Proactive Tips to Avoid the Dreaded “Traveler’s Trots”
The Centers for Disease Control and Prevention (CDC) reports that traveler’s diarrhea (TD) is the most common travel-related condition worldwide. While TD is rarely life-threatening in healthy adults, it can be extremely uncomfortable for travelers who succumb to it. Authorities suggest that practitioners provide a pre-travel consultation to talk about risks and prevention strategies.
Most cases of travel-related diarrhea are caused by food or water, and often travelers often get diarrhea from eating and drinking foods and beverages that have no adverse effects on local residents. In any case, it’s recommended that travelers frequently wash their hands throughout their travels. When traveling outside of the country, the CDC has identified these high-risk foods that travelers should be aware of and avoid:
- Salads and cut fruit
- Uncooked meat, fish or eggs
- Unpasteurized dairy products
- Tap or well water or foods made using tap or well water such as ice or juice
- Food from street venders
- Food served at room temperature
In addition to frequent hand washing and being careful of food and water, proactive plans should also include taking probiotics before, during, and after travel. According to a 2018 meta-analysis published in the journal Epidemiology and Health, “probiotics showed statistically significant efficacy in the prevention of TD.” Probiotics not only help reduce risk of traveler’s diarrhea, they can help reduce negative effects if it does occur.*
One strain of probiotics in particular has been shown to be specifically efficacious with regards to TD: Saccharomyces boulardii (S. boulardii). S. boulardii is a yeast probiotic that has been widely studied including several human clinical trials. Specifically related to TD, the authors of a 2010 systematic review and meta-analysis that was published in the World Journal of Gastroenterology concluded that based on the research S. boulardii can be “strongly recommended” for the prevention of TD. That analysis looked at 27 trials with more than 5,000 people and showed that S. boulardii was effective in 84% of the treatment arms featured in the studies.*
A 2007 meta-analysis conducted by the same author that was published in the journal Travel Medicine and Infectious Disease showed that probiotics were not only effective at helping avoid TD, they were also safe with no serious adverse reactions reported.* That analysis looked at 12 trials using either S. boulardii or a mixture of Lactobacillus acidophilus and Bifidobacterium bifidum.
If you have patients traveling, especially abroad to high-risk regions such as Asia, Africa, Mexico, Middle East, and Central and South America, it’s wise to do a pre-travel consultation to create a proactive TD plan. Packing S. boulardii probiotics will help reduce your patient’s risk of developing traveler’s diarrhea as well as helping avoid the digestive discomfort and unpleasant issues that can arise while traveling.*
Bae J. Epidemiology and Health. 2018;40.Centers for Disease Control and Prevention. Traveler’s Diarrhea. https://wwwnc.cdc.gov/travel/page/travelers-diarrhea Accessed online June 2019.
Giddings SL, Stevens AM, Leung DT. The Medical Clinics of North America. 2016;100(2):317-330.
McFarland LV. World Journal of Gastroenterology. 2010;16(18):2202-2222.
McFarland LV. Travel Medicine and Infectious Disease. 2007;5(2):97-105.