23. Jul 2019

Heidrun Valencak

Holiday fun not holiday hell

How to avoid traveller's diarrhoea

Your hard-earned holiday is just around the corner and most of us choose to relax overseas. But beware: Not only sand between our toes, impressive culture and exciting adventures await us at our destination, but also foreign and even dangerous germs that plague our well-deserved holiday and even come back home with us as an unwanted souvenir.

The moment you begin your long-awaited journey and finally indulge in your first welcome drink with the backdrop of a magnificent beach your tummy begins to rumble and groan – one of the first signs that your holiday is quite literally going down the drain! Traveller’s diarrhoea is probably one of the most common diseases that you can suffer from overseas. On average, every second tourist is haunted by Montezuma’s revenge, whereas the incidence varies quite strongly depending on your destination: The lower the standards of hygiene in your holiday destination and the higher the temperatures (germs thrive best at body temperature – i.e. 37°C), the more likely you are to take an unwanted break from your holidays. The intestines of the locals are used to the variety of germs – however, within the first two weeks, tourists encounter these “local” bacteria and viruses for the first time and are more susceptible towards diarrhoea and other complaints.

Traveller’s diarrhoea as an unwanted souvenir

So-called enterotoxigenic Escherichia coli, short ETEC-bacteria, are primarily responsible for diarrhoea. They produce toxins that cause watery diarrhoea, nausea, and vomiting. But thankfully these complaints only last a few days: The most ETEC-strains are self-limiting – i.e., they are removed from the intestines together with the watery faeces. Most infections are not dangerous, although they do ruin our holiday by confining us to our hotel rooms instead of tanning on the beach.
However, the whole thing becomes more complicated when pathogenic germs that really feel at home in the intestines and intestinal wall come into play: Salmonella, Shigella, Campylobacter, and Giardia lamblia all cause severe infections in the digestive tract, especially when the intestines are vulnerable because of the pre-holiday stress and already have a damaged intestinal wall: This so-called “Leaky Gut” allows germs to settle down in the intestinal wall and, therefore, don’t leave the body that quickly either.
Whoever suffers from a complicated case of traveller’s diarrhoea while on holiday has to face long-term consequences and brings the germ home as an unwanted souvenir. Up to 10% of all the afflicted develop chronic traveller’s diarrhoea that can last even weeks after the holiday is over. Another complication is the postinfectious irritable bowel syndrome with long-lasting stomach cramps, flatulence, and diarrhoea. A gift that everyone could do without!

Better safe than sorry – tipps on how to avoid traveller’s diarrhoea

Tipps für die nächste ReiseThe best way to prepare yourself against traveller’s diarrhoea is to follow these simple hygiene rules while on holiday overseas – after all, you want to have beautiful memories of your holidays and not the toilets.

„Cook it, peel it, boil it or leave it!“

should be your motto each time you go to the hotel buffet, or visit the local food truck. Make sure that meat, fish, and other kinds of seafood are properly cooked and not raw on the inside. Even classic breakfast dishes like a soft boiled egg or an omelette can be a breeding grounds of germs. You should also avoid salads and fruits that were washed with tap water. Rather enjoy fruits that you can peel yourself (e.g., bananas or mangos). Be careful with melons: Producers often add germ-laden water to increase their weight so that they can sell them for a higher price.

Speaking of water:

A few ice-cubes in your cocktail can also ruin your holiday. Often enough they have already melted in your drink – rather ask a second time or keep an eye on the bartender. Apart from that, pay attention to the hissing and popping sounds when you open a bottle of water to make sure the seal hasn’t been broken.

Germs that cause diarrhoea also lurk in sanitary facilities:

They can be found on doorknobs, hands, toilets and much more. Washing your hands regularly and thoroughly disinfecting them (especially before a meal and after going to the toilet) can reduce the risk of infection.

Travel probiotics

In addition to these sanitary measures, travel experts recommend preparing your intestines for your journey with special travel probiotics (e.g., OMNi-BiOTiC® TRAVEL): They contain selected helpful bacterial strains that stand up against Salmonella, Shigella, and co. and complement your natural intestinal flora in the best possible way while on holiday. Studies also show that the use of probiotics can reduce the duration of traveller’s diarrhoea by one or two days. To find out what shouldn’t be missing in your travel first-aid-kit, go to your local pharmacy.

Holiday stress for the digestive tract

As if pathogenic germs didn’t put our digestive system under enough strain: Constipation, flatulence, heartburn and other gastric complaints can take away our holiday joy. Stress upon arrival and a lack of movement on long flights or drives “paralyse” the intestines. A change in our daily rhythm and strange new dishes also slow down our digestion. The loss of liquids due to sweating or dry, climatized air makes our faeces thicker and more difficult to excrete. We often also suppress the need to go to the toilet, either because there is no toilet nearby or the sanitary facilities are so dirty that you’d rather do your “business” elsewhere. All these factors often lead to traveller’s constipation, accompanied by bloatedness and flatulence.

Even the stomach has to go through a lot while on holiday, especially because we “treat” ourselves: Fried and fatty foods, alcohol, nicotine, coffee, soft drinks, and other fizzy drinks put the stomach under strain as well as hot and exotic spices. All-inclusive-offers and lavish buffets often make us eat more than we are used to. This can overwhelm the stomach and lead to an inflammation of the stomach mucosa with symptoms such as heartburn and stomach ache.

Das in der Frucht enthaltene Papain sorgt für Schwung im Darm.But of course you can do something against it: Support your digestion with the power of papaya! This plant has an excellent reputation as a health-promoting fruit in tropical countries. The South American natives named the papaya the “tree of health” because of its abundance of digestive ingredients. The papaya contains the protein-digesting enzyme Papain that can give your stomach a much-needed boost while travelling. When stomach complaints arise, the combination of papaya and calming oats has been proven to be most effective. Why shouldn’t your stomach and intestines not also have a relaxing trip?

 

With these tips in mind, the entire team at the AllergoSan Institute would like to wish you a relaxing summer holiday – and a good “gut feeling” during your travels!


Traveller’s diarrhoea

 

Traveller’s diarrhoea usually begins between the third and ninth day of your travels and can last up to four days (+/- two days). The number of bowel movements (three to six times a day) as well as the amount of water (up to 85%) increase significantly. The diarrhoea is mostly accompanied by cramp-like pains when defecating (65-70%), nausea and vomiting (30-45%), and fever (12-25%).

The risk of contracting traveller’s diarrhoea in different countries

  • High risk: Up to 50% of all travellers suffer from diarrhoea when visiting Latin America, Asia, and Africa – even 80% of all travellers can be affected when on a Nile cruise.
  • Intermediate risk: When travelling to Southern Europe, Israel, and the Caribbean, 10-20% of travellers have diarrhoea.
  • Low risk: Less than 8% of all travellers suffer from diarrhoea when going to Northern Europe, North America, Australia, New Zealand, and Japan.

What to do against diarrhoea?

  • Drink a lot to maintain your liquid balance (tea, boiled water, etc., but no soft drinks: sugar withdraws even more water from the body)
  • Eat easily digestible foods (e.g. white bread, steamed carrots, rice, porridge, etc.)
  • Take probiotics to support the intestinal flora against diarrhoea pathogens.

When should you go to the doctor?

You should consult a doctor if the symptoms don’t improve within two to three days, the stool contains blood or mucus, you develop a high fever or if fatigue and cardiovascular problems occur. This also applies to children under the age of two, pregnant women, the elderly, and weakened individuals. You should also go to the doctor in suspected cases of infections with Salmonella and other highly contagious germs, or diseases such as Typhus and Cholera.

 

Stay informed!

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