The CDC calls it the “most predictable travel-related illness. Attack rates range from 30%–70% of travelers during a 2-week period.” 1
That’s the bad news. The good news is that most episodes resolve in 24 hours on only symptomatic treatment.
Now, imagine that you did not even need to experience that day of diarrhea.
I have traveled extensively to high-risk areas and never had any severe tummy trouble.
“Why do I get diarrhea when I travel?” 80% of the time, the cause is bacteria from contaminated water or food. Sometimes, the stress of traveling could trigger functional diarrhea. Another reason may be eating new food types your gut is not used to.
“Ever since I saw a tourist with diarrhea and vomiting in Mumbai Airport, I have taken these tips seriously. She was lying on a dirty floor, clothes soiled, too exhausted and sick to close the toilet cubicle door.”
Photo by Teguh Sugi: pexels.com
Now that you understand that the main reason for ‘Why do I get diarrhea when I travel?’ is infection, you can learn how to prevent it.
The six tips to avoid asking, “Why do I get diarrhea when I travel?”
1. Make sure that you sanitize
Carry hand sanitizer or wipes, and tissues with you everywhere you go. This will be much easier to remember post-COVID since it was a habit for three years.
This does not only apply to third-world travel. Public toilets in any country are often dirty and have no soap. So washing your hands might not be an option. In third-world settings, there is frequently no toilet paper or water.
Be prepared.
2. Don’t let even a drop of tap water touch your lips
Brush your teeth with bottled water
This is often the downfall. People do not realize that even this minor exposure could give you squirts.
Ensure bottled water is sealed
Beware of buying bottled water from street vendors. They often reuse bottles and fill them with tap water.
3. Avoid ice
For some reason, people don’t think of tap water when they hear ice. If you want to be 100% safe, no ice. Most restaurants in fancy hotels will use bottled water to make ice, but how can you be sure?
4. Stick to a safe diet
Don’t eat anything fresh that might be rinsed with tap water.
This means no salad.
In 2011, I traveled with my parents to India. From the Himalayas, to the Taj Mahal in Agra, we ended the trip in Goa. First, taking a birding trip to the jungle and then relaxing on the beach for the last few days. Miraculously, during the entire first two weeks, not one of us got sick. We had stuck to the rule that nothing touched by tap water passed our lips.
On our second last day, we had lunch at a rustic restaurant on the beach. The delicious plate of crisp calamari had a small slice of tomato and parsley on the side. My mother could not resist the fresh decoration. She spent the next 48 hours in the bathroom and had a miserable flight home.
Eat fruit that you can peel
After traveling for a while, we all start to crave something fresh.
Wipe the skin with a sanitizer wipe, then peel and eat.
Bananas, apples, oranges, mangos, and pineapples are some examples.
Photo by Any Lane: www.pexels.com
Eat meat and fish with caution
If two conditions are met, it should be safe to eat.
- It must be fresh.
Not hanging for days in the wet market or on a countertop covered in flies. - It must be well-cooked.
No rare steaks, and definitely no undercooked chicken. Let heat kill any lingering bacteria.
In 2013, I stayed on the remote island of Nosy Komba in Madagascar. No roads or electricity, so local restaurants had limited supply and refrigeration. Fish came out of the sea and onto your plate. If you ordered chicken pasta, they went outside and caught the chicken for your meal. The definition of freshness.
6. Take probiotics daily
“I swear by this. Start a probiotic one week before entering the risk area. A good quality probiotic once a day should suffice.”
In South Africa, the brands that I have tried and trust are:
Preventative dose = 1 tablet/capsule daily. Start one week before departure and continue through your entire trip.
Taking a probiotic does not mean you can be reckless and not obey the advice given in this post. They will offer protection against minor exposures that would have had you hanging over a toilet bowl.
Brand names might vary in your home country.
5. Consume local beer and yogurt
A close friend of mine, JE, has traveled extensively in Africa, and he swears by this. His theory is that beer and yogurt contain local processed water, probiotics, and antibodies. A novel idea; I love it.
“Since he told me this over ten years ago, if I am in a high-risk area, I do this. I drink a local beer when I arrive and eat a local yogurt every morning. As mentioned, I can vouch for probiotics, and I enjoy beer.”
Acute diarrhea despite following the tips
You now have some tools to prevent travelers’ diarrhea.
What if you are unlucky? You stick to the rules and get it anyway.
I discuss treatment options in my two articles below. The first one is about the use of probiotics and loperamide for the treatment of mild diarrhea. The second is about when antibiotics are appropriate and which one to choose.
Also read: My Compact DIY Travel Medicine Kit
Also read: Travelers’ Diarrhea Cipro vs Azithromycin
References:
1 Connor, B. (2023). Travelers’ diarrhea. Centers for Disease Control and Prevention. https://wwwnc.cdc.gov/travel/yellowbook/2024/preparing/travelers-diarrhea
