On the road to the unknown or the all inclusive resort!
Although traveler’s diarrhea is more common in tropical and developing countries, other destinations are not exempt. You are planning a family trip and you want to avoid the “turista”, Montezuma’s revenge, or any other colourful nickname according to the region you travel to such as Delhi Belly in India, Kathmandu Quickstep in Nepal. The statistics are meaningful: up to 60% of travelers can be affected by this condition since their systems are not accustomed to foreign bacteria1.
The infection causes diarrhea (more than 3 liquid stools a day), signs of dehydration, cramps and abdominal pain and sometimes even nausea and fever2. The effects are more pronounced in vulnerable populations such as our little ones, pregnant women and the elderly3. The turista is caused by undesirable bacteria such as Escherichia coli, Salmonella, Campylobacter, etc. These are mainly transmitted through the consumption of non-potable water (either directly or indirectly from ice cubes for instance)4. In some countries, attention should also be paid to uncooked foods (raw seafood and fish, salads and peeled fruits) and unpasteurized dairy products which may contain bacteria, or viruses or sometimes parasites2,3.
Traveler’s diarrhea often appears only a few days after arrival at the destination and can take as long to resolve2. In case of infection, the most important thing is to rehydrate by drinking water (obviously not contaminated) and then salts and minerals (sodium, potassium, calcium and magnesium)2,3, as found in bananas, potatoes, broths and soups prepared with sterile water. To minimize the burden on the intestines, it is wise to avoid dietary fibre such as found in whole grains and legumes, also limit very fatty meals (and desserts) as well as caffeine until the digestive system is restored.
Probiotics to ease your mind… and digestion
There are currently very few options to prevent traveler’s diarrhea1. Vaccination before an excursion overseas is not a guarantee against the turista, and is not suitable for all age groups5. To date, no vaccine has been developed specifically for this infection. Fortunately, probiotics can have a protective effect against this type of diarrhea6. The process is quite simple to understand if we consider the microbiota as the interface with the outside world, which would offer resistance to infection thanks to a more populous and more varied intestinal flora in travelers who are supplemented with probiotics7.
It is recommended to take a symbiotic, that is to say, a probiotic combined to a prebiotic (we find this combination in Probaclac supplements, which contains fructo-oligosaccharides) no less than 3 days before departure, daily for the duration of the stay and in the week after the return8. The bacterial strains that have shown a more preventive effect on travelers’ diarrhea are Lactobacillus acidophilus and Bifidobacterium bifidum9. Other studies confirm that Lactobacilli and Bifidobacteria represent an interesting bio-therapeutic option to challenge turista in children10. Experts agree that probiotics help treat acute diarrhea, especially in toddlers and young children11. These good bacteria act in different ways: by secreting antimicrobial substances to slow the reproduction of pathogens, by competing for the resources of the host (our human body), by inhibiting the virulence of bad bacteria, among other formidable tactics6.
It is frankly more practical to choose a probiotic that does not require refrigeration and is allergen-free for your trip (like Probaclac Travelers). It is suggested to take probiotics with meals, to allow the multiplication of beneficial bacteria and fortify the colonization of the intestinal flora. Only one capsule of Probaclac Travelers is sufficient for children, while the recommended dosage for adults is double that (two capsules per day).
Nevertheless, more scientific research is essential to determine the ideal composition, optimal dosage and duration of optimal supplementation for probiotic supplementation to make it an internationally recognized anti-infective agent12. Especially if you consider that more than a billion people (1 in 7 inhabitants) travel the world each year and that diarrhea can disturb … or even ruin… an adventure overseas. Until consensus is reached, include probiotics when packing for your journey and make them your travel insurance! The Probaclac Travelers supplement is an ally for holidaymakers looking for an adventure without worrying.
REFERENCES
1Kollaritsch H, Paulke-Korinek M et Wiedermann U. Traveler’s Diarrhea. Infect Dis Clin North Am. 2012 Sep ; 26(3) : 691-706.
2Mayo Clinic [Website]. Consulted December 2nd 2017. https://www.mayoclinic.org/diseases-conditions/travelers-diarrhea/symptoms-causes/syc-20352182
3Passeport Santé [Website]. Consulted December 2nd 2017. http://www.passeportsante.net/fr/Maux/Problemes/Fiche.aspx?doc=turista
4Youmans BP, Ajami NJ, Jiang ZD, Campbell F, Wadsworth WD et al. Characterization of the human gut microbiome during travelers’ diarrhea. Gut Microbes. 2015 ; 6(2) :110-119.
5López-Gigosos R, Segura-Moreno M, Díez-Díaz R, Plaza E et Mariscal A. Commercializing diarrhea vaccines for travelers. Hum Vaccin Immunother. 2014 ; 10(6) : 1557-1567.
6Surendran NM, Amalaradjou MA et Venkitanarayanan K. Antivirulence Properties of Probiotics in Combating Microbial Pathogenesis. Adv Appl Microbiol. 2017 ; 98 : 1-29.
7Riddle MS et Connor BA. The Traveling Microbiome. Curr Infect Dis Rep. 2016 Sep ; 18(9) : 29.
8Virk A, Mandrekar J, Berbari EF, Boyce TG, Fischer PR et al. A randomized, double blind, placebo-controlled trial of an oral synbiotic (AKSB) for prevention of travelers’ diarrhea. J Travel Med. 2013 ; 20(2) : 88-94.
9McFarland LV. Meta-analysis of probiotics for the prevention of traveler’s diarrhea. Travel Med Infect Dis. 2007 ; 5(2) : 97-105.
10Penna FJ, Filho LA, Calçado AC, Junior HR et Nicolli JR. [Up-to-date clinical and experimental basis for the use of probiotics]. J Pediatr (Rio J). 2000 ; 76 suppl 1 : S209-217.
11Sarowska J, Choroszy-Król I, Regulska-Ilow B, Frej-Madrzak M, Jama-Kmiecik A. The therapeutic effect of probiotic bacteria on gastrointestinal diseases. Adv Clin Exp Med. 2013 ; 22(5) : 759-766.
12Caffarelli C, Cardinale F, Povesi-Dascola C, Dodi I, Mastrorilli V et Ricci G. Use of probiotics in pediatric infectious diseases. Expert Rev Anti Infect Ther. 2015 ; 13(12) : 1517-1535.