Traveling allows you to explore other cultures, visit historical landmarks, and open up your own world to others. Unfortunately, traveling is not as simple as stepping off the plane and going on a sightseeing adventure. New continents and new countries bring about their own set of challenges for the foreign stomach. Put simply: What your body may be accustomed to in your home may be a disaster for the stomach of another traveler and vice versa.
Travelers’ Diarrhea, also called Travelers’ Sickness, is the most common form of illness experienced by those looking to see the world. Let’s discover the causes behind Travelers’ Diarrhea and how you can prevent it so that it doesn’t ruin your next trip.
What is Travelers’ Diarrhea?
According to the Center for Disease Control, an estimated 10 million international travelers experience some form of Travelers’ Diarrhea. It is an infection of the stomach and intestines that is primarily caused from bacteria. In fact, over 80% of the cases of Travelers’ Diarrhea are from common infectious bacterial agents. How this bacteria gets into your body is simple. We all need to eat. The problem is that many countries do not have strict food regulations. When food is ill prepared or mishandled, this gives the bacteria that causes Travelers’ Diarrhea a chance to thrive.
Once the bacteria enter your body, it needs to set up shop and reproduce. Typically, travelers may not experience any symptoms for a few days. If a traveler comes into contact with the bacteria towards the end of the trip, the infection may not be noticed until after the traveler is back in their home country!
While there are many types of bacteria, the most common strain that is connected with the majority of cases of Travelers’ Diarrhea is Enterotoxigenic E. coli, also called ETEC. It directly irritates the intestinal lining, causing the classic symptoms of watery and/or loose stool, bloating, and abdominal discomfort.1
Common Symptoms of Travelers’ Diarrhea
The most common symptoms of Travelers’ Diarrhea can be broken down into the following stages:
- Stool becomes loose and/or watery
- You will feel bloated
- Occasional abdominal cramping occurs
- Nausea begins
- There are sudden and strong urges to have a bowel movement
- A slight fever may occur
- You may need to vomit
- A headache will develop (pain will vary)
Stage 4 (Seek immediate medical attention if any of the following symptoms appear)
- Bowel movement are exceptionally painful
- Blood is present in your stool
To the average traveler, this type of short-lived infection may not be that big of a deal. For those with previous or current medical conditions such as bowel disease and stomach cancer, Travelers’ Diarrhea could dangerously increase your risk for a more serious infection.
Travelers’ Diarrhea vs. Irritable Bowel Syndrome
It’s important not to mistake Travelers’ Diarrhea for Irritable Bowel Syndrome. Travelers’ Diarrhea is short-lived, usually lasting no more than a week in most cases. It is caused by a bacterial infection and typically resolves itself. Irritable Bowel Syndrome, on the other hand, has no direct cause and needs to be managed over the long term. It usually involves diarrhea but is also accompanied by bouts of pain and constipation. Irritable Bowel Syndrome can be triggered by certain dietary and lifestyle choices. Drinking coffee and experiencing stress are two popular examples. If you believe you have Irritable Bowel Syndrome, you should talk with your doctor before traveling to developing countries.
Why Don’t I Get TD When Traveling in my Own Country?
If Travelers’ Diarrhea is so common, why don’t you seem to experience it when traveling within your own country? Everything from the type of food to how it is prepared is nearly universal within a specific country. For instance, food that is prepared for you in Philadelphia, PA is going to be handled and prepared nearly the same in San Francisco, CA. Despite being on opposite ends of the country, these two states have agreed to a specific standard of food handling and preparation. What’s more, there will not be great variations in the types of bacteria you find in the water and food supply within the same country. When traveling thousands of miles away, you are encountering an entirely new bacterial community that your body has never encountered before. The result is Travelers’ Diarrhea. If you stay in that new country long enough (e.g. – When moving abroad to teach ESL), your body will eventually adjust to these conditions and new types of bacteria.
Risk Factor for Travelers’ Diarrhea
The greatest risk factors can be divided into the following categories: types of people and countries to take the greatest precautions in.
Types of People
You are more likely to encounter Travelers’ Diarrhea if you:
- Travel during certain high risk seasons
- Have a suppressed immune system due to illness or medication
- Take over-the-counter medication that reduces stomach acid1
Take Great Caution in these Countries
You should always take precautions in any new country you travel to, especially in developing countries. The following is just a small list of countries was noted as areas to take a great amount of caution in while traveling. In the end this list is not exhaustive, and you should be cautious when traveling to any country.
- Haiti (1)
How to Prevent Travelers’ Diarrhea
It’s best to prevent Travelers’ Diarrhea rather than have to treat it. Let’s break down the best ways to prevent Travelers’ Diarrhea through actions, food choices, and supplementation.
- Wash your hands! Bring along a hand sanitizer if you won’t have access to clean water and soap.
- Thoroughly wash any items that will be coming into contact with your body. For instance: utensils, clothes, etc.
