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Preventing Traveller’s Diarrhea – Probiotics for Travelling

traveller's diarrheaGetting some Traveller’s Diarrhea when you travel abroad is a common occurrence with up to 12 million cases reported a year, and heading to some areas of Africa, Latin America, The Middle East and South East Asia can see tourist incidence rates of GI problems hit 50% or more! (1-2). Luckily for most of us it’s not too serious, however, it is unpleasant and can potentially ruin and limit your trip.

However, by strengthening our guts and understanding what to take for diarrhea prior to heading off on our adventures we can significantly reduce our chances of picking up anything nasty, and maximize our time away, as well as the money we spend on it.

Traveller’s diarrhea or ‘TA’ is caused by coming into contact with ‘fecally’ contaminated food, that’s human poo in straightforward language – not very nice, unfortunately it does happen, and the most likely places for contamination tend to be eating food from street vendors, markets and small restaurants (3). There’s normally an incubation period of 2-3 days, so it takes around 2-3 days from eating the contaminated food to getting symptoms, and the symptoms range from stomach cramps and nausea to vomiting, muscle pain and fever. Normally it’s over in a few days, but around 15% of cases can last between one week and one month.

Preventing Traveller’s Diarrhea

probiotics for diarrheaThe best method for avoiding TD is understanding where you are most likely to encounter problems, i.e street vendors etc, and avoiding eating there, as well as focussing on basic hygiene. However, obviously this isn’t a fool proof method, and can also stop a trip away being as authentic or adventurous as it could be. So in an attempt to avoid TD and still get the most from a trip away, traveller’s will often take antibiotics prophylactically to prevent any infection. The problem with this is that the overuse of antibiotics is associated with antibiotic resistance, and also taking antibiotics when we don’t need to can kill off the good bacteria that are living in our guts, and leave us more susceptible to infections and other health problems in the future. So really, although many people do it, it’s not a great idea.

However, a 2007 meta-analysis study (that’s an overall review of studies previously done on the subject) found that supplementation with probiotics could prevent 85% of cases of Traveller’s diarrhea (4). However, there were certain key factors that related to the success of probiotic supplementation in preventing TD. To give good resistance against TD the probiotics need to be taken in doses of at least 10 billion CFU’s (colony forming units). Also the probiotics should be continued throughout the whole period of susceptibility to TD. The study suggested that it could take a full 6-8 week period for the microbiome (gut) bacteria to fully return to normal after a trip away, so this means you need to be taking probiotics for a full 2 months after you return, just in case! This shouldn’t really be a problem, because in our opinion you should be taking probiotics everyday wherever you are, (if possible!). A final problem highlighted by the study is that many probiotics need refrigeration, so if you’re travelling for long periods of time that’s not going to be possible, and the probiotics will likely die off. So you need to use a brand that doesn’t need to be refrigerated.

Thankfully, this is not an issue with Intelligent Labs Probiotics as they don’t need refrigeration, (although you should try to keep them cool). Also each one of our capsules provides 50 billion CFU’s, so they are easily strong enough to provide full protection. Despite this, when travelling we do recommend increasing our normal dosage of one capsule a day to 2 capsules a day for a week before travel, and then keep taking 2 capsules a day for a full week after you return, and then going back to taking the normal one capsule a day. This will give you the best chance of avoiding any problems whilst you are away, (along with some basic common sense), so you can make the most of your trip.

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References

(1) Cheng AC, Thielman NM. Update on traveler’s diarrhea. Curr Infect Dis Rep 2002;4:70–7.

(2) Hill DR. Occurrence and self-treatment of diarrhea in a large cohort of Americans traveling to developing countries. Am J Trop Med Hyg 2000;62:585–9

(3) Centers for Communicable Diseases, CDC. Travelers’ diarrhea. CDC. 1-8. 4-27-2004. Atlanta, Georgia, Centers for Communicable Diseases. The Yellow Book.

(4) Lynne V. McFarlanda. Meta-analysis of probiotics for the prevention of traveler’s diarrhea. Travel Medicine and Infectious Disease (2007) 5, 97–105.