Travellers’ diarrhoea is the most common illness affecting travellers, caught mainly from food and water contaminated with bacteria, viruses or parasites where hygiene standards differ from Singapore’s. It is usually mild and self-limiting, settling on its own in a few days, and the priority is preventing dehydration rather than simply “stopping” the diarrhoea. Oral rehydration is the mainstay; antibiotics are not routine, and anti-motility medicines such as loperamide must be used with care.
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In a medical emergency, or for severe or sudden symptoms such as breathing difficulty, chest pain, fainting or stroke signs, call 995 immediately.
Blood or mucus in the stool, a high fever, severe or persistent symptoms, or signs of dehydration — and any diarrhoea in an infant, elderly, pregnant or immunocompromised traveller — need medical care; symptoms that persist after returning home should be checked.
How it is caught
The usual route is eating or drinking something contaminated with bacteria (the most frequent cause, such as certain E. coli, Campylobacter or Salmonella), viruses like norovirus, or parasites such as Giardia, which tends to cause more prolonged illness. Higher-risk exposures include street food, premises with poor hygiene, raw or undercooked meat and seafood, unpasteurised dairy, raw salads, and tap water or ice made from it. Unfamiliar food, more alcohol than usual and travel stress can add to symptoms.
Symptoms
Typically there are loose or watery stools — often three or more unformed stools in 24 hours — with stomach cramps, nausea, sometimes vomiting, bloating, urgency and occasionally a low-grade fever. It usually starts during the trip or within about a week or so of travel. The main danger is dehydration, so watch for a dry mouth, increased thirst, tiredness, passing less or darker urine, and dizziness, particularly in young children and older travellers.
Red flags
Seek medical care — abroad or on return — for blood or mucus in the stool, a high fever, severe or persistent diarrhoea or vomiting, severe abdominal pain, or signs of significant dehydration such as very little urine, marked weakness or confusion. Infants, the elderly, pregnant women and people who are immunocompromised or have a chronic illness should be assessed early. Symptoms that do not settle in a few days, or any that persist after returning to Singapore, warrant seeing a doctor, since prolonged post-travel diarrhoea can point to a parasite needing a stool test. Collapse or severe dehydration is a 995 emergency.
Treatment
Oral rehydration is the priority. Replace lost fluids and salts with oral rehydration salts (ORS) mixed with clean, bottled or boiled water, sipped frequently — especially important for children, older travellers and anyone with more than mild symptoms — and keep eating as tolerated once you are able. Loperamide can reduce mild-to-moderate watery diarrhoea in adults, but it is generally avoided if there is bloody diarrhoea, mucus in the stool or a high fever, is not for young children without medical advice, and does not treat the infection — check the label or ask a pharmacist, and this guide gives no doses. Antibiotics are not routine and not for prevention, because of side effects and antibiotic resistance; a “standby” course may be considered only for higher-risk travellers or remote trips, and only when prescribed in advance after individual assessment. Bloody or feverish illness is a reason to see a doctor rather than self-treat.
Preventing it
Careful food and water habits reduce the risk (though they do not remove it entirely). Drink only sealed bottled, boiled or properly treated water, avoid ice made from tap water, and choose food that is freshly and thoroughly cooked and served piping hot. Peel fruit yourself after washing it in clean water, and avoid raw salads, food left at room temperature, and unpasteurised dairy. Wash your hands with soap and water before eating and after the toilet, and carry an alcohol-based hand sanitiser (at least 60% alcohol) for when soap is not available — see our guide to food and water safety abroad. Packing oral rehydration salts before you travel means you are ready if it happens.
Special situations
Some travellers need extra care. In babies and young children, dehydration develops quickly, so oral rehydration salts should be started early and medical help sought promptly rather than waiting; anti-diarrhoeal medicines such as loperamide are not suitable for young children without medical advice. Older travellers, pregnant women, and anyone with a chronic illness or a weakened immune system should also be seen sooner rather than later, as they tolerate fluid loss less well and can become unwell faster. Making up oral rehydration salts correctly matters — use the stated volume of clean, bottled or boiled water rather than guessing the concentration — and keep sipping small amounts frequently even if nausea makes it tricky. If you are managing diabetes or take medicines such as diuretics or blood-pressure tablets, an episode of diarrhoea and vomiting can upset them, so ask a pharmacist or doctor about what to do when unwell before you travel.
When to see a doctor
See a doctor for any red flag above, for diarrhoea in a higher-risk traveller, for symptoms lasting more than a few days, or for any diarrhoea that continues after returning to Singapore — and call 995 for severe dehydration or collapse. A travel clinic or GP can also advise before the trip on precautions and what to pack.
Related travel-health topics
- Pre-travel health advice
- Travel vaccinations
- Food & water safety abroad
- Altitude sickness
- Motion sickness
- Travel-related DVT
- Rabies
- Japanese encephalitis
- Insect bite prevention
- Travelling with medication
- Malaria prevention
- Travel clinics in Singapore
Sources
- HealthHub (Singapore) — Travellers’ Diarrhoea: healthhub.sg
- Communicable Diseases Agency (CDA) Singapore — Health advice for travellers: cda.gov.sg
- NaTHNaC / TravelHealthPro — Travellers’ diarrhoea: travelhealthpro.org.uk
- CDC Yellow Book — Travelers’ Diarrhea: cdc.gov