Nobody packs for a family holiday expecting to spend days confined to a hotel room, desperately hoping no one else needs to use the bathroom. Yet traveller’s diarrhoea remains one of the most common illnesses affecting travellers around the world.
Depending on where you’re travelling, you may hear it called Bali Belly, Delhi Belly, Montezuma’s Revenge or Pharaoh’s Curse. While the names vary, they all describe a similar problem: an upset stomach caused by bacteria, viruses or parasites that your body isn’t used to.
The good news is that traveller’s diarrhoea is often preventable. By taking a few simple precautions before and during your trip, you can significantly reduce your chances of getting sick and enjoy more of your holiday.
What is traveller’s diarrhoea?
Traveller’s diarrhoea is a digestive illness that typically causes frequent loose stools, stomach cramps, nausea and sometimes vomiting or fever.
It usually occurs when travellers consume food or water contaminated with harmful microorganisms. Even destinations with excellent tourism infrastructure can pose a risk, particularly if hygiene standards vary between restaurants, street vendors and local water supplies.
Children can be particularly vulnerable because they may become dehydrated more quickly than adults.
The many names for traveller’s diarrhoea
Around the world, traveller’s diarrhoea has picked up a variety of colourful nicknames.
Bali Belly: Probably the most well-known term among Australian travellers, Bali Belly refers to traveller’s diarrhoea contracted in Indonesia.
Delhi Belly: A common term used by travellers visiting India and parts of South Asia.
Montezuma’s Revenge: Traditionally associated with travel to Mexico and Central America.
Pharaoh’s Curse: Often used to describe stomach illnesses experienced by travellers visiting Egypt.
Traveller’s Tummy: A more family-friendly term often used when travelling with children.
Despite the different names, the causes and prevention methods are largely the same.
What causes traveller’s diarrhoea?
Many people assume traveller’s diarrhoea is caused by one specific food, but that’s rarely the case.
The most common causes include:
- Contaminated drinking water
- Ice made from unsafe water
- Undercooked meat or seafood
- Unwashed fruits and vegetables
- Poor food handling practices
- Unpasteurised dairy products
- Viruses such as norovirus
- Bacterial infections including E. coli
- Parasites found in contaminated food or water
Sometimes travellers become sick despite taking precautions. Exposure can occur through something as simple as brushing your teeth with tap water or touching a contaminated surface before eating.
Traveller’s diarrhoea isn’t always caused by “dirty water” either. Many cases are caused by bacteria, viruses or parasites that are harmless to local residents because they’ve developed immunity through repeated exposure, but which can make visitors very sick. That’s why two people can eat the same meal and only the tourist gets sick.
How to avoid traveller’s diarrhoea
While no prevention strategy is foolproof, these tips can greatly reduce your risk.
Be careful with drinking water
While Australians rarely think twice about drinking straight from the tap, only around 50 countries are generally regarded as having tap water that’s safe for visitors to drink. In destinations where tap water isn’t considered safe to drink, stick to bottled, filtered or properly treated water.
Also remember to:
- Use safe water when brushing your teeth
- Avoid swallowing water while showering
- Check that bottled water seals are intact
- Use safe water when preparing baby formula
Think twice about ice
Ice is often overlooked as a source of contamination.
Unless you’re confident the ice was made using purified water, it may be safer to order drinks without it.
Eat food that is freshly cooked
Food that is served piping hot is generally safer than food that has been sitting at room temperature.
Choose:
- Freshly cooked meals
- Busy restaurants with high turnover
- Reputable food vendors
Be cautious with:
- Buffets that have been sitting for long periods
- Lukewarm food
- Food stored without refrigeration
Wash or sanitise your hands frequently
Good hand hygiene is one of the simplest and most effective ways to prevent illness while travelling.
Wash your hands:
- Before eating
- After using the bathroom
- After handling money
- After touching animals
Carry hand sanitiser for situations where soap and water aren’t available.
Be selective with street food
Street food is often one of the highlights of travel and can be perfectly safe.
Look for stalls that:
- Are busy with locals
- Cook food fresh in front of you
- Maintain clean preparation areas
Avoid food that appears to have been sitting out for long periods.
Peel it, cook it or leave it
A useful travel rule is:
“If you can’t peel it, boil it or cook it, think carefully before eating it.”
Fruits with protective skins, such as bananas, oranges and mangoes, are generally safer choices than pre-cut fruit.
It’s often recommended to avoid salad in counties with unsafe drinking water due to the fact that it could be rinsed in tap water.
Can you still get Bali Belly at a resort?
Unfortunately, yes.
Many travellers assume that staying at a luxury resort eliminates all risk, but traveller’s diarrhoea can occur anywhere. While reputable hotels and resorts typically maintain high hygiene standards, exposure can still happen through excursions, restaurants outside the resort or contaminated surfaces.
Even buffet breakfasts can pose risks if food has not been stored or handled correctly.
What should you pack?
A simple travel health kit can be invaluable.
Consider packing:
- Oral rehydration salts
- Anti-diarrhoeal medication (where appropriate)
- Hand sanitiser
- Disinfectant wipes
- Prescription medications
- A digital thermometer
If travelling with children, speak with your doctor before departure about medications suitable for their age.
What should you do if you get traveller’s diarrhoea?
If symptoms occur, focus on hydration.
Drink:
- Bottled water
- Oral rehydration solutions
- Electrolyte drinks
Seek medical attention if symptoms include:
- High fever
- Blood in stools
- Severe dehydration
- Persistent vomiting
- Symptoms lasting more than a few days
Young children, older adults and people with underlying health conditions should seek medical advice sooner.
Why travel insurance is non-negotiable
Most cases of traveller’s diarrhoea resolve without serious complications, but some can require medical treatment, hospital visits or changes to travel plans.
Comprehensive travel insurance can help cover:
- Overseas medical expenses
- Hospital treatment
- Emergency assistance
- Additional accommodation costs
- Changes to flights and travel arrangements
The cost of medical treatment overseas can quickly exceed the cost of an entire holiday, making travel insurance one of the most important items on your packing list.
In a nutshell
Traveller’s diarrhoea may be common, but it doesn’t have to ruin your holiday.
Whether you’re worried about Bali Belly in Indonesia, Delhi Belly in India or Montezuma’s Revenge in Mexico, the same principles apply: drink safe water, practise good hygiene, choose food carefully and make sure you have comprehensive travel insurance before you leave home.
A few simple precautions can go a long way towards keeping your family healthy and ensuring your holiday memories are made for the right reasons.
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