Author: Belinda Fay
When travelling overseas, many people may experience various health-related changes, such as traveller’s diarrhoea. High-risk destinations for traveller’s diarrhoea can include Latin America, Africa, the Middle East and Asia, however it may occur in many other countries depending on the circumstances.1
What’s to blame?
Cramps, nausea, vomiting and diarrhoea; symptoms experienced in traveller’s diarrhoea, are generally caused by consuming contaminated food or water.1 Various bacteria may cause these symptoms, with one of the most common being Escherichia coli. E. coli attaches to the lining of your intestine, releasing a toxin that causes diarrhoea and abdominal cramps.1
Symptoms of foodborne parasitic infections vary. Protozoa such as Cryptosporidium spp. and Giardia intestinalis most commonly cause diarrhoea.1 Helminthic (parasitic worm) infections can cause a wide range of symptoms depending on the organism. Viruses, such as rotavirus, are responsible for approximately 1 in 3 cases of traveller’s diarrhoea.1
The sources of foodborne illness are not always obvious. Food service workers with poor hygiene may contaminate food, or foodstuffs may have been prepared in unsanitary facilities.1 Many of the organisms involved can also be transmitted by water, soil, or person-to-person contact.
What you can do
When planning a holiday consider the local climate, insects, parasites, and sanitation.2 Probiotic supplementation may support your immunity and gut health. By establishing friendly bacteria in the gastrointestinal tract, the growth of harmful organisms is discouraged.3,4 Saccharomyces boulardii (SB) supports gut health and may aid in relief of symptoms of diarrhoea associated with travelling.5 SB discourages the growth of harmful microorganisms such as Clostridium difficile – a bacteria which is a known diarrhoeal agent.3,4 SB is shelf stable and does not require refrigeration, which is ideal when travelling.
In the case of infection, antimicrobial and antiparasitic herbs may assist with the cause of your diarrhoea. Artemisia annua (Chinese wormwood), Berberis vulgaris (barberry) and Juglans nigra (black walnut) are essential herbs to consider in the management of intestinal worms or parasites, as they have a long tradition of use for these infections.6-8 Barberry in particular has been demonstrated to be effective against a broad spectrum of fungi, protozoans, helminths, viruses and bacteria in test tube research (in vitro).9 Traditionally used for indigestion, barberry has antidiarrhoeal effects.9
Zingiber officinale (ginger) has antimicrobial activity and has been shown to be effective against various bacteria and parasites.9 Ginger is also an important digestive herb which can assist to reduce symptoms of nausea, and is used in traditional western herbal medicine to relieve GIT discomfort and painful digestion, which may be present during parasitic infections.6
Traveller’s diarrhoea should also be managed with rest and fluids. Since vital fluids, salts and minerals are lost, adequate fluid intake (which may include a rehydration formula containing salt/minerals) is essential to prevent dehydration.1
Practice good hygiene by cleaning your hands often with soap and water. Avoiding the following high-risk foods will also minimise your chances of exposure to pathogens:1,10
- Unwashed and raw fruits and vegetables.
- Tap water. Instead drink water that is bottled, boiled or treated. Use bottled water when brushing teeth.
- Ice cubes unless made from purified water.
- Cooked food that has been allowed to cool (street vendors).
- Raw or undercooked meat, poultry, seafood and eggs.
- Unpasteurised dairy foods, especially soft cheeses.
- Prepared food that has been left unrefrigerated for several hours.
Those who may be more susceptible to foodborne illness when travelling are pregnant women, the elderly, and those with weakened immune systems.1,11
Speak to your healthcare practitioner for more information about supplementation. Make sure to always read the label and use only as directed. If symptoms persist, see your healthcare practitioner.
To find a practitioner in your area, go to our Find-A-Practitioner page!
- Traveller's diarrhoea. Better Health Vic, 2017. Viewed 28 August 2017, https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/travellers-diarrhoea
- Travel health information. Australian Government: Department of Health, 2014. Viewed 20 August 2017, http://www.health.gov.au/internet/main/publishing.nsf/content/health-pubhlth-strateg-quaranti-index.htm#away
- Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA 1996;275(11):870-876.
- Krasowska A1, Murzyn A, Dyjankiewicz A, et al. The antagonistic effect of Saccharomyces boulardii on Candida albicans filamentation, adhesion and biofilm formation. FEMS Yeast Res 2009;9(8):1312-1321.
- Kollaritsch H, Holst H, Grobara P, Wiedermann G. [Prevention of traveler’s diarrhoea with Saccharomyces boulardii. Results of a placebo controlled double-blind study]. Fortschr Med 1993;111(9):152-156.
- WHO Monographs on selected medicinal plants, vol 1-4. Viewed 4 July 2017, http://apps.who.int/medicinedocs/en/d/Js2200e/Tahir M, Siddiqui MM, Khan AB. Hamdard Med 1997;40(3): 24-27.
- Braun L, Cohen M. Herbs and natural supplements: an evidence-based guide, 4th ed. Sydney: Churchill Livingstone Elsevier, 2015.
- Black walnut. Natural Medicines Comprehensive Database 2015. Viewed 29 Jun 2017, www.naturalmedicines.therapeuticresearch.comWHO monographs on selected medicinal plants: Berberis.
- Berberine. Altern Med Rev 2000;5(2):175-177.
- Traveler’s guide to avoiding infectious diseases. Medline Plus, 2017. Viewed 18 August 2017, https://medlineplus.gov/ency/article/001925.htm
- Food safety: how to avoid getting sick while travelling. Viewed 20 August 2017 https://www.smartertravel.com/2017/06/19/food-safety-avoid-getting-sick-traveling/