Quick answer
Stomach upsets, nicknamed Pharaoh's revenge, are the most common health complaint in Egypt, but you can cut the risk a lot by eating freshly cooked hot food, choosing busy places, washing hands with soap before meals, drinking only bottled or filtered water and going easy on raw salads and unpeeled fruit at basic eateries. Most cases pass in a few days with rest and rehydration; see a doctor promptly if you have a fever, blood in your stool, or can't keep fluids down.
What is Pharaoh's revenge, and how common is it?
Pharaoh's revenge is the local nickname for traveller's diarrhoea, a short-lived gut infection usually caused by bacteria such as E. coli picked up from food, water or hands; a good share of first-time visitors to Egypt get at least a mild bout.
It typically starts in the first week, often after the change of diet, jet lag and heat have already lowered your defences. Symptoms are loose stools, cramps, nausea and tiredness, and most cases settle within two to four days. It is unpleasant rather than dangerous for most healthy adults, but dehydration in the heat can make it hit harder, and it is more serious for young children, older travellers and anyone with an existing medical condition.
The aim isn't to avoid Egyptian food: it's one of the best parts of the trip. It's to make a handful of smart choices that keep the odds in your favour. This page is general information; see your GP or a travel clinic for advice that suits your health.
What should you eat and avoid in Egypt?
Favour food that is cooked to order and served piping hot, fruit you peel yourself, and bread fresh from the oven; be choosier about raw salads, cut fruit, lukewarm dishes and unpasteurised dairy.
| Generally lower risk | Take more care |
|---|---|
| Koshari, ful medames and ta'ameya cooked fresh in front of you | Raw salads and herbs at basic cafés and stalls |
| Grilled meat, kofta and fish straight off the grill | Buffet dishes that have sat lukewarm for hours |
| Bananas, oranges, mangoes and other fruit you peel | Pre-cut fruit, and berries washed in tap water |
| Freshly baked baladi bread and feteer | Unpasteurised milk, fresh cheeses and cream from street vendors |
| Hot tea, coffee and sealed drinks | Undercooked shellfish, and seafood away from the coast |
The old rule "boil it, cook it, peel it or forget it" is a little extreme for Egypt's better hotels and restaurants, which wash salads in treated water, but it's a good guide at simple local places. If you're keen to try Egypt's best dishes safely, read about koshari and our Egyptian street food guide, or join a guided Cairo food tour, where the guide chooses busy, trusted vendors.
Is street food safe in Egypt?
Street food from a busy stall, cooked hot in front of you, is often safer than food that has sat on a hotel buffet, because turnover is high and nothing waits around.
Choose the stall with a crowd of locals, especially families and office workers at lunchtime. Watch for hot oil and a hot griddle, food that goes straight from the pan to you, and a vendor who handles money separately from food or uses a tissue. Ta'ameya (Egyptian falafel made from fava beans) fried while you wait, a bowl of koshari ladled from steaming pots, or a hawawshi pocket straight from the oven are all good bets.
Skip the raw salad and pickles on the side if you're nervous, and avoid sauces or dips that look as though they've been sitting out in the sun. Sugarcane juice and fresh fruit juices are tempting on a hot day; our drinking water guide explains the ice question.
How do you stay well on a Nile cruise and at hotel buffets?
Eat from hot dishes that are steaming and freshly replenished, take salads from the main cold display rather than items left in the sun, and wash your hands with soap before every meal, not just sanitiser.
Nile cruise ships and large hotels cook for hundreds of international guests and generally run well-managed kitchens, but buffets are where many stomach bugs spread: food sits for long periods, and dozens of people handle the same serving spoons. A few habits help:
- Go early: arrive soon after the buffet opens, when dishes are freshest.
- Prefer the cooking station: eggs, pasta or grilled fish cooked to order are the safest plates on the table.
- Wash, don't just sanitise: alcohol gel doesn't kill every stomach virus; soap and running water before eating is better, then gel after touching shared tongs.
- Be wary of sundeck snacks: sandwiches and cakes left out in the afternoon heat are a common culprit.
Our Nile cruise food and drink guide covers what's served on board.
What should you pack for stomach upsets?
