I travel internationally at least once a year and recently it has been quite rough on my stomach. Despite following all of the usual precautions (don’t drink the tap water, don't eat raw foods, etc), I have fallen ill to traveler's diarrhea more times than I would like to admit. It is very difficult to control EVERYTHING when traveling. Electricity outages are frequent — It made me think of how the refrigerator may not actually be keeping the food from spoiling, if it is constantly being turned on and off. Eating out can become challenging. Spoons, forks, plates, cups may not be washed adequately and even prepping surfaces may not be cleaned sufficiently.
Diarrhea when traveling can affect up to 70% of travelers, so it is not a rare thing and I am certainly not alone. Bacterias really account for most of the cases of traveler's diarrhea. If you check out the CDC, there are generally 3 types of travel destinations in relation to traveler's diarrhea - countries that are low risk, intermediate risk and high risk. And clearly, 1 attack of traveler’s diarrhea doesn't necessarily prevent another attack from happening.
What is someone to do when traveling? I know when traveling my gut microbiome is put under pressure by the stress of traveling to a different time zone and the introduction of foreign bugs from contaminated food, so I wanted to review how probiotics can help with prevention. Probiotics are thought to help either by changing the immune system or by directly attacking the bag bugs and/or their toxins. Generally, when looking for an appropriate probiotic strain and product to buy, I first look up research studies using probiotics to treat the specific condition I’m interested in (in this case - traveler's diarrhea). Once I find the studies, I look at the publication date and review how many people were included in the analysis.
The two biggest players in the probiotic space to prevent traveler's diarrhea are:
First place - Saccharomyces boulardii CNCM 1-745
Honorable mention - L. rhamonosus GG
These two were studied as individual strains, not in combination with other strains. Most of the studies had participants take the individual probiotic strain 2-5 days before the trip and during the trip.
Of course, speak to your healthcare provider before traveling to discuss all of your options to prevent traveler’s diarrhea