How to Get your Gut Through a World of Travel

Here are my tips for to avoid traveler’s diarrhea, food poisoning, and the gut bug while traveling the world! As the saying goes, travel is only glamorous in retrospect.  Because in the moment, travel is tiring, unhygienic, and illness-inducing.  I once overheard a girl grumbling that she “wished she had got food poisoning, just so she could really get the whole experience of Morocco”.  Having just survived the 24-hour gut bug that had prevented me from experiencing or discovering  anything in Marrakech (aside from the severe deficit of public toilets), I could have smacked her right there.  Traveler’s diarrhea, Bali Belly, Montezuma’s Revenge – call it what you will – hits 20-50% of international travelers every year, and it ain’t no joke.  Here are some tips for keeping your gut healthy as you roam the globe.

How to avoid traveler's diarrhea and food poisoning while traveling the world, including a fun quiz on whether you should "eat it" or "leave it"!

First off, what is the gut bug?  Most often, traveler’s diarrhea is caused by enterotoxigenic escherichia coli bacteria.  When we eat these guys in unsanitary food, they worm their way down to our digestive tract then get cozy and reak havoc.  Locals often aren’t affected because they’ve adapted to these native bacteria.  Symptoms include severe stomach aches and cramps, feeling bloated, having the urgent need to defecate, and fever.

Where is it?  Although you can get a gut bug anywhere, it is especially prevalent in Latin America, Africa, the Middle East, and Asia.  I can personally vouch for two of these!

What causes it?  For the most part, it all comes down to water.  Fecal-contaminated water can be used to make ice, to wash veggies, or even to brush your teeth, and these all have the potential to make your day very bad.

PREVENT: how to avoid the traveler’s gut bug

  • Peel it, cook it, or toss it.  Fruits and veggies washed in contaminated water can pass that bug to you.  So if you’re like me and think it’d be a great and healthy idea to have a salad on your first day in Peru, you will likely only be able to muster the appetite for french fries for the remainder of the trip, negating any health benefits that stupid salad may have had.
  • Only drink water from sealed bottles.  And make sure you hear the seal pop.  Some restaurant will just refill bottles with tap water.  No bueno.
  • Beware tap water.  If you’re in an area that is really undeveloped, just use bottled water for brushing your teeth and washing eating utensils.
  • Ice.  You guessed it, often made with tap water!  And no freezing it does not kill the nastiest of bugs.  If you’re trying to be all cool and order “on the rocks”, well, you’re not gonna look so cool in about T minus 4 hours.

DEFEND: how to make your belly strong like bull!

  • Pepto Bismol.  God’s gift to travelers.  It reduces irritation in the gut and has a light antibacterial so any initial bacteria have less of a chance.  You can take 2 tablets 3-4 times/day.  One before and one after a meal (especially a risky meal) is a good rule of thumb.

  • Fermented yogurt and kefir.  Your gut is full of millions upon millions of natural bacteria, and that’s a good thing.  Eating yogurt or kefir helps to promote the good, natural bacteria in your gut.

TREAT: so you got the gut bug…what now?

  • Stay hydrated.  It already sucks having the symptoms of gut bug, but this can severely dehydrate you, and that feels about 100 times worse.  Make sure to rehydrate with clear liquids.  Water is alright, but you also need to replace the electrolytes you lost, like sodium and potassium.  Gatorade is great for this, or water and a banana.
  • Avoid dairy.  Lactate (the sugar molecule in milk) is often hard on the digestive system.  Give your gut a break while you’re recovering.
  • Carry Loperamide with you.  Our bodies are pretty smart, so when they decide that a certain symptom is necessary, say diarrhea, it’s for a reason.  In the case of the gut bug, it’s to get that bad bacteria outa there.  But sometimes that’s just not an option, like if you’re on a 12 hours overnight bus with no bathroom winding through the mountains of Peru.  When this is the case, it’s helpful to have an anti-diarrheal like Loperamide to help get you through.
  • If you’ve really got the bug, antibiotics are your lifeline.  Now i must say, taking antibiotics should not be the first method of protection.  Not only do they kill the bad bacteria, but they also kill off the good guys, which can cause imbalances (especially in women).  But if you really need it, you may be able to acquire some good ole antibiotics in the local pharmacies.  Look for names like ciprofloxacin (Cipro), ofloxacin, norfloxacin, or levofloxacin.  These are usually prescribed medications, but can be found over the counter in many underdeveloped countries.  They should go by these names, even if English isn’t the spoken language.  If you don’t speak the language, just write it out or gesture that you have a VERY upset stomach.  500 mg/day takes care of 95% of the cases of traveler’s diarrhea.  Again, these should not be taken as a first line of defense, nor should they be taken for an extended period of time. (And if you’re traveling within the U.S., you can use this find-a-doctor service for quick medical attention).

So let’s play a game…EAT IT OR LEAVE IT? 

1. This fried guinea pig.

It’s fried, therefore was probably heated high enough to kill off the bacteria. Go for it!

2. Whatever this fruit is.

You’ve got to peel off the outer layer to get to the fruit.  Good to go.

3. Whatever this French dish is.

Raw, unpeeled fruits and veggies, and that dollop of dairy stuff?  Trick question!  France has a developed water purification system so this should be ok.

4. The Cuba Libres that were in these glasses.

Ice and mint leaves, leave it!  Unless you think the alcohol is strong enough to kill the bugs, which in all honestly, it may have been…

5. This Moroccan platter.

Raw veggies,  some mystery cream dressing, leave it!

6. Whatever food this Ghanaian street vendor is making.

How to avoid traveler's diarrhea and food poisoning while traveling the world, including a fun quiz on whether you should "eat it" or "leave it"!

If it’s cooked, go for it.  Street vendors offer a window to the true culinary excitement of a country.  Don’t avoid them out of fear.  If it’s heated properly and isn’t something easily perishable, eat it!

7. The food at this pizzeria.

You know, make your own judgement call on this one.

8. The coconut milk from this machete-yielding girl.

It’s peeled, omnomnom!

9. Any food in the vicinity of this friendly feline.

Probably not.

But she’s such a preettttyyyy kitttyyy.

10. How ’bout these apples?

You’re getting the hang of this.  Peel em and they’re good.  Otherwise, negatory.

11. This bread.

In mother Russia, bread is good to go.

Some references

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