What to do when you pick up a stomach bug on holiday

Have you ever found yourself glued to the loo on holiday, while everyone else is enjoying the fun and the beautiful sights? Is your little one prone to having a ‘gippy tummy’ whenever you are away from home? Traveller’s diarrhoea is very common, affecting 40-60% of holiday makers and travellers. We’ve all been there at least once, feeling miserable with stomach cramps and diarrhoea and feeling totally stuck in the hotel room.

Luckily, over the years, I’ve learned a few tricks to prepare ahead for any unfortunate gastric upsets which help to firm things up, so you can enjoy more of your holiday. Here’s a guide on what to take with you or to have to hand just in case you do pick up a tummy bug whilst away.

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Recognising a stomach bug

How do you know if it’s a stomach bug? The main symptom of a stomach bug is having three or more bouts of loose and watery poo within the space of two hours. This may last from three to five days during the first week, but you should be back on track within 24 hours.

Tummy bugs usually infect travellers through contaminated food or water. The most common bacterial culprit is enterotoxigenic Escherichia coli (ETEC), which is responsible for nearly 30 percent of cases. Other common bacterial causes include Campylobacter jejuni, Shigella, and Salmonella species. Viruses such as norovirus and rotavirus, and parasites like Giardia intestinalis, Cryptosporidium, and Entamoeba histolytica, can also cause the tummy bug and will need medical attention.

How to slow up the diarrhoea

If you have mild diarrhoea, you should get better with time, keep hydrated and some home remedies can help. Ideally you want to pass the bacteria, virus or parasite out as quickly as possible, which unfortunately might mean sitting on the loo for hours and getting through loads of loo roll.

Drinking a lot of fluids to prevent dehydration is the most important measure, even if the symptoms are mild. It is recommended to consume clear fluids such as water, diluted apple or pear juices, coconut water or electrolytes. Keep in mind that these should be prepared with safe drinking water, and so this will most likely be from bottled water if you are unsure of the quality of the tap water where you are staying.

You can also take gel binders such as polymethylsiloxane polyhydrate to help manage symptoms of diarrhoea. These are clear and mix well in water, diluted juice or other liquids. A 2022 study found it effective in treating irritable bowel syndrome that was predominantly with diarrhoea symptoms known as IBS-D. It helps to adsorb the toxins related to the infection, so you don’t feel quite so rotten.

Activated charcoal can help absorb gases in the gastrointestinal tract and consuming it can potentially provide relief from symptoms until things naturally die down. Research has found that activated charcoal can help with diarrhoea management by attracting and expelling ingested toxins. It does turn the poo jet black, so do not be alarmed!

Natural remedies such as slippery elm, aloe vera, and marshmallow root can help soothe a sore stomach. Aloe vera, in particular, has antimicrobial and anti-inflammatory properties that can help to heal an inflamed gut.

If you have symptoms such as fever and severe pain, or you spot any blood or mucous (slime) in your poo, you should seek medical advice immediately.

After the infection

Once you have recovered from the diarrhoea and infection and things have calmed down, you should get started on rebuilding your gut flora which in turn will help to protect you from further infections. These may also help to reduce inflammation or bloating and gas. They may help to repopulate the gut bugs that are so important for our overall physical health as well as mood and mind. This can be from eating plenty of live yoghurt or kefir. You can also take with you on holiday some capsulated or powder sachets of live bacteria which can be taken to bolster up your protective microbiome and help to restore any lost beneficial gut bugs from the infection. I recommend you take these daily for at least 6 weeks immediately after the main symptoms of diarrhoea have slowed up.

Probiotics
Live bacteria known commonly as probiotics can help restore the balance of good bacteria in your gut. Research found that taking probiotics whilst taking antibiotics to be 37 percent effective in preventing antibiotic-associated diarrhoea. Probiotic strains such as Bifidobacterium Longum can help reduce inflammation, while Lactobacillus Plantarum can maintain a healthy intestinal lining.

When possible, you should try to complement probiotics with a diet rich in prebiotics to help feed your natural remaining beneficial bacteria. Underripe bananas, onions, garlic, and whole grains are packed with prebiotics and help feed beneficial bacteria in the gut.

Ideally take probiotics away from the antibiotics and this usually works best just before bedtime.

Saccharomyces boulardii
This beneficial yeast called Saccharomyces Boulardii can help both to prevent and support the gut during a diarrhoea episode. A randomised trial showed that it improved the quality of life for people with the looser side of irritable bowel syndrome.

Saccharomyces boulardii isn’t naturally occurring in foods. However interestingly this strain is originally isolated from the skins of lychee and mangosteen fruits in 1923 by French scientist Henri Boulard. It is now more common to find it available in the form of oral supplements.

Supporting gut immunity
After the infection your gut lining will be tender and sensitive, and this can leave it more open to infections. Nutrition can play a role at repairing the gut lining and the nutrients involved include zinc, vitamin A, vitamin D and beta glucans. These nutrients can help to bolster the gut immune system known as Secretory IgA (SIgA) which helps to create tolerance for a wide range of foods and also protects us from future infections.

Zinc can help repair the gut lining and improve immune function. It can help to restore the integrity of the gastric lining and helps to bolster up all the gastric juices so you feel hungry and it also encourages a healthy sense of smell and taste.

Vitamin A can be found in foods such as carrots, sweet potatoes, fish oil, and mangoes. Meanwhile, vitamin D can be obtained from food like outdoor reared meat, eggs, milk, and salmon, as well as exposure to sunlight…which hopefully you will get lots of on holiday! Beta glucans come from eating oats and certain mushrooms such as Shiitake.

These can also be supplemented, if you feel your diet or your child’s diet is not nutritious enough to help restore things.

Round Up

I hope you all have a wonderful holiday that is not disrupted by a tummy bug. If you want to stock up on a holiday First Aid kit before you go away and need any supplement suggestions, then get in touch with our NatureDoc support team who can help you pack with confidence.

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