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6 ways to keep your stomach safe anywhere on Earth


What's that I hear? A collective "Ewww, gross"? Let's settle down and demystify this common travel ailment, officially called travelers' diarrhea (TD) but also known by a variety of colorful nicknames, including turista, Montezuma's revenge, Delhi belly and the Turkey trot, depending on where you are in the world. 


But TD is not inevitable. The main cause is food and water contaminated with bacteria (such as E. coli and salmonella), viruses and parasites from animal feces. When those pesky microorganisms hit your gastrointestinal tract, your gut essentially erupts in an effort to get rid of the invaders. Your odds of getting sick are higher when a rudimentary water system — such as those in developing regions — fails to adequately separate tap water from waste water. What's more, food-safety standards from farm to table are usually less stringent than in the U.S., Western Europe, Australia, New Zealand and Japan. Meat can become contaminated at the slaughterhouse, fruits and vegetables come in contact with manure-based fertilizers, and restaurant workers often aren't taught to wash their hands before handling food -- even after using the toilet.

What can I do to stay safe? 



Are street food carts off-limits? 

  • Pick a cart with a long line and quick turnover, which means food is hot and fresh. Certain vendors are popular because their food is tastier and safer -- it's worth the extra minutes in line.
  • Return to a cart you've enjoyed. Finding a vendor serving safe, delicious food can be the beginning of a beautiful friendship -- he may even share recipes if you ask.

Likewise, probiotics ("good" bacteria) found in yogurt have not been clinically proven to prevent TD (the CDC says evidence is "inconclusive" to date), and taking antibiotics preemptively is not recommended for most travelers. Readers of Budget Travel's blog, This Just In, recently posted their own TD remedies, including ginger and cayenne pepper pills, but research doesn't yet support those remedies either. One reader suggested that drinking alcohol after every meal helps keep her safe. Spak jokes that, like chicken soup, "It couldn't hurt."

Are there any apps that can help me vet restaurants for safety? 
At the moment, DineSafe.com covers more than 250,000 restaurants in the U.S. and Canada and offers an Android app (an iPhone app is under development) that allows you to find a restaurant's health rating, with explanations of what the ratings mean and a record of recent inspections. Hopefully similar apps are being cooked up that will help vet eateries in regions with health-inspection protocols less vigorous than ours.

What should I do if I get traveler's diarrhea? 
Because it may be possible to follow food-safety rules strictly and still be struck down — whether it's at a sketchy dive or a four-star restaurant — there are some must-pack meds you'll need to help you bounce back. Imodium, or any other over-the-counter product containing the active ingredient loperamide, may help control diarrhea. Spak says you should take diarrhea seriously, making sure you treat it yourself or seek medical help because it can lead to dehydration and other serious conditions.

Before you leave for your trip, ask your doctor if she'll prescribe an antibiotic, such as ciprofloxacin or azithromycin, and whether taking an antibiotic along with loperamide is appropriate for you. Stay hydrated and get plenty of rest so you can enjoy the remainder of your vacation. Although travelers' diarrhea can last several days, it's usually not dangerous if treated properly. But if your TD is accompanied by a fever of 101 degrees or higher, bleeding, or severe abdominal pain, see a doctor — there may be something more serious afoot and you'll likely have to stop taking loperamide. 

It's also worth remembering that you can get TD-like symptoms from a major change in your diet — which is what can happen when you take an exotic trip. If you're a relatively healthy eater who switches to an all-ice-cream-and-chorizo meal plan the minute you're away from home, don't blame the restaurant or street vendor for your bellyache! 
Credible edibles
Bring with you:

  • Packaged breads, cereals and crackers
  • Granola and energy bars
  • Instant soup
  • Peanut butter

Buy on the road:

  • Unpeeled fruits and vegetables, like avocados, bananas, oranges, peas, and edamame
  • Nuts in their shells
  • Bottled soft drinks, beer and wine


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