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About Travelers' Diarrhea

Recently I’ve heard from two folks with a not uncommon complaint: while traveling they picked up some intestinal bug, took the locally available antibiotic, and their gut has never been the same. The process for proper healing from the combined assault of the parasite and the treatment requires a full understanding of all that can be affected and what needs to be resolved.

Choosing the Right Foods

Start with what you are eating. As with most situations in my clinical practice, my first recommendation involves counsel on what foods to include and what foods are better avoided.

Helpful foods for a recovering intestine include:

  • Homemade bone broth – but only the kind that wiggles like jello when it’s chilled. It’s easy to follow the recipe and easier to enjoy. Properly made bone broth is rich in gelatin and glutamine, both of which helps to restore normal gut permeability. The lining of our intestines is supposed to be sufficiently permeable to allow nutrients to pass into our bloodstream, but sufficiently snug to prevent more sizable (and allergenic, inflammatory) particles from drifting in before they are properly digested.
  • Fermented foods – which means kombucha and sauerkraut, as well as kefir and yogurt for folks who tolerate and partake of dairy. Repopulating your gut with food-sourced healthy bacteria is an important part of the healing process.
  • Nutrient dense proteins and fats. When your digestion is weakened, you want to make every bite valuable. Liver and other organ meats, salmon and salmon eggs, eggs – particularly the yolks, and pasture-raised butter are good examples of foods that will deliver a lot of nutritional value in a concentrated serving.
  • Okra, ideally lightly steamed, donates a nice mucilaginous coating to the intestines as it passes through. Temporary, but soothing, and allows for a reprieve from irration and time to heal.
  • Dark leafy greens – lightly steamed and served with avocado, coconut oil, or butter – provide valuable vitamins and are usually well tolerated even by a recovering intestine. Servings should be limited to half a cup of cooked greens at a time: excessive fiber can irritate the gut and promote unhealthy bacterial overgrowth. Abdominal gas after eating greens means that is more fiber than you can handle at the moment!

Foods that can aggravate and should be avoided include:

  • Alcohol and caffeine – whether that is in coffee, tea, or chocolate.
  • Sugars of all sorts: processed and refined sugars are the worst, but even fruit can provide too much of a sugar load. Sugars enhance the growth of candida, which is probably doing just fine after all the antibiotics you might have taken. We would like to rein it in: everyone has a “little” bit of candida in their intestines: you have too much if you have bloating, cramping, and gas, particularly when you eat fermented foods or take healthy probiotics.
  • Grains can be problematic, but if someone normally tolerates sprouted grains well, they can be tried in the recovery period, in limited amounts as they can also feed candida. Even when well grains should be sprouted before consuming to inactivate their exterior anti-nutrients.
  • Spicy foods, or strongly acidic foods such as tomato, should be avoided as they can over-stimulate the actions of the intestines.
  • Vegetable oil, as always, should be avoided, particularly for cooking. That means no restaurant eating unless you know they cook in friendly fats.
  • Nuts and seeds – even properly prepared, these can be irritating.

Foods not found on either list need to be evaluated on an individual basis. Some folks do fine with a bit of cheese or some roasted chicken – others just can’t digest that much. I urge people to pay particular attention to the first hour after a meal and give their thumbs up or thumbs down depending on how they feel.


Supplements can be helpful.The supplements that can be helpful are really just micro-packages of what you should be eating at every meal, and include:

  • Probiotics: I like to use a powdered syn-biotic preparation (including both prebiotic and probiotic) such as Bio-Immersion’s Original Synbiotic Formula. A truly challenged or inflamed gut needs to start with a very small amount of a broad spectrum probiotic that can be gradually increased to tolerance. Start with 1/4 tsp. or less, and increase to 1 tsp once or twice daily between meals.
  • L-Glutamine: straight from the bone broth, it can also be taken in 500 mg capsules or powdered form. Doses up to 10,000 mg. a day are titrated according to the patient’s state. Metabolic Maintenance L-glutamine not only helps heal the gut but can be a good alternate brain fuel, sometimes erasing the brain fog that is part of parasitic illness.
  • Other supplements that I may rely on, depending on individual circumstances, include magnesium, anti-oxidants, and others. I might select a homeopathic remedy if the person has a clear “symptom picture”. Quite commonly after a lot of antibiotics, people can feel either stagnant in their guts (might benefit from Sepia 30C) or as if their digestive forces are traveling at odds: up against the tide, down to quickly, with knots in the middle (Nux Vomica 30C).

Mind-body considerations 

We are never more aware of the importance of a healthy intestinal tract than when it’s been ravaged and left unhappy, which makes us unhappy as well. There is a well-documented relationship between our mood and our intestines, one familiar to anyone who has had nervous diarrhea or a jittery stomach.

At the very simplest level, a degree of mindfulness brought to the process of eating can be helpful.These are always good principles, but particularly important when not feeling well.

  • Eat your meals while sitting comfortably in a restful environment, attending primarily to your food and perhaps some friendly conversation. Avoid reading, watching television or emotional excitement while eating.
  • Chew your food well. Chewing alerts the rest of the team that food is on its way and starts the secretion of digestive juices.
  • Eat slowly, allowing your body time to process what you’re feeding it, and giving you time to notice when you’ve had enough.
  • Avoid overeating – some of your food will go undigested and possibly feed unfriendly bateria.
  • Go for a walk after eating. Normal peristalsis is enhanced by walking.

For most folks, returning to these simple principles allows time and support for their gut to heal. People with persistent problems can need further individual evaluation and treatment, ideally from an integrative practitioner well experienced in addressing gut and immune health challenges.