Travel Medicine
This post is for a good friend who will be doing an overland adventure through the Amazon. He asked me if there was anything he could do that would help keep him from getting sick while on his journey. Travel healthy!
For my readers who live in litigious countries, I am legally obligated to say to you: Please note the information below is not meant to diagnose, prevent or treat any disease. The information is provided for information only. There are inherent risks with travel (in fact there are inherent risks with living). If you make the sovereign decision to implement any of the information you obtain here, be sure that you aren’t allergic to any of the products I mention below BEFORE you go on your trip.
Before I submerged myself into indigenous Ecuadorian existence for three weeks back March of 2010, I researched the medical literature and interviewed several herbalists, nutritionists and conventional doctors about disease prevention for rainforest travel. Traveling with a group of Chinese Medicine Practitioners I had plenty of opportunities to see what other practitioners were trying, what worked and what didn’t. The following is an assembly of what I learned from the medical literature, what I’ve learned from treating disease and what actually worked while we were traveling.
When traveling in the Amazon, several things became quickly apparent. First, the South Park episode about saving the rainforest is a fairly accurate depiction. The Amazon literally wants you to become a part of it. Second, there are so many insects there who want to eat you that concerns about mosquito bites almost become a joke. Just be grateful that malaria can be treated and hope that you don’t get something worse.
Prevention of Gastrointestinal Infections:
Step One:
Your digestive tract should naturally be full of an incredibly diverse population of gut flora composed mostly of bacteria and fungi. When you consume food and water, unless it has been sterilized or chlorinated, you are naturally exposed to these various organisms and you establish a balance of both beneficial and pathogenic flora. Like an ecosystem, the more diverse, the more difficult it is to cause disruptions or allow invasion of non-native species. When antibiotics or chlorinated water are introduced, the balance of the digestive flora is significantly disrupted and the diversity plummets. Critters that wouldn’t normally be able to grow there are given the opportunity to invade. Doing a 14-21 day course of probiotics, prior to embarking on your journey, can add an extra barrier of defense by reducing the viability and survivability of any potential bacterial and fungal invaders. This is especially important for anyone who has been on a course of antibiotics in the past few months. You should also note that if you are on any proton pump inhibitors for heartburn like, Prilosec, Protonix or Zantac, you are at a much higher risk of GI infection since you have no stomach acid.
The Best Probiotics: Obtain a combination that provides various forms of bifidobacterium, lactobacillus and saccharomyces boulardii. In my clinical experience, the refrigerated brands, which contain live bacteria, and are much more effective despite claims from companies that sell the non-refrigerated forms. It’s important to get it from a company that ships these cold otherwise they die during shipping. My favorite brands are Jarrow, Natural Factors, Metagenics and Pharmax. These can be obtained from health food stores or from several online companies. If you order it online in the summer, pay the extra money for overnight shipping so it doesn’t overheat. Take the suggested dose with at least 8oz of water, 30 minutes before or two hours after eating. During your course of treatment, reduce your fruit and sugar intake and eat more vegetables, onions and legumes. This will ensure proper survival and establishment of these bacteria.
Of course you should take all the necessary precautions and try to minimize your exposure to unclean drinking water, uncooked vegetables and fruits that can’t be peeled. Be sure to educate yourself with more complete information at the CDC’s website.
Step Two:
While You are Traveling
Oil of Oregano – I use this in my clinical practice for various bacterial and fungal infections. I recommend it with a high level of confidence for prevention of GI infections while traveling. To emphasize its effectiveness, I often have patients with GI symptoms send in stool samples for analyses. Whenever pathogenic bacteria or fungi are found, sensitivity testing is performed so we know what substances will and will not kill the invaders. Oil of oregano often tests equally or more effective than antibiotics for clearing the various pathogens. Follow up stool tests almost always confirm these findings. In over ten years of practice I’ve never seen any side effects. However, if you have a tendency toward gastritis (inflammation of the stomach lining) oil of oregano can irritate it. If you develop any pain in the area above the naval (your stomach) I would discontinue it. Make sure you aren’t allergic to it before you decide to use it as you main defense.
