Most episodes of acute diarrhoea get better without the need for specific medical advice. However, if diarrhoea persists for more than 14 days, is associated with blood and/or high fever, or if cramping abdominal pain becomes severe or constant then you should seek medical advice. If you are a food handler then you should consult your doctor and inform your employer.

What will the doctor do?

• The doctor will want to talk to you about your symptoms to try to identify a cause. The doctor will also want to examine you, including your abdomen and possibly your back passage.

• The most important test to perform at this stage is an examination of your stool to determine whether there are any infective agents present that might be the cause of the diarrhoea and other symptoms.

• It may also be necessary to examine the bowel by endoscopy to determine whether there is inflammation in the rectum or colon (colitis).

How should I treat diarrhoea?

• Before starting any treatment it is worthwhile considering that there might be an aggravating factor such as acute stress and anxiety, excess alcohol or a new recently prescribed drug.

• Most episodes of acute diarrhoea will settle spontaneously without the need for any medical treatment. However, if the episode is severe, it is important to ensure that you take additional fluids and salts to replace those lost in the diarrhoea. For infants, young children and the elderly who are more sensitive to fluid losses, it is wise to use a pre-prepared oral rehydration solution which can be purchased over the counter of most pharmacies.

• For most adults oral rehydration can usually be achieved simply by increasing fluid intake in the form of mineral water, fruit juices (which also contain potassium) and salty soups (sodium), together with some form of carbohydrate (rice, pasta, salty crackers) which is important for promoting fluid and salt absorption.

• There is no need to stop eating although sufferers often prefer a lighter diet in the early phase of the illness. There need be no interruption in breast feeding for breast fed infants. Bottle-fed infants should still receive full-strength formula milk.

• An anti-diarrhoeal drug such as loperamide is available from pharmacies without prescription. This is often helpful early in the illness to reduce bowel frequency. However, it should not be used in infants and very young children because of concerns that it may depress respiration.

• For travellers with severe diarrhoea for whom loss of one or two days would seriously affect their activities (particularly the business traveller), the severity and duration of the illness can be dramatically reduced by taking a short course of a broad spectrum antibiotic. Even a single dose can be effective. If this might be the case, then it is worthwhile seeking medical advice about whether this might be appropriate for you before you travel.