Tourist diarrhoea often strikes during the first week at the travel destination, but it can recur, perhaps even repeatedly, during one's stay. As a rule, diarrhoea lasts from a few days to about a week and typically goes away on its own.

• Make sure that you do not infect anyone else. Be careful with hand hygiene.
• Remember that diarrhoea and vomiting can reduce the effect of any medication that you may be using.

Medicinal charcoal has a highly dubious effect on diarrhoea.

Food and Fluid Replenishment

Diarrhoea can result in substantial fluid and salt losses. One clear sign of this is that there is a darker and smaller amount of urine than normal. It is important that you replenish lost fluids by drinking abundantly and often. Avoid solid food for the first 24 hours if you don’t like how it tastes.

Children run a very great risk of suffering from fluid loss in connection with diarrhoea. The smaller the child, the greater the risk. Dryness of the mouth, dark and reduced urine, lethargy, fever and sunken eyes are serious symptoms of a lack of fluid.

Semper fluid replenishment (can be flavoured with about a teaspoon of concentrated fruit juice) is recommended for children, but you can also mix in your own fluid replenishment formula:

• 1 litre of bottled, boiled or purified water (see under the heading “Water Purification”)
• 0.5 - 1 teaspoon of salt and 2-3 tablespoons of sugar (which allows the salt to be absorbed by the body more easily)
• feel free to flavour with apple or lemon juice.

The liquid is drunk cool and is kept for a maximum of one day in the refrigerator.


Day 1

Nursing infants
Continue to nurse the infant, but more often than usual. Extreme cases of diarrhoea or vomiting also call for replenishing fluids. It may be necessary to spoon-feed. If so, give small amounts at a time, but do it often. The child should be given at least 700-800 ml of liquid per day.

Children up to 3 years of age
During the first four hours, give only replenishing liquid (approx 100 ml per hour). Over the remaining portion of the first 24-hour period, give approximately 1000 ml of liquid in a mixture of 2/3 replenishing liquid and 1/3 corn gruel.

Children over 3 years of age
During the first four hours, give only replenishing liquid (approx 100 ml per hour). During the remaining portion of the first 24-hour period, give approximately 1500 ml of replenishing liquid.

Adults
Adults should drink at least 200 - 300 ml per hour. Drink whatever you think tastes good; pure water, carbonated beverages, fruit juice (orange juice is excellent), soup or tea. If in addition to suffering from diarrhoea you also vomit, try taking small sips, for example, every five minutes.



Day 2

Children
Continue with the liquid supplement in approximately the same quantity as before. If the child can keep down the liquid, carefully begin with boiled food, e.g., potatoes, rice, fish or meat. Carrot purée / soup (1 can of purée, 200 ml of water, 2 teaspoons of sugar and a little salt) works very well. Give frequent small meals.

Adults
Even if the diarrhoea continues, begin to eat lighter food, e.g., mashed bananas, crisp bread, rice, boiled potatoes. Dairy products, raw vegetables and fruit other than bananas can exacerbate the diarrhoea. Avoid alcohol, coffee and heavy, fatty meals.

Afterwards 
As the diarrhoea subsides, return gradually to your regular food. If on the other hand the diarrhoea/vomiting continues or returns, wait before returning to solid food.



Pharmaceutical treatment of adults and children over 12 years old

There are two different medicinal ways of reducing diarrhoea:

• anti-diarrhoeal agents that stop the diarrhoea but do not remedy the cause, and
• antibiotics that attack the infection itself.

Anti-diarrhoeal agents - loperamide - can within the course of a few hours stop a mild case of diarrhoea. This may be practical if, for example, you need to sit on a bus or an aeroplane for a period of time. The agent should not be given to children under 12 years old. Neither should they be used if you are pregnant, have a fever or suffer from bloody diarrhoea. Moreover, anti-diarrhoeal agents should not be used more than two days in a row. At the same time, you should continue to drink more than usual.

Antibiotics attack bacterial infections and can be used if dietary treatments and anti-diarrhoeal agents do not help. However, the use of antibiotics increases the risk of spreading antibiotic-resistant bacteria. Therefore, antibiotics should only be used for self-treatment and in cases of severe diarrhoea. If you become lethargic, urinate less or have darker urine than usual, get a fever, frequent vomiting or bloody diarrhoea, seek a physician as soon as possible. If no doctor is available, you should definitely begin with the antibiotic treatment! Moreover, continue to ingest liquid. Once the diarrhoea has stopped, you can stop with the antibiotic remedy.


Seek a physician as soon as possible

• If the sick person becomes lethargic, has sunken eyes, drinks poorly or urinates in small amounts
• In the case of bloody diarrhoea, severe abdominal pains, high fever or repeated vomiting.
• If the diarrhoea in the case of an infant continues for more than about a day and the child is urinating small amounts.
• If the diarrhoea in the case of a child lasts for more than 3 days.
• If the diarrhoea in the case of an adult lasts for more than 5-6 days.