Admittedly, because we mostly prepare our own food when we travel, we rarely get traveler’s diarrhea anymore. Most traveler’s diarrhea comes from eating food that’s been contaminated with another person’s feces. In our early days of traveling, before we went to Fez, Morocco in 2012 where John got Cyclosporiasis, we ate most of our meals in restaurants on our overseas trips. Usually, we didn’t get sick. But, the problem with eating out anywhere in the world is that, when you do get sick, you can get really sick.
It can be hard to find good disinfectants to safely remove the yuck from fruits and vegetables, but vinegar is something that’s widely available all across the world and it works well, and safely as a disinfectant. Soak your fruits and veggies in a mixture of water and vinegar for about 15 minutes. If you’re on your way somewhere and the only food available looks questionable, either don’t eat it and go hungry, or dowse it in vinegar. In India, if bananas arrived at our table skinned and naked, we dipped them in a bowl of straight-up vinegar before eating them (we simply ordered the bowl of vinegar as part of our meal). We dipped everything in vinegar before eating it. And we never got traveler’s diarrhea in India, the Traveler’s Diarrhea Capital of the World.
There are a lot of myths and misunderstandings about the human digestive system. Most of the time, if you’re having nausea and vomiting, you probably have food poisoning, but when you’re traveling, it could be a variety of other things too like malaria, typhoid dengue, giardia, or even Chagas Disease. A lot of diseases cause diarrhea (with or without vomiting). So, what do you do if you get traveler’s diarrhea en route to a place that’s far away from good health clinics?
Travelers Diarrhea Treatment When Pharmaceuticals Aren’t Available
If you’re in some rural community just outside of Delhi or located in the backwoods of China in a rural community far away from a clinic, you may not be able to access antibiotics to cure traveler’s diarrhea unless you happened to bring those things with you in a travel medicine bag. Depending on the extent of your illness, it may be difficult for you to leave your room in search of treatment, but don’t despair. There are a number of natural remedies for diarrhea that are easy to find all over the world. They work through alternative mechanisms and on a different time-line than antibiotics, but these remedies will do the trick if you’re in a pinch.
Black Tea for Diarrhea, Plain White Rice, Bananas, Apples, or Potatoes
A good idea is to drink 1 cup of strong black tea right away when the diarrhea starts (if possible) and then eat small portions of PLAIN white rice (no oils, no butter, JUST RICE). The black tea has an astringent effect on the gut while the rice has a binding effect on the bowels. This more “natural” approach allows the body to continue to purge toxins as necessary, but it encourages the body to rebalance and stop with the shits. This isn’t foofy-talk…black tea and rice really work, but if they don’t, it was probably for the best. Be sure to keep drinking clear fluids to stay hydrated. When it comes to diarrhea and/or vomiting, it’s dehydration that will ultimately kill you. Stay on top of that by drinking sips of apple juice or water frequently.
Bananas or potatoes are another good choice if you have traveler’s diarrhea. Both are bland and full of potassium, which can help soothe an irritated colon. If you aren’t allergic to apples, they can help bind the bowels and stop diarrhea much like black tea.
Papaya Seeds for Diarrhea
Rather than taking Bactrim chronically on a big trip (people do this apparently), papaya seeds are a better choice. Ground up papaya seeds can be used to prevent and sometimes treat gastrointestinal disturbances like traveler’s diarrhea. The seeds are anti-inflammatory and antibacterial. Extracts of papaya seeds are effective against E. coli, Salmonella, and Staphylococcus infections. If you’re traveling in a place where there are papaya fruits available, you can take the seeds right out of the fruit and grind them up with a mortar and pestle (or whatever is available—they’re about the size of black peppers) and drink the powder in some water with just a sprinkle of lime juice (citrus in large quantities can be irritating to the intestinal tract). Papaya leaves as well as the seeds are some of the few effective treatments available for Dengue, but this fruit isn’t all fun and games: green papaya ingested or even laid on the skin over a pregnant woman’s uterus can cause a miscarriage. And men who eat papaya seeds may have diminished fertility (in some Asian countries, papaya seeds are used as a form of birth control for men).
The Problem with Over-the-Counter Diarrhea Medications
It’s not usually wise to “stop-up” the diarrhea once it starts using things like loperamide or Lomotil. Diarrhea is the body’s attempt to “purge” a pathogen or toxin so when you take a drug to stop the diarrhea, it’s like you’re holding the disease organism or toxin in the body. Sometimes…I would say, rarely, this option may be necessary, but usually IT’S A BAD IDEA. So think over your situation carefully before you pop a pill. If you’ve had diarrhea for 3 days or travelers diarrhea that’s really severe and accompanied by other symptoms like fever, nausea, vomiting, lack of appetite, body aches, headache, etc., you might have a more severe infection like typhoid, malaria, giardia, or dengue. In that case, taking a drug to merely stop the diarrhea could be like putting a cork in your anus and allowing those nasty organisms to stay inside your body and proliferate at will.
Antibiotics for Diarrhea
Travelers tummy and diarrhea in particular are always unfortunate when you have a long trip ahead of you. In many places in the world, you can get antibiotics to help you overcome traveler’s diarrhea even if you arrived in the country without the proper meds, but in order to choose the right ones, you have to have some idea of what’s causing the travel diarrhea. For example, if you have malaria, Bactrim won’t help, but if you have Cyclosporiasis, anti-malarials like Atovaquone-Proguanil won’t help. In fact, taking these drugs could make things worse by destroying the good bacteria in your intestinal flora, leaving your poor intestines even more defenseless than before. That being said, I’ve read in some places online that some travelers taking Bactrim (Trimethoprim and Sulfamethoxazole) for traveler’s diarrhea prevent, which sounds like a terrible idea to me. Bactrim is a broad-spectrum antibiotic that kills some of the good bacteria in the body as well as the bad. Some sources say that it’s 100% effective at preventing traveler’s diarrhea, but it won’t prevent other illnesses like malaria, dengue, or Chagas. So, in other words, you may still end up getting sick and having diarrhea, even after taking Bactrim for an extended period of time. Since research suggests that immune health is in large part dependent on the health of the colon, it seems unwise to me to take broad-spectrum antibiotics of any kind long-term unless it’s absolutely necessary. And by absolutely necessary, I mean, unless the likelihood of getting traveler’s diarrhea is so high as to warrant killing off good intestinal flora that might protect a person from serious versions of other diseases, it might be better to instead, just carry Bactrim along on a trip abroad and take it immediately if you get travelers diarrhea. Since Bactrim works to treat a number of different diseases that manifest as “travelers diarrhea”, that’s what I would do.
However, if the Bactrim doesn’t work right away—if it doesn’t produce a noticeable betterment of general health and a lessening of diarrhea within 24 hours—then you need to consider other possible causes for your travelers tummy.
Food to Avoid When You Have Traveler’s Diarrhea
Avoid greasy foods as well as mangos, chilis if you have travelers diarrhea. Instead, as mentioned above, eat bananas and white rice. Wash these down with black tea. DRINK PLENTY OF FLUIDS, particularly decaffeinated ones that will keep you from becoming dehydrated. It may help to avoid ALL FOODS except bananas and white rice if the diarrhea is severe. Chances are, you won’t starve to death and as long as you continue to drink fluids, you’ll be okay. Fasting briefly when you have diarrhea can give your body a chance to recalibrate.