Traveller’s Diarrhoea

In this blog, Rick from Health Generation will discuss some prevention and treatment strategies for traveller’s diarrhoea.

It’s winter in Australia now and many Aussies are heading overseas for a vacation to escape the cold and get a dose of sun. Asia is a popular destination, however sanitary conditions are not as strict as in Australia and many people suffer from traveller’s diarrhoea. In fact, traveller’s diarrhoea affects 20-50% of international travelers, depending on the destination and season.

Symptoms of traveller’s diarrhoea include abdominal cramps, pain or bloating, nausea, fever, dysentery, vomiting, blood in stools and urgency to go to the toilet. It is thought that the ingestion of bacterial pathogens is the greatest risk of traveller’s diarrhoea. Viruses and parasites are thought to account for a much smaller percentage of cases. However, a recent scientific article by Simons et al 2016 discussed the possibility of Norovirus being a larger contributor to traveller’s diarrhoea than previously thought. This could change the current conventional treatment strategy of using antibiotics.

Check out the high risk areas for traveller’s diarrhoea.

You’ve paid all that money for flights and accommodation so the last thing you want is to be sitting around in your hotel room feeling sick and not being able to enjoy your holiday. However, even worse, the effects of traveller’s diarrhoea might not end there. As I discussed in my blog on irritable bowel syndrome (IBS), traveller’s diarrhoea increases the risk of post-infectious  IBS (PI-IBS) by as much as 10 fold. The risk of developing PI-IBS also increases with increased duration of traveller’s diarrhoea (TD).

Therefore, while the main focus should be on prevention of TD, shortening it’s duration should also be a priority.

Preventing TD

The main risk minimisation strategies include:

  • Always wash hands well before eating
  • Drink only bottled or suitably filtered water
  • Avoid ice
  • Avoid close contact with people who show symptoms of acute gastroenteritis

Steffen 2005 found that the following also increased the risk of TD:

  • Staying in 5-star hotels
  • Drinking too much beer
  • Tours, particularly all-inclusive and adventure tours

Several studies have shown that certain strains of probiotics can reduce the risk of developing TD. One such strain is L. Rhamnosus GG (LGG) which is sold in Australia by Ethical Nutrients as Eczema Relief. Galactooligosaccharides (GOS) is a prebiotic supplement that has also shown effectiveness in reducing the risk of developing TD. Unfortunately, GOS is currently not available for purchase in Australia.

Treating TD

The most important thing to remember if you have TD is to rehydrate using the correct ratio of salts (sodium & potassium) and sugar (glucose). Fluids and electolytes are rapidly lost during vomiting and diarrhoea and they need to be constantly replenished. This is particularly important for infants and children who are at a greater risk of dehydration. Ethical Nutrients manufacture a product called Re-Hydrate that has the correct ratios of salts and sugar as specified by the World Health Organisation. Alternatively, you can make your own solution using water, salt and sugar using the recipe outlined here. This site also has some other useful rehydration tips.

Several studies have shown that certain strains of probiotics can reduce the duration of TD, along with GOS.

Therefore, both GOS and probiotics, such as LGG, taken before and during an overseas vacation can be used to both reduce the risk of developing TD and to shorten it’s duration. Both supplements may also be effective in restoring the microbiome if antibiotics are used to treat TD.

The conventional medicine approach to treating TD focuses on using antibiotics. However, the use of antibiotics to treat TD should be used with caution. Firstly, antibiotic resistance is on the rise and some are questioning this approach, suggesting that antibiotics should be limited to severe cases only.  Secondly, a recent study showed that antibiotics may increase the risk of colonisation of pathogenic microbes. Thirdly, I previously mentioned that Norovirus may be a more common cause of TD than previously thought. In such cases, antibiotics are not an effective treatment. Lastly, the negative impact that antibiotics have on the microbiome is becoming well known. Therefore, antibiotics may be doing more harm than good in many cases!

The best treatment for traveller’s diarrhoea is prevention. If you’re going on vacation to a high risk area, be sure to take the necessary precautions to minimise the risks so you can enjoy your holiday and stay healthy.

Book a FREE appointment with Rick today, either at his office or via skype Australia wide

About the Author

Rick Hallion is a nutritionist located in Coffs Harbour, NSW. Rick has a special interest in gastrointestinal conditions and believes that the gut is central to good health. Rick offers sound practical advice for treating a whole range of gastrointestinal conditions. 

traveller's diarrhoea coffs harbour

 

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