Antibiotics kill the bacteria causing an infection, but they also affect the “good” bacteria that live in your gut. That’s why up to 1 in 3 people get loose stools or diarrhoea during or after a course. Probiotics are often suggested to help. Here’s what they can and can’t do.

What are probiotics?

Probiotics are live “friendly” bacteria or yeasts, found in supplements like Lactic acid bacillus (Vizylac) and in foods such as yoghurt with live cultures, kefir and some fermented foods.

Do they help after antibiotics?

Research suggests some probiotics can reduce the chance of antibiotic-associated diarrhoea, especially in children. The evidence is strongest for certain strains, such as Lactobacillus rhamnosus GG and the yeast Saccharomyces boulardii. Results vary by strain and dose, so not every probiotic will work the same way.

How to take them with antibiotics

• Space them out. Take the probiotic at least 2 hours before or after your antibiotic dose, so the antibiotic doesn’t kill it.
• Start early. Begin on the first day of the antibiotic course.
• Keep going a little longer. Many people continue for 1–2 weeks after the antibiotics finish.
• Follow the pack. Doses and storage (some need the fridge) differ between products.
• Always finish your antibiotics as prescribed, even if you feel better.

Food that helps your gut recover

• Fibre-rich foods: oats, beans, lentils, fruit and vegetables feed your good bacteria.
• Fermented foods: live yoghurt, kefir, sauerkraut and kimchi.
• Plenty of fluids, especially if you have loose stools.

Who should check with a doctor first

• People with a weakened immune system, for example during chemotherapy or after a transplant
• People who are seriously ill, or have a central line or catheter
• Premature babies
• Anyone pregnant or breastfeeding

When diarrhoea needs a doctor

See a doctor straight away if you have severe or watery diarrhoea many times a day, blood in your stool, a fever, or bad stomach cramps during or after antibiotics. These can be signs of a C. difficile infection, which needs treatment. Read more in our guide to stopping diarrhoea.

This article is for general information only and isn’t a substitute for advice from a doctor or pharmacist. Always read the label before using any medicine.

Getting ill abroad is stressful enough without hunting for a pharmacy in a language you don’t speak. A small travel health kit takes ten minutes to pack and covers the most common problems on the road.

Your regular medicines

• Pack enough for the whole trip, plus a few extra days in case of delays.
• Keep them in your hand luggage, in their original labelled packs.
• Carry a copy of your prescription or a letter from your doctor, especially for injections, controlled medicines or large quantities.
• Check the rules of the country you’re visiting. Some medicines that are legal at home are restricted elsewhere.

Stomach and travel sickness

• Motion sickness tablets such as Dramamine, taken 30–60 minutes before travelling. See our motion sickness guide.
• An anti-diarrhoeal such as Imodium for adults and children 12+. Read when to use it and when not to.
• Oral rehydration salts, to replace fluids if you get a stomach bug.
• A probiotic such as Vizylac, if you like to take one.

Allergies, aches and skin

• An antihistamine such as Claritin, Zyrtec or Allegra for hay fever, insect bites and hives. Which one?
• A pain and fever reliever such as paracetamol or ibuprofen.
• An antifungal cream such as Mentax: hot, sweaty shoes are a classic cause of athlete’s foot.
• Sunscreen (SPF 30+), after-sun and lip balm with SPF.
• Insect repellent, especially where mosquitoes carry disease.

First aid basics

• Plasters in different sizes and blister plasters
• Antiseptic wipes or cream
• A small roll of tape and gauze
• Tweezers and a digital thermometer
• Hand sanitiser

Before you go

• Check whether you need any vaccinations or malaria tablets. See a doctor or travel clinic 6–8 weeks before you leave.
• Get travel insurance that covers medical treatment and repatriation.
• Save the local emergency number and your insurer’s helpline in your phone.

This article is for general information only and isn’t a substitute for advice from a doctor or pharmacist. Always read the label before using any medicine.

Vaginal yeast infections (thrush, or vaginal candidiasis) are very common: most women get at least one in their lifetime. They’re caused by an overgrowth of Candida, a yeast that normally lives in the body in small amounts. They aren’t usually serious and respond well to treatment, but other conditions can look similar.

Common symptoms

• Itching and irritation in and around the vagina
• Burning, especially when urinating or during sex
• Redness and swelling of the vulva
• Thick, white, “cottage cheese” discharge, usually without a strong smell

What raises your risk

• Recent antibiotics, which reduce the “good” bacteria that keep yeast in check
• Pregnancy and hormonal changes
• Uncontrolled diabetes
• A weakened immune system
• Tight, non-breathable clothing and staying in damp clothes

Is it a yeast infection or something else?

Several conditions cause similar symptoms but need different treatment:

• Bacterial vaginosis (BV): thin, grey-white discharge with a strong fishy smell, especially after sex. Usually less itchy.
• Trichomoniasis: a sexually transmitted infection with frothy, yellow-green discharge and a bad smell.
• Urinary tract infection: burning, frequent urge to urinate, and cloudy urine, usually without itching.

Antifungal treatment won’t help these, so if you’re not sure, see a doctor or sexual health clinic.

Treatment

If you’ve had a yeast infection diagnosed by a doctor before and recognise the same symptoms, an over-the-counter antifungal can treat it. Clotrimazole vaginal tablets (Femcare) are inserted at bedtime for 7 nights in a row.

• Finish the full course, even if symptoms improve sooner.
• Avoid sex, tampons and douches during treatment.
• Clotrimazole can weaken latex condoms and diaphragms.
• Symptoms usually improve within 3 days. See a doctor if they don’t, or if they last more than 7 days.

