Love traveling and street food? Tips to avoid Travelers' Diarrhea! By Vivian V Nguyen

12/7/2019

For my foodie wanderlusters out there, do you love to travel? Do you enjoy trying new foods? Now a days, people are starting to book a plane ticket to a new country and indulging in their delicious street eats! The street food culture is widely practiced in many countries. Being able to immerse yourself in the local food culture and scenery is all part of traveling! Whether the food you are ready to eat is served at a night market, little random shops located on the side of the road, or a sit-in restaurant, it's good to keep a few things in mind to keep your tummy happy! Trust me, you’ll want to avoid being tied to the bathroom or inside your room all day because you’ve contracted travelers’ diarrhea! Let’s just say, it's better to be safe than sorry! Don’t you agree?!

WHAT IS TRAVELER'S DIARRHEA?

It's not something fun, I’ll tell you that much! Travelers’ diarrhea is caused by different pathogens such as bacteria, viruses and protozoa (Giddings, Stevens, & Leung, 2016). It is commonly contracted through bacteria in contaminated food and water, but also through poor sanitation practices or hygiene.

Sometimes it’s out of the travelers’ control, but taking precautions can help decrease the risk of getting travelers’ diarrhea!

Generally, countries are divided into 3 risk groups:

High risk destinations: Asia, Mexico, Africa, the Middle East, and South and Central America.
Intermediate risk destinations: Eastern Europe, some Caribbean islands, and South Africa.
Low risk destinations: the United States, Canada, Japan, New Zealand, Australia, and Western and Northern Europe (Centers for Disease Control and Prevention, 2017)

Photo Credit: Risk Areas for Traveler's Diarrhea by Travelmed.com

TIPS FOR KEEPING YOUR STOMACH SANE (PRECAUTIONS)

Photo credit: Happy Sad Tummy by svtdesign from Shutterstock

#1 safety tip is to always wash your hands and keep them clean! It's also good to carry around anti-bacterial wipes or hand sanitizer
Some countries water might be contaminated. Drink bottled beverages. Avoid ice in your cup unless you know their source of water.
Eat what and where the locals eat! It’s best to avoid foods that are not local to the region.
Avoid eating foods that has been sitting. Aim for food that is cooked in front of you, or prepared to order!

WHAT TO DO IF YOU'VE BEEN ATTACKED?!

Photo credit: [Gut bacteria] from Creative Common Zero Public Domain.

OH NO! You’ve been hit with travelers’ diarrhea! It's unfortunate, I know the feeling all too well, but it doesn’t have to be the end of your trip! Below are treatments for you according to the Centers for Disease Control and Prevention (CDC) (Centers for Disease Control and Prevention, 2017) to help ease the process. You’ve got to get back out there to enjoy the rest of your travels right?

The treatments below are separated by the severity, so choose the treatment that best relates to how you’re feeling!

Mild diarrhea= tolerable, with a few diarrhea stools in a day, and not causing distress.

Drink lots of fluids to prevent dehydration.
Consider over-the-counter medications such as Imodium or Pepto-Bismol, this can help decrease frequency to the bathroom.

Moderate diarrhea= your body is in distress with more diarrhea stools in a day but not exceeding 10.

Same treatments as mild diarrhea
Consider oral re-hydration salt which is widely available in most countries.
If you have a prescribed antibiotic, consider taking it!

Severe diarrhea= unbearable, more than 10 watery stools within 24 hours.

Same treatments as mild and moderate diarrhea
If you're showing signs of dehydration or unable to retain fluids, seek help from a medical professional.

