Digestive Health

Keeping healthy on your travels

It’s that time of year when we are looking out of the windows at the rain and excitedly thinking about getting away from it all and going on holiday.

For an increasing number of people that means travelling overseas.

In fact, 2016 saw 70.8 million visits overseas by UK residents, the highest figure recorded by the International Passenger Survey (IPS). Most of the visits were for holiday purposes and within the EU.

But along with packing your summer clothes, buying travel insurance and arranging for the cat to be fed, is there anything else we need to do to prepare for our travels? We often overlook thinking about our own wellbeing and some of the far-flung places that we travel to can bring their own challenges in this regard.

Traveler’s diarrhoea (TD)

Thinking about your gut health when you travel is important. With as many as 20-50% of international travellers developing diarrhoea, depending on the areas they visit.

TD is a term for the temporary, but often severe, GI infection that we can pick up when abroad. Most people recover within four days but about 10% of us may have symptoms for over a week and having to miss out on holiday activities is not how we want to spend our valuable time. So how can we be mindful of this when we are ticking off our holiday list?

As well as packing some oral hydration sachets and anti-diarrhoea treatments in our suitcases in case we develop ‘Delhi belly’ or ‘Montezuma’s revenge’, it’s good practice to make sure that you have a list of the nearest pharmacies or clinics where you will be staying.

So, once you’ve packed your ‘TD pack’ is there anything that we can do to help ourselves before we leave the house?

Where are the high risk areas?

The organisms that cause TD are commonly reported worldwide, however, transmission is more likely in countries which have lower food hygiene standards, inadequate sanitation facilities and lack of access to clean water.

High-risk areas include most of Asia, the Middle East, Africa, and Latin America; more than 20 percent of travellers from a high-income country may experience TD in these areas . Intermediate-risk areas include southern Europe, Israel, South Africa, some parts of the Caribbean and the Pacific islands, with estimated incidence rates of between 8%-20%.

Tips to protect your gut before you travel

Over half the cases of TD are caused by bad and sometimes pathogenic bacteria. Simplistically, these types compete for space with good bacteria in your gut. The theory is that the more good bacteria you have the less chance there is for bad bacteria to latch on to your gut cells. And as they both compete for the same space in your gut you may help deprive the less favorable types.

You can feed (and therefore increase) your good bacteria by eating a diet rich in fermentable fibre. So it would be sensible to fill your diet full of fermentable fibre found in beans, lentils, fruit and vegetables for a few weeks before you travel. In fact, it’s what we should be doing every day to maintain our gut health but less than 10% of us do.

Whilst not all cases of TD are caused by bacteria, this is one way in which we can help to maintain our gut health before we travel.

Worth considering outside of keeping your gut healthy when you are away is making sure you have travel insurance set up as well as checking to see what vaccinations you will need.

Tips to avoid diarrhoea when travelling

Obviously, it makes sense to try to avoid picking up harmful bacteria when you are away. Often the bad bacteria which cause TD are spread by bad hygiene practices, which means that the person preparing your food hasn’t washed their hands properly and the kitchens where food is prepared isn’t hygienic.

With this in mind, you should try to avoid uncooked foods as heating foods to a high temperature will kill many species of bacteria. Even when the food is cooked, avoid dishes that look like they have been hanging around for a while, giving bacteria the chance to grow. In the same way avoid drinking unbottled water unless it’s boiled, which kills most bacteria.

What to do if you do get Travellers Diarrhoea

If you can you should let the infection run its natural course and keep yourself hydrated with oral hydration sachets and only consider taking diarrhoea prevention products if you need to travel.

Always consult a pharmacist or healthcare professional if you have TD longer than a few days or if your symptoms get worse.

Medical advice can be found here


References

[1] https://www.ons.gov.uk/peoplepopulationandcommunity/leisureandtourism/articles/traveltrends/2018

[2] https://www.medicinenet.com/travelers_diarrhea/article.htm#what_causes_travelers_diarrhea