We're about to get real here, folks. Traveling around the world and experiencing new foods and flavors is wonderful, yes. However, it is also frequently an assault on your digestive flora with less-than-appealing outcomes. Traveler wellness woes are almost always food-related, so what can be done to help prevent it? One reporter from the NYT shares what he learned after an unfortunate run-in with a mango in India.
There are a number of myths surrounding traveler's diarrhea: The good bacteria in your gut is enough to overcome any bad bacteria. (Wrong.) Imodium will only lengthen your illness. (Wrong again.) In fact, "there is no food on the planet that will protect against an onslaught of toxic bacteria," says Dr. Phyllis Kozarsky, an expert on traveler's health at the Centers for Disease Control and Prevention, in this New York Times article. Instead, an early dose of antibiotics is strongly recommended. Trying to "wait it out" just means you give the bacteria more time to thrive, making you that much sicker. Antibiotics are "often miraculous cures, because 80 percent to 90 percent of traveler's diarrhea cases are caused by bacteria," says Dr. Kozarsky. As with all things, an aggressive treatment of antibiotics has its own problems, but it is still the most effective way to cure a bout of traveler's diarrhea.
Additionally, the advice to avoid Imodium, otherwise known as loperamide, is also misinformed. Imodium doesn't lengthen the illness; it simply lessons the symptoms, a "significant benefit when the short trip to the bathroom seems like a marathon."
So how can one ward off getting sick while abroad? Dr. Michael Fischbach, a microbiologist at the University of California, San Francisco, recommends eating yogurt and other fermented foods, particularly after you've taken antibiotics, although he admits "there is little evidence proving the effectiveness of this strategy." Other recommendations include daily doses of Pepto-Bismol, but only if it's a brief trip, as antacid therapies are not healthy for long periods of time.
Finally, try limiting meals to foods that resist bacteria or those that have been well cooked. As Dr. Kozarsky says, "If you eat things that are still steaming, the bacteria will be killed."
Read More: When the Mango Bites | New York Times Well Blog
(Image: Flickr user Alex Kehr, licensed under Creative Commons)
TW Salt Mill by Wil...

My cousin swears by taking a shot of higher-proof alcohol before eating any sort of fresh produce in places with questionable water (it kills the bacteria, I think). He did this at dinners out in South America when eating salad and never once got sick. Of course, it's not so practical for everyday eating. Here's an article from the NY Times that backs it up: http://www.nytimes.com/2005/02/15/health/15real.html?_r=1
My husband got what we assumed was a mild case of traveler's diarrhea from a meal in Turkey, but he just took some generic Imodium and he was fine within a couple days. I'll keep the advice about antibiotics in mind should that ever happen again!
I got food poisoning from a first class lounge in Brazil. No problems eating street food for weeks on end, but the first class lounge did me in. There's nothing worse than bolting out of your seat on a red eye to throw up on a plane. I now carry imodium, pepto and graval on all flights. Trust me, you don't want to be on your knees vomiting during turbulence.
My worst case of food poisoning was from Ecuadorian street food. I ate fritada (long-boiled, then fried pork chunks). It had been prepared in a kitchen without running water, and then sat out in the open for an unknown length of time. I'd been taking Pepto daily, but that did nothing to stop the ensuing misery. Good thing I'd been to see Dr. Kozarsky before my trip and she'd equipped me with antibiotics! As soon as I could keep them down, my illness went away.
On a cruise with my husband and his family everyone got sick after our stop in Israel where we had lunch in the old town in Jerusalem. I was taking probiotics the whole trip and wasn't affected. I also brought charcoal capsules with me, and those that were willing to try the capsules said they helped the symptoms go away faster.
I carry Cipro with me when I go overseas. I have never used it (started carrying it after my first trip to China where I came down with awful food poisoning along with another person in the group). But, I have given it to travel companions twice and they said it was miraculous.
Of course the standard advice of, "Talk with your physician about the risks of antibiotics" and "ensure you are not allergic to the antibiotic you are carrying" still apply. But I feel loads happier and safer knowing I have my little pharmacy kit with me (ibuprofen, cough drops, allergy pills, Cipro, band aids, Imodium, etc).
I got very sick with a milkshake in England 3 weeks ago, but was just fine in Morocco last year, so you never know... Of course, I'm always super packed with the basic medecine like Imodium, so that helped!
It'd be nice to have more specific advice about prevention. I've traveled in the developing world and never once got sick, but a little common sense goes a long way. The most basic thing: if worried about the water, don't drink it. I developed a fondness for seltzer (gaseosa) on my first trip since any bottled seltzer was probably safe. If water is sketchy, avoid green salads and fruit we couldn't wash properly. If food handling was questionable, skip it. I could usually come up with something I wasn't worried about, and I ate plenty of street food.
Flying back from London to Brazil last year, I got sick with plane food...It was a meat served with a weird sauce, really dark, and I didn´t eat all of that...It really sucks to feel sick in a plane just an hour after I ate that...I have a friend who got sick with pasteurized orange juice served on a plane...
I understand the fact when we don´t want to be rude or not polite with people from other country...I almost refuse a hot chocolate served on a really dirty mug from a tour guide from Santiago...I drank it and nothing happened...got luck!
Another thing to keep in mind is that if your diarrhoea is bacterial, the culprit was likely food that was eaten 48-72 hours previously. We tend to associate our illness with our last meal, but that's often not the case. Bacteria have incubation periods.
Sometimes, street food can be the safest option, especially when served piping hot. Hotel food, even from 5 star hotels, can be sketchy. A friend of mine got two types of parasitic worms from eating food from her swanky hotel during a business trip to China.
@Lillies: Agreed- I have eaten street food in India, Paris, and throughout Mexico, and the only food-borne illness I have experienced was due to the Chili's in the Chicago airport (against my will).
I thought I was safe in eating fried rice with shrimp in a Tokyo department store but it nearly ruined my vacation. Even imodium didn't offer any relief. My doll of a husband had the hotel front desk write him a note that he took to the pharmacy and when he returned he had the front desk translate the dosage instructions. I have no idea what the pills are but they were magical and I bounced back within 24 hours. I went to instant care and got antibiotics when I got home but I'm still holding onto the mystery japanese pills for any future travels.
This post makes me cringe. I have never traveled outside the US but have great dreams to do so....however, nausea and stomach upsets are my worst nightmare and we're going out of the country for our honeymoon next year. Makes me want to pack my suitcase full of pre-washed fruits&veggies and snackable items!!!!!
@KPIES you really should not be worried. It sounds to me like some of the stories listed here are cases of bad luck - Japan and England aren't exactly places known for poor food safety practices. Outside of developing countries or rural areas, the chances of getting a serious food-borne illness abroad are probably as likely as getting one back in the States.
@jardin bleu I totally agree with you and thanks for sharing this. I feel always bad when I eat some foods in traveling. What ever the food was was good quality but I always suffered very bad after eat food during the travel. I will keep this medicine ever now in my pocket during the travel.
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