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How to prevent traveller’s diarrhea

by on January 23, 2017

If you’ve ever travelled to a country near the equator, you may have experienced what is commonly known as traveller’s diarrhea, or more eloquently, Montezuma’s Revenge! When you’re away for only 1 or 2 weeks, spending a few days at arms reach from the toilet is not what most of us call an ideal vacation.

Besides naturopathic medicine, travel is a passion of mine, and I love to travel to “exotic” places, where the culture, language, ecosystems and food is different from my home. As you can imagine, I have had my fare share of common traveller’s illnesses! These episodes have definitely coloured my travel stories, but more importantly, they have pushed me to search for a better way to prevent getting sick when I travel and prevent the long-term outcomes of traveller’s diarrhea.

More often than not, traveller’s diarrhea is caused by the bacteria E. coli, but it can also be caused by viruses and parasites, and food and water are the main vehicles for getting contaminated with these bugs. Although street food and unpeeled fruit are the known culinary taboos of travel, there’s actually evidence showing that fancier hotels and resorts pose a greater risk for getting traveller’s diarrhea. This isn’t to say that you’re guaranteed to stay healthy by eating street food, but keep in mind that the number of stars next to the name of the hotel you are staying in doesn’t guarantee the hygienic practices in the kitchen.

What should I eat when I travel?

To begin, the risk of eating contaminated food is greater as we approach the equator – so all the beautiful tropical destinations. Traveling at higher latitudes decreases the risk of getting sick when you travel. When choosing food, raw or undercooked meats and seafood and unpeeled fruits and vegetables tend to be the main culprits, so enjoy the fresh fruit and vegetables, but make sure you clean them well!

When drinking water, it’s important to drink clean water, and since it’s important to drink more water in warmer climates, you really want to make sure you have a good source of water. Bottled water is an option – but it creates a lot of garbage. If you can, drink boiled water. If that is not an option, there are also lots of water purifying systems on the market that are easy to pack and can come in handy, depending on the type of travel you are doing.

What else can I do to prevent traveller’s diarrhea?

Taking probiotics when you travel can reduce the risk of getting traveller’s diarrhea by as much as 50%. This is something I always pack with me when I travel now.

It’s important to note that not all probiotics are created equal. The most beneficial strains are:

  • L rhamnosus
  • Lactobacillus acidophilus
  • Bifidobacterium lactic
  • Saccharomyces boulardii

Also note that some strains of probiotics offer no protection, so keep these four strains in mind when selecting your probiotic.

If you know you will be on the move a lot and won’t have access to refrigeration, choose a shelf-stable probiotic.

One brand I like is the Genestra HMF Travel, which contains 3 of these 4 strains, a dose of 35

billion CFUs per capsule and is shelf-stable. It’s a good idea to start taking a probiotic 2 weeks before you leave, for the duration of your trip and for up to 2 weeks upon your arrival.

Should I take antibiotics just in case?

Several years ago, I was told that it was a good idea to pack some antibiotics “just in case”. At the time, I thought it was a great idea, but not so much anymore.

Antibiotics are helpful to treat a bacterial infection. Since the most common cause of traveller’s diarrhea is E. coli, a bacteria, it seems to make sense to take an antibiotic to treat traveller’s diarrhea. However, this is not the case, for a few reasons.

  1. An antibiotic won’t treat a virus or parasite.
  2. Taking an antibiotic to treat traveller’s diarrhea creates 4 times more risk of developing IBS.
  3. Taking a probiotic decreases the risk of developing IBS.
  4. There are great options for treatment without antibiotics.

There are herbal alternatives that are far superior to antibiotics as they are effective for bacteria, viruses and parasites. Two of my favorites are garlic and oil of oregano. Fresh garlic is effective, but it has to be eaten in large quantities, which is likely not going to happen when you’re feeling ill. Garlic capsules are just as effective. The benefit of using garlic is that is does not affect our beneficial flora.

The active ingredient in garlic is Allicin. One reliable brand of garlic capsules, with a good amount of Allicin is Allimax. It is important to get a good quality product in order to ensure proper treatment.

Oil of oregano is also very effective for bacteria, viruses and parasites ; however, it does kill our beneficial flora, so in my opinion, it is not as good as garlic. If you choose this, make sure you use an enteric coated capsule so it’s effective further down in your digestive tract where you need it!

Can I take Imodium to stop my diarrhea?

Diarrhea caused by a bacteria, virus or parasite is a reaction of the body trying to eliminate this pathogen. Although unpleasant, it is a necessary part of the illness. Stopping diarrhea with this kind of medication allows the pathogen to multiply in the body, leading to side-effects such as IBS or other digestive symptoms in the long run. Imodium can be helpful if you have to sit on a bus or airplane for hours, but besides that, it should be avoided.

What about dehydration?

It is important however to remember that it is easy to reach the point of dehydration from traveller’s diarrhea, especially children. Although it’s important to ensure proper rehydration. Electrolyte replacement drinks are ok it it’s all you have, but try to avoid them as much as possible. Some people also say that coconut water is a good electrolyte replacement. If you’re having a drink in the hot sun, sure, but if you’re trying to hydrate yourself or your child, coconut water will not help. The electrolyte ratio of the coconut water is not appropriate for rehydration, as it contains too little sodium and glucose, and too much potassium.

In a pinch, you can make your own oral rehydration solution, which meets the World Health Organization’s standards. Simply mix:

  • 1 Liter of purified or boiled water
  • 6 Tbsp of sugar
  • 1/2 tsp salt

You can also carry rehydration tablets or packets with you to mix with water if needed. One brand I like are Nunn Electrolyte Replacement tablets.

There you have it. There are lots of options to prevent and treat traveller’s diarrhea and spend more time enjoying your trip than getting to know the bathroom!

Please note that this article is not intended to replace medical care and if your symptoms don’t resolve within a few days, it is important to seek care from a trained medical professional.

** I have no affiliation with the products or brands mentioned in this article, and I receive no compensation for mentioning them here.

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