Traveler’s diarrhea may be avoided by consuming specific probiotic strains

An upset stomach commonly occurs when traveling abroad and is known as traveler’s diarrhea. Clinical studies have suggested consuming the Lactobacillus rhamnosus, LGG^® probiotic strain^{1, 2} (hereafter referred to by use of the trademark LGG^®) or a specific blend of the Bifidobacterium, BB-12^®, Lactobacillus acidophilus, LA-5^®, Streptococcus thermophilus, STY-31™ and Lactobacillus bulgaricus, LBY-27™^{3, 4} (hereafter referred to by use of the trademarks BB-12^®, LA-5^®, STY-31™ and LBY-27™) probiotic strains may be associated with a reduced incidence of traveler’s diarrhea. 

Traveler’s diarrhea is the most common travel-related illness

Unfortunately, travel and exotic holidays sometimes come hand-in-hand with consumption of contaminated food and drinking water.⁵ Reasons include exposure to climates and sanitary practices that are different to what we are more accustomed.⁵ Food and water contamination can occur anywhere in the world, but the regions that carry the greatest risk include the Middle East, Africa, Mexico, Central and South America, and Asia (excluding Japan and South Korea).⁶ In high-risk countries, the incidence of traveler’s diarrhea can be as high as 50%.^{7, 8}

Consumption of contaminated products can cause traveler’s diarrhea, a digestive tract disorder that commonly causes loose stools and abdominal cramps.

Travel-related upset stomach is usually caused by consumption of pathogens

Traveler’s diarrhea is usually acquired by consuming food that has been contaminated by feces containing different types of pathogens; the bacterial pathogen Escherichia coli is a common culprit.⁹ These infectious organisms colonize the small and/or large intestine. Most of them produce toxins that increase the flow of water and electrolytes into the bowel.⁹ A fluid imbalance can cause large and uncomfortable increases in stool production.⁹

Digestive issues may be eased by supplementing with probiotics 

There is increasing evidence suggesting probiotics may help improve gastrointestinal health.^{1, 2, 3, 4, 13} A meta-analysis concluded probiotics may help to reduce the risk of traveler’s diarrhea.¹³ As with all probiotic strains, it is crucial to choose a probiotic strain that has been investigated in clinical studies and in the relevant therapy area.
Read more about choosing a probiotic strain.

The LGG^® probiotic strain may help reduce the risk of traveler’s diarrhea

A clinical study investigated the impact of consuming the LGG^® strain at a potency of 2 billion CFU/day on the incidence of traveler’s diarrhea. The study was conducted in healthy adults who traveled to Asia, Africa, and central and south America. The intervention started 2 days prior to departure and ended on the last day of the trip.² n=126 received the LGG^® strain and n=119 received placebo. Just 3.9% of the intervention group experienced traveler’s diarrhea, compared to 7.4% of the placebo group.²

Reducing the incidence of traveler’s diarrhea by consuming the LGG^® strain is supported in other research. In a clinical study of 756 participants who traveled to Turkey, the incidence of traveler’s diarrhea was significantly reduced in the LGG^® group compared to the placebo group.¹

A specific probiotic blend of probiotic strains may be beneficial for travelers’ health

The effect of a blend of the BB-12^®, LA-5^®, STY-31™ and LBY-27™ strains on gastrointestinal health has been studied in randomized, double-blind, placebo-controlled studies.^{3, 4}
94 travelers were randomized to receive the probiotic blend or placebo for 2 days prior to travel and for the duration of their 2 week visit to a high-risk country. There was a 39% reduction in the incidence of traveler’s diarrhea in the group that consumed the probiotic blend compared to placebo.³
In a study that investigated the effect of travel on bowel movements and regularity once home from a trip, 101 travelers consumed a placebo or the specific blend before, during and after their trip. Not only was the probiotic blend associated with a reduced incidence of diarrhea while away, but none of the group experienced upset stomach once home, compared to 18% of the placebo group.⁴

 

Probiotics as a precautionary measure when traveling abroad

To help avoid an upset stomach and maintain regularity when traveling abroad, consumption of the LGG^® probiotic strain or the specific blend of the BB-12^®, LA-5^®, STY-31™ and LBY-27™ probiotic strains should be considered.^{1, 2, 3, 4, 13}

Read about probiotics for antibiotic-associated diarrhea and infant diarrhea

 

 

CFU: Colony Forming Unit

BB-12^®, LA-5^®, STY-31™ and LBY-27™ are trademarks of Chr. Hansen A/S.

The article is provided for informational purposes regarding probiotics and is not meant to suggest that any substance referenced in the article is intended to diagnose, cure, mitigate, treat, or prevent any disease

Reference list

1. Oksanen PJ, et al. Prevention of travellers' diarrhoea by Lactobacillus GG. Ann Med. 1990;22(1):53-6. (PubMed)
2. Hilton E, et al. Efficacy of Lactobacillus GG as a Diarrheal Preventive in Travelers. J Travel Med. 1997;4(1):41-3. (PubMed)
3. Black FT, et al. Prophylactic Efficacy of Lactobacilli on Traveler’s Diarrhea. In: Steffen R, et al., editors. Travel Medicine: Proceedings of the First Conference on International Travel Medicine, Zürich, Switzerland, 5–8 April 1988. Berlin, Heidelberg: Springer Berlin Heidelberg; 1989. p. 333-5. (Source)
4. Black FT, et al. Report from a placebo-controlled double-blind trial of 4 lactobacilli strains (HIP) used as a prophylactic agent against traveller's diarrhoea. 1988. Unpublished data.
5. Mayo Clinic. Traveler's diarrhea. Updated. (Source)  Accessed 12th June 2020.
6. Centers for Disease Control and Prevention. Travelers Health. Updated.  (Source) Accessed 12th June 2020.
7. Steffen R, et al. Traveler's diarrhea: a clinical review. JAMA. 2015;313(1):71-80. (PubMed)
8. Steffen R, et al. Epidemiology of travelers' diarrhea: details of a global survey. J Travel Med. 2004;11(4):231-7. (PubMed)
9. Leung AKC, et al. Travelers' Diarrhea: A Clinical Review. Recent Pat Inflamm Allergy Drug Discov. 2019;13(1):38-48. (PubMed)
10. Al-Abri SS, et al. Traveller's diarrhoea. Lancet Infect Dis. 2005;5(6):349-60. (PubMed)
11. Leggat PA, Goldsmid JM. Travellers' diarrhoea: health advice for travellers. Travel Med Infect Dis. 2004;2(1):17-22. (PubMed)
12. Ericsson CD. Travellers' diarrhoea. Int J Antimicrob Agents. 2003;21(2):116-24. (PubMed)
13. Bae JM. Prophylactic efficacy of probiotics on travelers' diarrhea: an adaptive meta-analysis of randomized controlled trials. Epidemiol Health. 2018;40:e2018043. (PubMed)