer from it within two weeks of starting their trip. In over 80% of cases, traveller's diarrhoea is caused by bacteria (there are numerous potential culprits), and therefore responds promptly to treatment with antibiotics. Treatment with antibiotics will depend on your situation -how sick you are, how quickly you need to get better, where you are etc.

Traveller's diarrhoea is defined as the pas­sage of more than three watery bowel-actions within 24 hours, plus at least one other symp­tom such as fever, cramps, nausea, vomiting or feeling generally unwell.

Treatment consists of staying well hydrated. Rehydration solutions like Gastrolyte are the best for this. Antibiotics such as Norfloxacin, Ciprofloxacin or Azithromycin will kill the bacteria quickly.

Loperamide is just a 'stopper' and doesn't get to the cause of the problem. It can be help­ful, for example if you have to go on a long bus ride. Don't take Loperamide if you have a fever, or blood in your stools. Seek medical attention quickly if you do not respond to an appropriate antibiotic.

Amoebic Dysentery

Amoebic dysentery is very rare in travellers but is often misdiagnosed by poor-quality labs in Southeast Asia. Symptoms are similar to bacterial diarrhoea, ie fever, bloody diarrhoea and generally feeling unwell. You should al­ways seek reliable medical care if you have blood in your diarrhoea. Treatment involves two drugs; Tinidazole or Metronidazole to kill the parasite in your gut and then a sec­ond drug to kill the cysts. If left untreated complications such as liver or gut abscesses can occur.

Giardiasis

Giardia lamblia is a parasite that is relatively common in travellers. Symptoms include nausea, bloating, excess gas, fatigue and in­termittent diarrhoea. 'Eggy' burps are often at­tributed solely to giardiasis, but work in Nepal has shown that they are not specific to this infection. The parasite will eventually go away if left untreated but this can take months. The treatment of choice is Tinidazole, with Metro­nidazole being a second line option.