Pack oral rehydration salts, soap or hand sanitiser, and whatever your doctor recommends for your situation, including any prescription standby treatment; ask about this at your pre-travel appointment rather than buying unfamiliar medicines on arrival.
- Oral rehydration salts: the most important item. A few sachets per person take up no space.
- Soap leaves or small liquid soap: toilets at sites and cafés don't always have soap.
- Hand sanitiser and wet wipes: for after handling money, camels and shared surfaces.
- Doctor-recommended medicines: your GP or travel clinic can advise whether an anti-diarrhoeal or a prescribed standby antibiotic is appropriate for you, and when you should and shouldn't use it.
- Bland snacks: plain crackers or biscuits are useful for the day after.
Egyptian pharmacies sell their own popular stomach remedies, and your guide may swear by one. Brands and active ingredients differ from Australia, so check with the pharmacist that anything new is compatible with your other medicines, and follow the pack and pharmacist directions. See our healthcare and pharmacies guide.
What should you do if you get sick in Egypt?
Rest, keep drinking small amounts of safe fluids with rehydration salts, and eat plain food as your appetite returns; most mild cases ease within a couple of days.
Practical steps on a tour:
- Tell your guide early. On a private trip it's easy to swap a long day for a shorter one, push back a temple visit or rearrange the order of sights.
- Rehydrate. Sip water mixed with rehydration salts steadily through the day. Avoid alcohol, strong coffee and very sugary drinks.
- Eat simply. Plain rice, bread, bananas, soup and yoghurt from a reputable kitchen. Hotels and cruise chefs will gladly prepare something plain.
- Stay cool. Heat and diarrhoea together dehydrate you quickly, so stay out of the midday sun.
See a doctor promptly if you have a high temperature, blood or mucus in your stool, severe abdominal pain, signs of dehydration (very little or dark urine, dizziness, confusion), vomiting that stops you keeping fluids down, or symptoms lasting more than a couple of days. Get help sooner for children, older travellers, pregnant women and anyone with a chronic condition. Hotels and cruise ships can call a doctor to your room, and your travel insurer's assistance line can direct you to a suitable clinic. Make sure your travel insurance covers medical care.
Do probiotics or vaccines prevent traveller's diarrhoea?
There's no single pill or jab that prevents all traveller's diarrhoea; the evidence for probiotics is mixed, and the vaccines doctors commonly recommend for Egypt (such as hepatitis A and typhoid) protect against specific infections rather than everyday upsets.
Some travellers like to take a probiotic for a few weeks before and during the trip; it's unlikely to harm a healthy adult, but don't treat it as protection. The measures that make the real difference are the ones above: hot food, safe water, clean hands, and not overloading your stomach with rich buffet food and alcohol in the first days after a long flight.
For vaccine advice, read our vaccinations and health prep guide and talk to your GP or a travel clinic, and check the health section of Smartraveller's Egypt advice before you go.
Frequently asked questions
How do I avoid getting sick in Egypt?
Drink only sealed bottled or filtered water, eat freshly cooked hot food from busy places, peel your own fruit, be selective with raw salads at basic eateries, and wash your hands with soap before meals.
Is salad safe to eat in Egypt?
In good hotels, cruise ships and established restaurants, salads are usually washed in treated water and are generally fine. At simple cafés and street stalls, it's safer to skip raw salads and herbs.
How long does Pharaoh's revenge last?
Most mild cases settle within two to four days with rest and rehydration. See a doctor if it lasts longer or you have fever, blood in your stool, severe pain or signs of dehydration.
Is street food in Egypt safe for tourists?
Food cooked hot in front of you at a busy stall is often a safe choice. Avoid food that has been sitting out, raw sides at basic stalls, and drinks with block ice.
Should I take medicine for diarrhoea to Egypt?
Pack oral rehydration salts, and ask your GP or travel clinic which medicines are suitable for you, including whether you should carry a standby treatment and when to use it.
Can I get a doctor on a Nile cruise if I'm sick?
Yes. Cruise ships can call a doctor on board or at the next mooring, and larger towns along the river, such as Luxor, Edfu and Aswan, have clinics. Contact your insurer if you need treatment.