- Use bottled water when brushing your teeth and washing your face
- Do NOT swim in contaminated or suspicious water
Food & Drink Choices
- As inexpensive as it may be, avoid food truck choices in high risk countries
- Buy bottled water if you are unsure of the local water supply
- Request no ice when in restaurants
- Choose food items that involve very little preparation
- Eat fruits and vegetables that have a skin you can peel off yourself
- Stick to ordering food and drinks that require high levels of heat such as coffee and baked products
- Do not consume raw food in high risk countries
- Take a broad spectrum probiotic 2 weeks before your trip
- Continue taking a probiotic supplement during and after your travel
- Consider a whole-food based multivitamin to boost your immune system
- If you do not want a multi-vitamin, focus on Zinc
The Travelers’ Diarrhea Diet
If you happen to succumb to Travelers’ Diarrhea, then it will be important to follow a certain diet to avoid further irritation of your stomach. Try the following diet to quicken your recovery time and avoid the worst symptoms:
- 8 to 11 cups of plain water (preferably bottled)
- Take a probiotic supplement
- Find a broad spectrum probiotic and take one serving up to 4 times per day
- If you can’t find a broad spectrum, then make sure it contains Lactobacillus acidophilus at the very least
- Stick to plain foods:
- Bland cereal (e.g. – Cheerios)
- Eggs (NO cheese)
- Avoid the following foods:
- Deep-friend foods
- Tomato sauce
How to Treat Travelers’ Diarrhea
Aside from changing the way you eat, you may also want to look for help from medications. Here is a list of the common medications that people take for Travelers’ Diarrhea and their level of effectiveness.
Broad Spectrum Antibiotics (Prescription)
The following medications are all antibiotics that have been used for Travelers’ Diarrhea. These antibiotics, while having some success, have all had serious side effects reported including the damaging of healthy gut-friendly bacteria. You may destroy the bacteria causing Travelers’ Diarrhea but your immune system and flora of gut-supporting bacteria will be compromised.
- Ciprofloxacin (Cipro)
Prescriptions (Specifically for Diarrhea)
The following medications are designed specifically to treat the symptoms of diarrhea. While these medications have been found to be effective, they also come with the risk of side effects including hives, stomach pain, bloody stool, and fast heart rate. These prescriptions will be ineffective for anyone with a serious stomach-related disease.
Over-the- Counter Treatments
The following over-the-counter remedies are an easy to access solution to Travelers’ Diarrhea. Although they do not treat the direct cause of TD, they do help alleviate the symptoms. Both act as an anti-inflammatory, helping to sooth that bloated feeling. They also slow down the movements of the stomach, helping to reduce the constant urge to go to the bathroom. Again, while effective at reducing symptoms, they do not treat the direct cause.
- Immodium AD
- Pepto Bismol
If you want to avoid problematic medications and over-the-counter options, then supplementing your diet is the best option. In particular, probiotics allow you to support your body’s natural ability to fight off the bacterial infection. Probiotics also support your immune system, aiding in the process of adjusting to the presence of the new bacteria.
- Broad spectrum probiotics
- Most important strains:
- Lactobacillus acidophilus
- S. boulardii
- Bifidobacteria bifidum 2
Probiotics and Travelers’ Diarrhea
Enhancing your body’s ability to fight off infection by increasing the numbers of gut-friendly bacteria may help quicken recovery and avoid Travelers’ Diarrhea altogether. Various studies have demonstrated how effective probiotics can be for preventing and treating Travelers’ Diarrhea. One study published in the Journal of Nutrition highly recommends the use of probiotic supplements, especially for the treatment of Travelers’ Diarrhea. 2
If you want to go the natural way of preventing and treating Travelers’ Diarrhea, then there will be a few things to take into consideration:
Are there food sources of probiotics?
If you happen to run out of probiotics or you simply can’t find a reputable brand, then there are several food sources you can take advantage of. Fermented foods such as yogurt, kefir, sauerkraut, and kimchi all contains extremely high levels of probiotics. What’s more, some of these food options are regional, helping you adjust to that area’s bacterial community.
Don’t I need to refrigerate probiotic supplements?
While some probiotics do require refrigeration for optimal performance, there are just as many that are shelf stable. Probacto probiotics, for instance, is a great solution for Travelers’ Diarrhea and it does not need to be placed in a refrigerator.
What is the best probiotic supplement?
Ideally, you want a broad spectrum probiotic; one that features a number of strains of bacteria. If you can limited options, be sure that following strains are found within your probiotic supplement:
- Lactobacillus acidophilus
- S. boulardii
- Bifidobacteria bifidum2
If you’re looking for a specific brand, Probacto probiotics are one of the best. It provides you with a wide range of bacteria that have been proven to complement your intestinal gut flora.
Traveling is a life changing experience. You shouldn’t have to limit your adventures because of Travelers’ Diarrhea. TD is a frustrating illness that is unpredictable and embarrassing. There are plenty of ways to prevent TD from occurring including taking care to wash your hands and avoiding contact with contaminated foods. If you want to fortify your body then you need to supplement with a scientifically proven probiotic product. Choose Probacto probiotics to safeguard your stomach and your adventure.
1. Travelers’ Diarrhea. Center for Disease Control. USA.gov. November 21, 2006. Web. http://www.cdc.gov/ncidod/dbmd/diseaseinfo/travelersdiarrhea_g.htm
2. Vrese, M; Marteau, P. Probiotics and Prebiotics: Effects on Diarrhea. J. Nutr. March 2007
vol. 137 no. 3 803S-811S.