In addition to the fact that this stuff really works, it provides additional benefits that make it ideal for travel in hot, humid areas. First, it doesn’t seem to wipe out the beneficial bacteria in the gut. Second, it has pretty strong antifungal properties and is an added tier of protection from topical fungal infections like, jock itch, candida and athlete’s foot, that thrive in warm, damp climates. For women, if you do end up having to take strong antibiotics on your trip, it’s very effective at preventing yeast overgrowth.
Dosage: For travel, I recommend 300 mg before every meal and an extra 150mg if you consume any small meal or drinks of unknown origin. My favorite brand from Designs for Health but most brands in health food stores are acceptable.
Story: In my own experience traveling through the Amazon, I was in several situations where I ended up sharing foods prepared by the indigenous peoples and even sharing drinks out of one cup passed around entire communities. No, I don’t recommend this. However, I was fine for the first 17 days. There was finally an incident where I decided to hike back from a village with a friend. The kind Santa Agua gentleman, who guided us back down the mountain, led us to his home where his wife offered us some fresh strawberries. It was so hot, we were tired and hungry, and the strawberries smelled so amazing. I didn’t have my oil of oregano but decided to take a chance. Sure enough, the next day I had new visitors in my tummy. This leads me to what to do if you do get sick.
If You Get a Gastrointestinal Illness or Disturbance
For the reasons mentioned above, I do everything I can to avoid taking antibiotics. However, I fully acknowledge that there is a time and a place for their use and urge travelers to get a prescription from their doctor to have if needed. I think it’s important to understand that developing diarrhea is an immune response that is designed to make the intestinal tract uninhabitable for those little invading critters. Just because you get diarrhea, doesn’t mean you have an actual pathogenic bacteria. Your body will initiate an immune response against almost anything it’s not familiar with. Stopping it with anti-diarrheal medicines can give invasive pathogens an opportunity to really establish themselves and make you really sick. There is, of course, a balance. If you are so sick that you are unable to stay hydrated then these medications might be necessary. Consult a physician.
Below is a combination I have found to be very effective at treating diarrhea or GI infections while traveling. This combination usually results in significant improvement within a day or two and is even capable of warding off more severe infections. It’s quite normal to still have loose stools and some cramping for several days after the initial infection. Important: If the diarrhea becomes severe or explosive, continues to get worse or is accompanied with vomiting or fever then it’s time to seek and use conventional medicine.
v Apo-Enterit 30 drops in water 3-4 times per day. Available from BioResource Inc. This is a German Biologic Drainage Remedy designed specifically for food poisoning and diarrhea.
v Pil Curing (aka Culing Pills) – these are available in vials from Chinese Medicine Pharmacies or from Chinese Medicine Herbalists. The best one is from the US Distributor, Solstice Medicine Company and is screened for various chemicals. Take 1-2 vials three times per day.
v Coptis – this is an herb with extremely potent antibiotic properties. It was one of the primary herbs used for bacterial infections for several hundred years in China. Take a small dose of 2-3 pills with each dose of Pil Curing. Available from Chinese Medicine Pharmacies and Practitioners. The company Mayway makes a nice preparation.
v L-Glutamine – this is optional but very helpful. 1000mg twice per day on an empty stomach helps to reduce inflammation in the wall of the intestines
Dietary recommendations if you are having gastrointestinal issues: Avoid raw vegetables and fruit. Eat easy-to-digest grains and small amounts of animal protein. A little fruit, fruit juice or coconut water throughout the day can provide extra potassium to help prevent dehydration. Careful, too much will make everything worse. Broth with lots of salt will also help to keep you hydrated.
Watch for future posts about travel medicine. Until then, travel healthy!
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