* According to the CDC, pregnant women and children aged 3 years or younger should check with a health-care provider before taking over-the-counter drugs and avoid medicines containing bismuth such as Pepto-Bismol. (Centers for Disease Control and Prevention, 2017)

SOME FOODS TO EAT OR AVOID UNTIL SYMPTOMS ARE RELIEVED:

Avoid caffeinated drinks and dairy
Try to eat bland or complex carbohydrate foods such as crackers, rice, bread, plain noodles, applesauce, or bananas.
Drink lots of fluids such as water, canned fruit juices, sports drink or weak tea. (“Traveler’s diarrhea - Diagnosis and treatment - Mayo Clinic,” 2019)

VIVIAN'S BONUS TIPS:

Download the Google translator app. If you know you’ll be without wifi or data travel plan, download the offline version of the language you want!
Don’t be afraid to try different ways to communicate, i.e. body language
Looking for a product may be challenging, research a similar item in your visiting country. Screenshot that product and show the photo to the staff. They can find it for you, or something similar.
Pack a traveler “emergency” kit before your trip to include first aid and medications just in case. (sample photos to the right)

Just remember to be cautious and use your best judgment!
Also, don’t forget to have fun and enjoy all the wonderful food traveling has to offer!

Author: Vivian V Nguyen, Dietetics Student at San Francisco State University

References:

Giddings, S. L., Stevens, A. M., & Leung, D. T. (2016). Traveler’s Diarrhea. Medical Clinics of North America, 100(2), 317–330. https://doi.org/10.1016/j.mcna.2015.08.017
Managing Travelers’ Diarrhea While Traveling Abroad (2017, July 24). Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/features/managing-travelers-diarrhea/index.html
Riddle, M. S., Connor, B. A., Beeching, N. J., DuPont, H. L., Hamer, D. H., Kozarsky, P., Ericsson, C. D. (2017). Guidelines for the prevention and treatment of travelers’ diarrhea: a graded expert panel report. Journal of Travel Medicine, 24(suppl_1), S63–S80. https://doi.org/10.1093/jtm/tax026 ‌
Steffen, R., Hill, D. R., & DuPont, H. L. (2015). Traveler’s Diarrhea. JAMA, 313(1), 108. https://doi.org/10.1001/jama.2014.17152
Traveler’s Diarrhea. (n.d). Mayo Clinic. Retrieved from https://www.mayoclinic.org/diseases-conditions/travelers-diarrhea/diagnosis-treatment/drc-20352188

Images:

First Aid: https://target.scene7.com/is/image/Target/GUEST_c445d8ff-692d-4c2f-acb2-0e8001250c4a?wid=488&hei=488&fmt=pjpeg
Gut bacteria: https://scx1.b-cdn.net/csz/news/800/2017/diarrhea.png
Happy Sad Tummy: https://image.shutterstock.com/image-vector/sad-sick-cry-healthy-strong-260nw-1294767964.jpg
Hand Sanitizer: https://i5.walmartimages.com/asr/b3940ae8-3675-4df7-8a34-9e180578cddc_1.13843aaf87f38421c3bf0f47e6081a3c.jpeg?odnHeight=450&odnWidth=450&odnBg=FFFFFF
Loperamide: https://target.scene7.com/is/image/Target/GUEST_2f73a3d3-80a8-4468-8a45-813ffa628c15?wid=488&hei=488&fmt=pjpeg
Oral rehydration salts: https://images-na.ssl-images-amazon.com/images/I/91Z5lRMjs1L._SY550_.jpg
Pedialyte: https://images-na.ssl-images-amazon.com/images/I/61lh3w-52TL._SL1300_.jpg
Pepto: https://i5.walmartimages.com/asr/6c064226-9e01-495c-8406-dfd7ac71c1fc_1.4841310ef2a10ccf28c088910fe9842b.jpeg?odnWidth=undefined&odnHeight=undefined&odnBg=ffffff+
Personal Photos of street foods by Vivian Nguyen. 2018
Risk Areas for Traveler's Diarrhea: https://cdn.shopify.com/s/files/1/0236/7341/files/ch6_fig6_0_travdiah.jpg?919598664155318772
Wet Ones: http://www.wetones.com/img/travel_products.png

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