Traveler’s diarrhea is one of the most common illnesses among travelers. In fact, very few people have no stories to tell about it. Did you know that more than 55% of people traveling from an industrialized to a developing country experience symptoms related to traveler’s diarrhea? ¹ If you are one of them, you may find the experience somewhat funny in hindsight. However, I bet you did not find it funny at the time the symptoms occurred. It is estimated that 20% of people who get Tourista will be bedridden and that 8–15% of people will have had symptoms for more than a week! ² Of course, no one would ever wish to have their trip affected by it. Are there effective ways to prevent traveler’s diarrhea? Could certain probiotics help us put the odds on our side? Let us shed some light on the subject to help support our immune system when travelling.

What is traveler’s diarrhea?

Also known as Tourista, Traveler’s Diarrhea is an infection that causes various symptoms such as diarrhea, nausea, vomiting, and even fever. It occurs during a trip abroad and is caused by bacteria (e.g., E. coli), parasites or viruses. Since it is mainly transmitted through food and water, all travelers are at risk. It is also important to know that the illness is contagious. For this reason, I invite you to stay away from people who seem to spend a lot of time near the bathroom! 

Let’s talk about the risks

When we talk about risks associated with traveler’s diarrhea, certain destinations come to mind, some of the high-risk destinations include:

• South America
• Mexico
• Africa
• Middle East
• Asia

Besides the destination, it is important to know that some people will also be more at risk. This includes travelers who: engage in riskier eating behaviors;

• take medication to decrease gastric PH;
• suffer from chronic diseases;
• are genetically more predisposed to catching viral infections.⁴

How can this infection be prevented?

Everyone dreams of travelling in the best possible conditions. Therefore, it may seem wise to put the chances on our side by taking certain precautions.

Before departure: prophylactic (preventive) measures

In the context of infectious diarrhea, travelers have three options.

• Vaccination
• Antibiotics*
• Taking a probiotic supplement

* Despite its proven efficacy, taking antibiotics should be avoided because of the widely documented side effects associated with them.

        When traveling: hygiene and caution in food choices 

Obviously, the way you eat and drink will have an impact on the risk of catching Tourista. To avoid the worst, it is advised to:

• Wash your hands for 20 seconds before eating.
• Drink bottled water and avoid having any ice or juice made from concentrate.
• Favor the consumption of fruits and vegetables that have a skin or peel.
• Consume meats and fish that are well cooked
• Continue taking the probiotic supplement for the duration of the trip

Probiotic update

How can taking probiotics protect you from infections? Probiotics work by stimulating the immune system and suppressing the colonization of pathogens (bacteria, viruses). That said, just like medications, each probiotic is effective in a specific area. Would you take antacids for a headache? I don’t think so. Following the same reasoning, in this context it is important to choose the probiotic strain with demonstrated benefits for traveler’s diarrhea.

There is still much to learn about gut bacteria and the possibilities for prevention. However, the studies that have been done so far on the subject only serve to sustain our interest in probiotics and their impact on the prevention of Traveler’s Diarrhea.

To give you a heads up, I thought I would share with you the results of a study conducted by Bio-K+ on 277 subjects. In this study, taking the probiotic supplement compared to the placebo resulted in a significant reduction of traveler’s diarrhea (all types: typical, moderate, and mild) in men and a significant reduction of moderate diarrhea in subjects over 37 years old.

This leads me to some interesting questions. Could it be that men are less cautious than women in their food choices when traveling (no hard feelings, gentlemen!)?  Would the intestinal flora of subjects over the age of 37 be less balanced and thus more predisposed to benefit from the treatment?

These questions remain unanswered for the moment. ⁵

Having said that, integrating different strategies to prevent, diarrhea is often a winning solution to minimize the risk of spending one’s vacation bedridden or on the toilet.

Although traveler’s diarrhea is very unpleasant for the person suffering from it, it is rarely dangerous. In most cases, the symptoms eventually go away on their own, less than a week after they first appeared. If you are suffering from it despite the precautions, the important thing is to focus on good hydration, to remember to take electrolytes and to maintain good hygiene rules, to avoid spreading the virus to other travelers. Enjoy your trip!

1. Yates J. Traveler’s diarrhea. Am Fam Phys 2005; 71:2095-2100
2. DuPont HL. New insights and directions in traveler’s diarrhea. Gastroenterol Clin North Am 2006;35(2):337-53.
3. https://www.canada.ca/fr/sante-publique/services/maladies/diarrhee.html
4. https://www.badgut.org/information-centre/a-z-digestive-topics/caring-for-your-gut-while-travelling-abroad/
5. BIO-K+CL1285 (L.acidophilus, L. casei) prophylaxis for traveler’s diarrhea (unpublished)