You May Love to Travel, But Your Stomach...Not So Much

You may be looking forward to a spring break getaway or scheduling summer travel. Whatever your plans, you don’t want digestive problems like diarrhea, constipation, or indigestion to interfere. So, it’s important to think ahead about ways to maintain your digestive health while you’re away.

To help you avoid common pitfalls and plan for possible difficulties, gastroenterologist Arthur Magun, MD, draws on his many years of expertise treating patients to explain how travel can disrupt your digestive health and what you can do to make your trip more pleasant. 

Could you start by explaining what “digestive health” means?

Digestive health involves two important concepts.

One is eating (and drinking) foods that provide all the necessary nutrients for living.

The second is avoiding foods that disrupt the normal functioning of the human digestive tract. “Normal” refers to the absence of abdominal pain, bloating, reflux, cramps, diarrhea, or constipation.

We often think of three main digestive issues associated with travel: diarrhea, constipation, and indigestion. Would you add anything?

Those three certainly cover most scenarios. In some people, nausea can accompany indigestion.

What is it about travel that disrupts our digestion?

There are several reasons travel disrupts the normal functioning of our gut. First, if, during our travels, we drink the local tap water, we could introduce new and different strains of bacteria and other pathogens into our gut.

Second, travel often introduces us to foods we generally don’t eat, which could mean more (or less) fiber, different forms of sugar, and unfamiliar vegetables—all of which can affect the gut.

Third, we sometimes drink less fluid when we travel to avoid trips to the bathroom. While this may offer short-term convenience, it can lead to constipation and discomfort.

Fourth, catching flights, taking trains, renting cars, and sleeping in an unfamiliar bed are all stressors. Travel stress can disrupt the normal functioning of our gut, leading to constipation for some people and diarrhea for others.

What is the most effective preventive strategy for each possible digestion issue?

It’s exactly right to approach different issues with different strategies. Let me answer this way:

• Diarrhea: This is a common problem when traveling. It is usually caused by a change in the water we drink, but occasionally, it can be attributed to overeating. As much as possible, drink bottled or spring water rather than the local tap water. And avoid huge meals. In addition, be very cautious about salads and fruits that may have been washed with local tap water. The safest policy is to avoid fresh salads, fruits, and other uncooked foods, especially in less developed countries.
• Constipation: As I mentioned, constipation can be due to a lack of adequate fluids (dehydration). Dehydration also makes stool harder and more difficult to pass. So, drink at least one to two quarts of bottled water every day. And if your gut is sensitive to travel stress, schedule a little time to decompress. For example, why not make regular exercise part of your trip?
• Indigestion and nausea: Overeating and alcohol drinking are the most common causes of indigestion and nausea. For myself and my patients, I recommend moderation. I’d also like to mention Helicobacter pylori, a food-borne bacterium that can damage the lining of your stomach (gastritis). To lower the risk of an H. pylori infection, make sure your food is adequately cooked. 

If these preventions don’t work, what are the most effective coping strategies?

Unfortunately, there might be circumstances or conditions that travelers cannot predict or anticipate. In these cases, it’s best to have a plan:

• Diarrhea: Immediately stop drinking the local water and skip two meals in a row to rest the intestine. Imodium pills can slow diarrhea, so including them in your toiletries kit is prudent.
• Constipation: Drink more fluids. Also, milk of magnesia or other magnesia derivative can loosen stool, so including it in your toiletries kit is prudent. (Alternatively, it is usually available in local pharmacies.)
• Indigestion and nausea: Pepto-Bismol and famotidine (Pepcid) are effective for indigestion, nausea, and gastritis. I recommend adding them to your toiletries kit.

How should someone with a chronic digestion issue plan for their travels?

People with chronic diarrhea should pack Imodium pills. People with chronic indigestion or nausea should pack Pepto-Bismol tablets and Pepcid. And, whatever your issue, it’s very important that you read and follow the dosing directions carefully. 

Are there any serious digestion issues or conditions that should keep you from traveling?

No, there are no serious digestion issues that make travel impossible. That said, ulcerative colitis, Crohn’s disease, and a history of diverticulitis all require careful medication planning. If you suffer from one of these conditions, you should check in with your doctor. 

Arthur Magun, MD, is a professor of medicine in the Division of Digestive and Liver Diseases at the Vagelos College of Physicians and Surgeons, where he is also a member of the Academy of Clinical Excellence.