Priobiotics for traveler’s diarrhea?

For many inhabitants of North America, as the winter months approach, we look forward to a warm tropical vacation to escape from the cold.  Popular destinations include Mexico and the Caribbean.  However, many of us share valid concerns about traveler’s diarrhea.  Traveler’s diarrhea is the most common illness that affects travelers.  High-risk areas for traveler’s diarrhea include developing countries in Africa, Asia, the Middle East, and Latin America.

Traveler’s diarrhea is often referred to by many names:  Deli Belly, Bali Belly, Montezuma’s revenge, or Thai dal wave.  As funny as some of these names are, TD is no laughing matter.

Steps to avoid traveler’s diarrhea

1. Only drink bottled water (even to brush your teeth)
2. Avoid eating raw fruits or vegetables
3. Avoid ice cubes that may be made with local water
4. Maintain good hygiene.

Symptoms of traveler’s diarrhea

1. Abdominal cramps
2. Diarrhea
3. Dehydration–mild to severe
4. Nausea/vomiting
5. Lethargy
6. *Fever/Vomiting/bloody stool–more severed form with greater risk of dehydration

Probiotics to prevent traveler’s diarrhea?

Probiotics are dietary supplements that contain bacteria or yeast that are potentially beneficial.  A recent meta-analysis which reviewed 12 randomized controlled trials which met inclusion criteria found that probiotics significantly prevent TD (McFarland, 2007).

Results:

“The pooled relative risk indicates that probiotics significantly prevent TD (RR=0.85, 95% CI 0.79,0.91, p<0.001)”

CONCLUSION:

“Several probiotics (Saccharomyces boulardii and a mixture of Lactobacillus acidophilus and Bifidobacterium bifidum) had significant efficacy”

Safety

“No serious adverse reactions were reported in the 12 trials. Probiotics may offer a safe and effective method to prevent TD.”

My conclusions:

While in medical school, I learned that bismuth containing preparations such as Pepto-Bismol may help to prevent contracting traveler’s diarrhea.

Read:  take it before you develop TD rather than waiting until after!

In fact, a recent study found that these preparations can provide a rate of protection of 65% when taken 4 times per day (Ericcson, 2005).

Additionally, probiotics rather than antibiotics may become the preferred method of preventing traveler’s diarrhea!

For those who are unlucky or unprepared and develop traveler’s diarrhea, the illness is often self-limited, but medical care may be required for more severe cases.  Taking steps to prevent TD will help you get the most enjoyment out of your vacation or travels…

References:

McFarland LV.  Meta-analysis of probiotics for the prevention of traveler’s diarrhea.  Travel Med Infect Dis. 2007 Mar;5(2):97-105.

Ericsson CD. Nonantimicrobial agents in the prevention and treatment of traveler’s diarrhea.  Clin Infect Dis. 2005 Dec 1;41 Suppl 8:S557-63.