Avoiding Traveler's Tummy

When I travel, I’m obsessed with a lot of things, most notably -- especially given my background in the health and life sciences -- avoiding traveler’s diarrhea. Before my recent trip to India, I informally polled my friends and colleagues and was surprised to find out that way over 90% of them fell victim to this travel ailment that, at the least, will lay you up for a few days and, at the worst, will end your well-planned trip. Even my physician friends have become ill, after being seduced by tempting ice cream flavors or a delectable chutney. I was determined that this would not be my fate. (I have a very quirky/sensitive digestive system, and have to be especially conscientious.) 

I’m happy to report that I just returned from a delightful two week trip in Southern India sans any sort of gastrointestinal infection.

I’m sharing my tips -- regarding behaviors, and products -- to avoid (or treat) Traveler’s Belly. And, yes, I know that some of you may claim I’m not being very adventurous with my overly zealous pro-hygienic efforts when I'm on the road. But in my Indian travels, I enjoyed a wide array of foods without a day of illness to interrupt even a moment of my many nature-based adventures.

• Pepto-Bismol -- I take two chewable tabs before each meal and at bedtime every day of the trip and the day after I return. The only notable side effect is that it blackens your tongue (and poop). You have to take it as per this protocol otherwise don’t bother.

• Imodium -- This is taken only if I develop diarrhea and am forced to ride buses, trains or planes, where rushing to the bathroom isn’t an easy option.

• Zithromax (Z-Pak) or Azithromycin -- My physician who specializes in travel medicine wrote a prescription for this antibiotic. It’s only used should things get “messy,” aka symptoms that include fever, nausea, vomiting, severe cramping, or blood in the stool.

• Purell wipes, alcohol swabs and liquid alcohol-based hand sanitizer -- the Purell wipes and alcohol swabs come in handy when any surface (such as the airline tray table), utensils, bottles or cans, for example, appear suspicious in terms of hygiene. And, of course, I used the hand sanitizer liberally after touching any surface and before touching my hands to food or my mouth.

• bamboo reusable utensils and a collapsible mug, such as the Sea to Summit X-Mug -- These come in handy should I decide to eat at a place -- such as a street vendor (something I wouldn’t do anyway) where the utensils and dishware may not be properly washed.

• Peanut butter squeeze packs -- This is my emergency high protein food in the off chance that I’m completely uncomfortable with my food choices. (This didn’t happen in India but it did happen one day when I was traveling by bus in Laos last summer.)

• SteriPEN and the LifeStraw water bottle -- Both of these devices allow me to drink potentially microbiologically-contaminated water. The SteriPEN uses ultraviolet light to purify the water that may be infected with bacteria, viruses or protozoa, while the LifeStraw is a water bottle that uses a central core filter to virtually eradicate bacteria and protozoa.

And as to the behavioral don’ts when traveling to avoid gastrointestinal illnesses:

1. No ice, that includes iced coffee, fruit smoothies, and ice cream
2. No raw fruits unless you peeled them yourself, and that includes chutneys or raw fruit that may be garnishing a cooked dish
3. No undercooked meats or fish of any sort
4. No cold food, and that includes salads
5. No fruit juices that may be diluted with tap water
6. No buffets unless the food is piping hot
7. Don’t use tap water to brush your teeth
8. Don’t eat foods where you see flies alighting or you notice the food is not protected from flies
9. I know some people can and do eat street food. I can’t, so it’s on the No-No list.
10. If you’re not accustomed to eating spicy food, now’s not the time to start, especially eating it for each meal of the day. Not everyone’s stomach can tolerate a spicy breakfast if you’re used to something rather bland.
11. Carefully examine the seal on water bottles; if it's not sealed don't drink it.