Traveler’s Tummy, Dheli Belly, Montezuma’s Revenge. Whatever name it goes by one thing is certain, Traveler’s Diarrhea (TD) is uncomfortable at best and downright deadly at worst. And if you’re planning that summer vacation to faraway destinations, you likely have legitimate concerns about getting sick.
The good news? Taking a good quality probiotic supplement can be the key to stopping TD before it starts.
What is TD?
As the name implies, Traveler’s Diarrhea is just that: a gastrointestinal infection contracted while traveling that results in loose, watery stools (diarrhea). Symptoms generally last up to four days, but about 10% of sufferers may continue experiencing problems for a week or more.
In severe cases the infection can cause dysentery – frequent and bloody diarrhea coupled with fever and acute abdominal pain – which if left untreated, results in extreme dehydration with potentially life-threatening complications.
Where and How Does it Strike?
Up to 60% of travelers experience TD annually. Bacterial infection is responsible for at least 80% of the estimated 10 million cases that develop each year. The primary culprit is E. coli, found in contaminated food and water. Infections from E. coli and other bacterial pathogens like C. jejuni and Salmonella certainly can and do occur in developed countries, but the risk for TD is highest in the Middle East, Africa, Mexico, Central & South America, and most of Asia.
These areas generally have more large populations without access to adequate plumbing or latrines so that there is a greater prevalence of environmental contamination from open sewage. Poor refrigeration from inadequate electrical capacity and lack of access to clean water creates unsafe food preparation and storage practices.
How Do Probiotics Help?
With a bacterial infection the go-to treatment historically has been antibiotics, which are effective but come with downsides. Most antibiotics indiscriminately kill good bacteria along with the bad, throwing off the balance of your gut microbiome. And with the rise of antibiotic-resistant bacteria caused by the overuse of antibiotics in medicine and the food supply, the better approach is to protect yourself from contracting TD in the first place.
This is where probiotics – literally “for life” – come into play. By boosting your gut with the good bacteria that naturally reside in your GI tract you’ll make big strides in preventing TD. Probiotics work for two fundamental reasons:
- Increased immunity. 70% of your immune system is in your gut where the beneficial microorganisms replicate and form colonies that line the inside walls of the intestines and push out bad bacteria. This creates an effective physical barrier so that bacterial pathogens like E. coli have less opportunity to invade your system.
- Better digestion. Your gut microbiome naturally contains over 400 different bacterial species that are necessary for manufacturing certain vitamins (vitamin K2, vitamin B12) and enhancing nutrient absorption. Most importantly for travelers in particular, these good bacteria support optimal digestive function by promoting regularity and reducing symptoms of GI upset.
Best Probiotics for Travel?
There’s no question that replenishing lost fluids and electrolytes is crucial when hit with any bout of diarrhea. But in terms of prevention, a 2007 meta-analysis of 12 studies conducted from 1977 to 2005 found “85% of TD cases were prevented by probiotics.”
The authors go on to point out probiotics’ effect of mediating the microbiome in response to travel exposure, without permanently disrupting its normal composition, as a primary advantage of their use over other TD prophylactics.
In other words, probiotics are not only effective in preventing TD, but offer fewer potential side-effects than other methods.
So before you say “bon voyage,” be sure to pick up a probiotic supplement that has:
- At least 5 billion Colony Forming Units (CFUs) per serving.
- A mixture of species from Lactobacillus and Bifidobacterium plus a yeast like S. boulardii. The greater diversity of microorganisms, the greater the health benefits.
- Enteric coating or other manufacturing technology that protects the delicate bacteria from bile and stomach acid. This also reduces the need for refrigeration.
- A prebiotic such as inulin (FOS) to feed the good bacteria for optimum synbiotic support.
Start taking your probiotics 3-5 days prior to travel and continue for the duration of your time away, and for 3-5 days after returning home.
With the almost daily publication of new studies showing the significant impact your gut microbiome has on your digestive health, it comes as no surprise that probiotics are increasingly looked to as the best first step in addressing GI upset, especially for travelers. While it’s not possible to completely avoid risk factors for TD, some good rules of thumb are to wash your hands often, avoid street vendors, undercooked meat, fish & poultry, untreated water (including ice cubes), and food left out for long periods. And last but not least, supplement with a good quality probiotic. Happy gut, happy travels!
David H. Rahm, M.D. is the founder and medical director of The Wellness Center, a medical clinic located in Long Beach, CA. Dr. Rahm is also president and medical director of VitaMedica. Dr. Rahm is one of a select group of conventional medical doctors who have education and expertise in functional medicine and nutritional science. Over the past 20 years, Dr. Rahm has published articles in the plastic surgery literature and educated physicians about the importance of good peri-operative nutrition.