How to Avoid Food Poisoning When Traveling Abroad
Doesn’t really matter how many stamps are in your passport or how many languages you speak. You’re not a black-belt traveler until you’ve notched at least one spectacular poop story.
There’s nothing like the Cronenbergian body horror of feeling your guts melt into loose goop when you’re thousands of miles from home, or seemingly that far from proper plumbing. Sometimes traveler’s diarrhea hits you just as you’re about to head home, like the Mexico City trip when my ride to the airport was spent sweating and clenching for dear life. Sometimes it hits you upon arrival, like my friend who spent her first four days in India sight-seeing her bathroom and not much else. Calling these literal shitshows “Montezuma’s revenge” or “Delhi belly” doesn’t make them any less miserable.
I’m that person who gets sick on pretty much every trip, often on hours-long drives with strangers, usually in places where public restrooms don’t offer a lot of privacy. I have resigned myself to intensive preparations when I get on a plane, but how best to do so? I asked Dr. Partha Nandi, author of Ask Dr. Nandi, and consulted the healthiest travelers I know, so next time I visit a host family, I can make a first impression without defiling their only bathroom.
Before you travel, hit up a doctor familiar with travel medicine
And not just for vaccinations. Two top recommendations from Dr. Nandi are anti-diarrheal medication such as bismuth subsalicylate (aka Pepto-Bismol), or loperamide (I can vouch for this one), and anti-motion sickness meds. These pills can help a transient case of diarrhea resolve quickly, or at least keep symptoms at bay. As the FDA will tell you, foreign pharmacies can be, um, a crapshoot: “Many drugs sold in developing countries contain impure or toxic ingredients.” In a pinch, an American embassy may be able to help, but that’s a last resort, for sure. Better to pregame with your doc and keep your meds with you.
Any time you’re getting on a plane, eat foods that are easy on your system
Flight alone will muck up your gut. At altitude, Dr. Nandi says, your digestive system requires more energy to work properly. So after and before flights, eat sensibly and skip inflammatory foods and those that will make you gassy; skip the greasy meats, beans, and processed carbs. Instead, Dr. Nandi says, reach for “nuts, turkey meat, and carrots, as these are all things that don’t cause inflammation.”
When abroad, avoid raw unwashed fruits and vegetables
Traveling to developing countries is not the time to try out a raw food diet. The Centers for Disease Control and Prevention and US Food and Drug Administration recommend eating raw fruits and vegetables only when you yourself have peeled them or washed them in clean water. Don’t eat street mangos, don’t eat salads, don’t drink fresh orange juice. If those plants have been washed at all, it’s likely to have been in tap water. If you wouldn’t drink the water, you don’t want to order the watercress salad.
Drink only bottled and filtered water
Ice cubes. Residual droplets on just-washed hands. Damp lettuce. Contaminated water -- the top cause of illness during travel -- can be sneaky stuff. Your digestive system is a dazzlingly complex ecosystem of microorganisms, prone to disruption by a change in daily routine or unfamiliar microbes from foreign food and water. Even if locals can drink tap water, the various bacteria, protozoa, and viruses therein can knock your newbie gut out of whack.
Bottled water is the safest bet, and order the carbonated version, to ensure that it was actually sealed rather than refilled at the tap. Having your own water filter and/or water sanitizer tablets is good backup for when bottles may not be available. Use boiled, filtered, or bottled water for everything. A traveler friend told me about the “look of horror” that crossed her husband’s face when he watched her blithely rinse a toothbrush under a questionable tap. Now she always keeps a bottle of clean water next to the sink whenever traveling.
Choose your street food very carefully
This one hurts, a lot. But not all street food is created equal. Some have raw toppings, like the cilantro and onion that were sprinkled on a 50-cent taco I ate in a tiny town in rural Oaxaca. Delicious, but it cost me around $500 in medical bills and antibiotics when I got home. Watch, too, to see that the food is freshly cooked -- ideally quite hot -- and hasn’t been sitting out in a cart or in a buffet tray. If it’s hot and well-cooked, then just use your best judgement around the sanitation of the cart. Life’s all about risks and rewards, so if you've done your due diligence, might as well enjoy.
Make yourself waterproof in the shower
This one is easy to mess up, because you probably don’t realize how much water you drink in the shower. In places with iffy tap water, avoid getting any in your mouth or eyes while bathing. It’ll feel weird to clamp your mouth and eyes tightly, but as a friend who frequents Guatemala told me, “It’s worth showering in total darkness to avoid total darkness in the toilet later on.”
Take some ginger for an upset stomach
Ginger is one of the oldest natural remedies for upset stomachs, reducing inflammation and acting as a natural antibiotic. “Taking care of your body through natural remedies can be surprisingly effective,” Dr. Nandi says. It’s also versatile, common, and portable: think tea bags or candied ginger. It won’t reverse an infection, but it can help ease painful symptoms while you wait for stronger meds to kick in.
Keep your hands obsessively clean
Soap. Warm water. Thorough scrubbing, followed by thorough drying. You know the drill. Just do it way more often. Or use an alcohol-based sanitizer before eating and after using the bathroom. Pathogens can enter the system with a simple touch of your hand to your mouth, nose, eyes, or ears, so try to keep your hands off of yourself, and your companions, unless they are freshly cleansed.
If the shit does hit the fan, power all the way down
If food poisoning hits, don’t panic. “Mind over matter,” Dr. Nandi says. “No matter how sick you are, you are only going to feel as horrible as you let yourself feel.” Once you address your state of mind, he recommends “complete and utter bed rest.” If that doesn’t make things better, it’s time to seek medical help. He recommends investing in travelers insurance to find a competent doctor. If you are traveling to a developing country with a higher risk of getting ill, keep an eye out for clinics as you travel. Occasionally a bathroom emergency can devolve into a medical one.