Conditions
Traveler's diarrhea: treatment and when to worry
Traveler's diarrhea usually lasts 2 to 7 days and most often gets better with fluids and oral rehydration salts. If it is ruining your plans, not improving, or comes with fever or blood in the stool, our doctor can see you by video, give you a lab order if needed and, if appropriate, prescribe. We see tourists and residents of all ages in Puerto Rico.
Is it an emergency? Call 911.
Is this an emergency?
This is not an emergency service. Call 911 or go to the nearest emergency room if you have:
- Blood in the stool, or black stool
- A fever of 102 °F (38.8 °C) or higher
- Not urinating, very dark urine, dizziness or confusion (serious dehydration)
- Vomiting that stops you keeping fluids down
- Severe or constant belly pain
- A baby or young child who is listless, has no wet diapers or can't drink
Help lines
At a glance
Traveler's diarrhea
Common symptoms
- Loose stools and an urgent need to go
- Cramps or belly pain
- Nausea or vomiting
- Fever
- Blood in the stool, in the most severe cases
- Other names
- Diarrhea on vacation
- Usual test
- Stool test, only if diarrhea persists or the evaluation calls for it
- Treatment
- Oral rehydration; antibiotic only when the medical evaluation calls for it
- Possible complication
- Dehydration
On this page(9)
What is traveler's diarrhea?
Traveler's diarrhea is diarrhea that starts during or right after a trip, from contaminated food or water. According to the CDC, bacteria cause 75% to 90% of cases; viruses such as norovirus, and parasites, cause the rest.
The CDC estimates that 30% to 70% of travelers get it during a 2-week trip, but that range is global and varies a lot by destination: it is not a Puerto Rico figure. It can still happen here, especially after a buffet, a cruise, or food that sat out in the heat. If symptoms started after eating reef fish and come with tingling in the mouth, hands or feet, it may be ciguatera.
If you live on the island and picked up a stomach virus at home, read about the stomach bug in adults instead.
How we treat traveler's diarrhea by video
You see Dr. Diana Nieves Castro, a Puerto Rico-licensed general practice physician with several years of emergency-department experience, in English or Spanish. The doctor asks when it started, how often you are going, whether there is fever, blood or vomiting, how well you are keeping fluids down and what you ate, and checks for signs of dehydration.
We evaluate, diagnose and treat; if needed, we give you a lab order for a lab near you. If appropriate, the doctor prescribes and we send your prescription to your pharmacy. We do not prescribe controlled substances, and we never promise an antibiotic before the evaluation.
On vacation or a cruise? See our care for tourists and visitors. You need to be physically in Puerto Rico during the visit. If the patient is under 21, a parent or legal guardian stays on camera for the whole visit and shows photo ID.
Your doctor
Dr. Diana Nieves Castro, MD
General practice physician
Several years of emergency-department experience.
Founding Executive Director of The Health Initiative.
Your visit in 3 steps
Request a visit online 24/7 — we confirm your time by email or text.
Request your visit.
Book a visit, choose "Doctor visit" and pay by card.
See the doctor.
We send you a secure video link. It works on your phone, tablet or computer, including from your hotel room.
Get your plan.
If appropriate, the doctor prescribes and we send your prescription to your pharmacy; if a test would help, you get a lab order.
What the visit costs
A doctor visit costs US$79, the same price for every age, with no membership. Your card is charged when you request the visit, and you get a full refund if the visit can't take place. A doctor's note after your visit is included at no extra charge, which helps if you need to change a flight.
We do not bill insurance; on request we give you an itemized receipt (superbill). See all prices.
Traveler's diarrhea symptoms
The CDC describes symptoms that start suddenly and range from mild to severe:
- Loose stools and an urgent need to go
- Cramps or belly pain
- Nausea or vomiting
- Fever
- Blood in the stool, in the most severe cases
Treatment, and when a test is ordered
Rehydrate first. Take frequent sips of oral rehydration salts or drinks with electrolytes. The CDC says bacterial diarrhea usually lasts 3 to 7 days untreated and viral diarrhea 2 to 3 days.
Over-the-counter medicine. Loperamide cuts down how often you go, but the CDC says not to use it with bloody diarrhea or fever. Bismuth subsalicylate is not for people with an aspirin allergy, gout, kidney problems or on blood thinners, and not for children under 3 or pregnant women; it is also avoided in children and teens with a viral infection. Loperamide is rarely given to children under 6: ask the doctor before giving either one to a child. Ask the doctor or pharmacist if you are unsure.
Antibiotics. The CDC reserves them for moderate or severe diarrhea, the kind that stops you doing anything or brings blood. The doctor decides whether one is appropriate for you.
Tests. If diarrhea lasts more than 2 weeks, or the doctor suspects a parasite or an infection that needs specific treatment, we give you a lab order for a stool test at a lab near you and go over the result with you.
Diarrhea on a cruise
According to the CDC, norovirus causes more than 90% of diarrhea and vomiting outbreaks with a confirmed cause on cruise ships. Wash your hands with soap and water, especially before eating and after using the bathroom, and tell the ship's medical center if you get sick. In port in San Juan? See the cruise passenger guide.
Children and dehydration: when to go to the ER
Children dehydrate faster. If you are traveling with a child who has diarrhea, see diarrhea and vomiting in children. According to MedlinePlus, signs of serious dehydration include not urinating or very dark urine, dry skin, sunken eyes, dizziness, a fast heartbeat or breathing, irritability or confusion.
Go to the emergency room or call 911 for fainting, confusion, a fever of 102 °F (38.8 °C) or higher, blood in the stool, vomiting that stops you keeping fluids down, or severe belly pain. See when to go to the ER.
How we care for you
We evaluate, diagnose and treat; if needed, we give you a lab order for a lab near you.
We see adults and children of all ages. Patients under 21: a parent with patria potestad (parental authority) or a legal guardian is on camera for the whole visit and shows photo ID.
Real-time video visit. We send you a secure video link. It works on your phone, tablet or computer.
If appropriate, the doctor prescribes and we send your prescription to your pharmacy. We do not prescribe controlled substances.
You must be physically in Puerto Rico during the visit (visitors, tourists and cruise passengers are welcome).
In an emergency, call 911.
Frequently asked questions
How long does traveler's diarrhea last?
Can I take loperamide for traveler's diarrhea?
Can I see a doctor by video for diarrhea while on vacation in Puerto Rico?
Do I need an antibiotic for traveler's diarrhea?
About this page
Author: The Health Initiative
Medical care provided by Dr. Diana Nieves Castro, MD (PR license 24027)
Disclosure: Founding Executive Director of The Health Initiative
Published: 2026-09-30 · Updated: 2026-10-02
Sources (4)
- Travelers' Diarrhea, CDC Yellow Book (CDC) (opens in a new tab) (accessed 2026-10-02)
- Cruise Ship Travel, CDC Yellow Book (CDC) (opens in a new tab) (accessed 2026-10-02)
- Dehydration (MedlinePlus, NIH) (opens in a new tab) (accessed 2026-10-02)
- Food poisoning from marine toxins (CDC Yellow Book) (opens in a new tab) (accessed 2026-10-02)