See a doctor if

• It’s your first yeast infection, or you’re not sure that’s what it is
• You’re pregnant
• You have a fever, lower abdominal pain, or a foul-smelling discharge
• You get 4 or more infections a year, or it comes back within 2 months
• You have diabetes or a weakened immune system
• You’re under 12 or the person affected is a child

Prevention tips

• Wear breathable cotton underwear and change out of wet swimwear or sweaty clothes quickly.
• Avoid perfumed soaps, bubble baths, douches and vaginal deodorants.
• Wipe from front to back.
• If you have diabetes, keep your blood sugar well controlled.

This article is for general information only and isn’t a substitute for advice from a doctor or pharmacist. Always read the label before using any medicine.

Constipation means having fewer than three bowel movements a week, or stools that are hard, dry and difficult to pass. It’s very common and usually caused by too little fibre or fluid, inactivity, changes in routine, or some medicines. The good news is that simple changes fix most cases.

Quick ways to get relief

• Drink more water. A warm drink in the morning can help get things moving.
• Move your body. A brisk 10 to 15 minute walk stimulates the bowel.
• Don’t ignore the urge. Go when you feel the need, and give yourself time.
• Try a footstool. Raising your feet so your knees are above your hips makes it easier to pass a stool.
• Eat prunes or kiwi fruit. Both have a gentle natural laxative effect.

When a laxative helps

If lifestyle changes aren’t enough, a short course of laxative can help. Stimulant laxatives like bisacodyl (Dulcolax) make the bowel muscles contract and usually work within 6 to 12 hours, so many people take them at bedtime.

• Adults and children 12+: 1 to 3 tablets (5 to 15 mg) once a day.
• Swallow tablets whole. Don’t take them within an hour of milk or antacids.
• Don’t use a laxative for more than 1 week without talking to a doctor.

Stimulant laxatives can cause cramps. Bulk-forming laxatives (fibre supplements) and osmotic laxatives work more gently and are often tried first for ongoing constipation. A pharmacist can help you choose.

Long-term habits for regular bowels

• Increase fibre gradually to about 25 to 30 g a day: whole grains, beans, lentils, fruit, vegetables, nuts and seeds. Add it slowly to avoid bloating.
• Drink enough fluid, especially as you eat more fibre.
• Stay active most days of the week.
• Keep a routine. Many people find the bowel is most active after breakfast.
• Check your medicines. Iron supplements, some painkillers, antacids and other medicines can cause constipation. Ask your pharmacist.

When to see a doctor

• Blood in your stool or bleeding from the bottom
• Unexplained weight loss, or severe or ongoing stomach pain
• Constipation that lasts more than 3 weeks despite changes
• A sudden change in bowel habits that lasts more than 2 weeks, especially if you’re over 50
• You can’t pass wind, and your stomach is swollen, or you’re vomiting

Also see: how to stop diarrhoea fast.

This article is for general information only and isn’t a substitute for advice from a doctor or pharmacist. Always read the label before using any medicine.

Diarrhoea is usually caused by a stomach bug, food that didn’t agree with you, or something you ate while travelling. Most cases clear up on their own within 2 to 3 days. The goals are to stay hydrated, ease symptoms, and know when it’s time to get help.

1. Replace lost fluids first

The biggest risk with diarrhoea is dehydration, especially for children and older adults.

• Sip water regularly through the day.
• Use an oral rehydration solution (ORS) to replace lost salts and sugar, especially if diarrhoea is frequent.
• Clear broths and diluted fruit juice can also help.
• Avoid alcohol, and limit caffeine and very sugary drinks, which can make diarrhoea worse.

2. Eat simple foods

You don’t need to stop eating. Start with small portions of plain foods such as rice, bananas, toast, crackers, plain pasta, potatoes and boiled chicken. Avoid fatty, fried, spicy and very sugary foods until you feel better. Some people find dairy harder to digest for a few days.

3. Anti-diarrhoeal medicine

For adults and children 12 and over, loperamide (Imodium) slows the gut so more water is absorbed, reducing the number of loose stools:

• Take 4 mg (2 tablets) after the first loose stool, then 2 mg (1 tablet) after each loose stool that follows.
• Don’t take more than 8 mg (4 tablets) in 24 hours. Higher doses can cause serious heart rhythm problems.
• Don’t use it if you have a fever, or blood or mucus in your stool. These can be signs of an infection that needs to clear naturally or be treated by a doctor.
• Stop and see a doctor if diarrhoea lasts more than 2 days.

4. Probiotics

Probiotics such as Lactic acid bacillus (Vizylac) may help restore healthy gut bacteria, particularly when diarrhoea follows a course of antibiotics.

When to see a doctor

Get medical advice if you have:

• Diarrhoea lasting more than 2 days (adults) or 24 hours (young children)
• Blood or black, tarry stools
• A high fever (over 102°F / 39°C)
• Severe stomach pain
• Signs of dehydration: very little urine, dark urine, dizziness, a very dry mouth, or in children, no wet nappies for 6 hours or more
• Diarrhoea after travel abroad, recent hospital stay, or a course of antibiotics
• A weakened immune system, or diarrhoea in a baby under 6 months

Travelling soon?

See our guide to preventing motion sickness, and pack an anti-diarrhoeal and rehydration salts in your travel kit.

This article is for general information only and isn’t a substitute for advice from a doctor or pharmacist. Always read the label before using any medicine.