Podcast: WHAT DOES YOUR DOCTOR SAY?

Episode: How to control traveler's diarrhea?

Leading: Dariusz Litera

Guest: Dr. Marcin Roszkowski, family medicine specialist

Duration: 11 minutes

Vacations, dietary changes, enjoying local cuisine, and traveling to warmer climates can all pose a risk of gastrointestinal problems. The discussion includes practical tips on hygiene, food choices, safe water, and situations in which diarrhea or vomiting require increased vigilance.

Dr. Marcin Roszkowski, a family medicine specialist, is our guest. He explains the factors that contribute to food poisoning, why dehydration can be dangerous, and which groups of patients should be especially careful when dealing with gastrointestinal infections.

The discussion is educational and practical in nature. It covers both simple preventative measures while traveling and alarm symptoms that should prompt a medical consultation.

Full podcast transcript

[00:00:00] Introduction. What are the most common causes of food poisoning on vacation?

Dariusz Litera:

Today, your doctor is Dr. Marcin Roszkowski, a specialist in family medicine. Good morning.

Dr. Marcin Roszkowski:

Good morning.

Dariusz Litera:

Another installment in holiday preparations. This time, perhaps a less pleasant ailment, one everyone is familiar with. What are the most common causes of food poisoning during the holidays, and how can you easily avoid them?

Dr. Marcin Roszkowski:

Pleasant topic or not, nothing human is alien to us. This is a rather broad question. How can we avoid such situations? We travel. What matters is how long we stay in a given place and in which places we stay.

Food poisoning is spread by contact, through dirty hands, through contaminated food, through food preparation, through poor hygiene by people who may have infections, or through food that has been stored in inappropriate conditions.

Dariusz Litera:

And something developed there, like salmonella. This salmonella thing is quite serious. Sometimes entire resorts have been closed. Salmonellosis has broken out, or people from the same wedding party have gathered in the same ward.

Dr. Marcin Roszkowski:

I was a victim of salmonella as a child. We were poisoned by an orange soda called Orange Soda.

[00:01:15] Different bacterial flora when traveling. Can the body react to new foods?

Dariusz Litera:

I remember from our previous encounters how important it is what we consume at our destination. How different it is from what we've eaten before, and how different the bacterial flora we'll encounter is from what we simply have.

Dr. Marcin Roszkowski:

It will be either pathogenic or physiological, just foreign to our bodies. But let's imagine we're planning this big trip, getting on a plane, and landing in Bangkok. How could we not take advantage of so many culinary delights?

[00:01:55] Street food and restaurants. How to choose places to eat when traveling?

Dariusz Litera:

Still street food.

Dr. Marcin Roszkowski:

Street food, delicious restaurants, the flavors and aromas are overwhelming. It's impossible not to take advantage. The traditional advice is: go where there are many locals, where they eat. There's no sanitary inspection there. If someone runs a restaurant or sells food products and there are infections, no one will come. That person will go bankrupt. So, in a sense, they care about their customers.

Dariusz Litera:

We're guided by these simple guidelines. We're following the locals' lead in this case. And this isn't just a sheeple, quite the opposite, because locals go where the food is good.

[00:02:29] Water, ice, hands, and heat treatment. How to reduce the risk of infection?

Dr. Marcin Roszkowski:

This is meant in jest, of course, but there are a few things we should observe regarding the transmission of pathogenic bacteria and viruses. It's not just bacteria that cause food poisoning, but viruses and other organisms as well.

When it comes to fluids, we try to drink either boiled or bottled water. This also applies to brushing our teeth. Thermally processed foods, especially meats or eggs that are fully processed rather than semi-raw, are also safer.

We wash our hands frequently and try not to use ice. Ice is made from tap water, and tap water can come from various sources and vary in quality.

It bears repeating, even though everyone knows it: we wash our hands for 30 seconds. The soap has to work on germs, so those 30 seconds matter.

We also remember, for example, that when changing our children's diapers, we must wash our hands afterward. We love our little ones very much, and these diapers don't mean anything unpleasant to us, to a certain extent. But a child can also develop viruses. They can transmit them to mom, dad, and the entire family. Then everyone stays in bed while we're away.

Dariusz Litera:

Instead of visiting wonderful places and seeing the world.

[00:03:33] Does alcohol protect against food poisoning?

Dariusz Litera:

There are also myths and urban legends: you don't have to worry about anything, just wash it all down with alcohol.

Dr. Marcin Roszkowski:

A glass with dinner?

Dariusz Litera:

And you'll be healthy. Is that a myth?

Dr. Marcin Roszkowski:

This isn't confirmed by research. These studies are quite modest, as no one has conducted serious, academic, double-blind experimental studies on alcohol versus infections. However, no studies confirm that alcohol reduces the number of infections.

Dariusz Litera:

In some cases it can even be harmful.

Dr. Marcin Roszkowski:

Especially if diarrhea is already present. Alcohol should be avoided during diarrhea.

Dariusz Litera:

And this is where a red warning light should really go off, because we could just end up harming ourselves.

Dr. Marcin Roszkowski:

Yes, definitely. Alcohol can worsen symptoms and prolong recovery.

[00:04:24] Rehydration for Diarrhea and Vomiting: Why Is It So Important?

Dariusz Litera:

It is absolutely necessary to remember to hydrate the body if diarrhea, poisoning, or vomiting occurs.

Dr. Marcin Roszkowski:

We lose fluids, so we need to replenish them.

Dariusz Litera:

Here, with particular emphasis on hot spots. If we're traveling to exotic locations, it's warmer than usual.

Dr. Marcin Roszkowski:

There is perspiration, there is loss of water through sweat.

Dariusz Litera:

This is absolutely no joke, because even a large adult organism can lose so much water that its condition will deteriorate very quickly.

Dr. Marcin Roszkowski:

Yes, it will gradually worsen. We may need to seek medical attention.

[00:04:55] When does diarrhea require medical consultation?

Dariusz Litera:

And this isn't a joke either. So if these kinds of symptoms appear, hydrate. And what remedies should we take? Or at what point should we seek help?

Of course, at first everyone thinks: okay, it happens, it happened, it'll be okay, we'll get through it. I'll drink some water or some light tea. I won't add sugar, it'll be okay. I won't eat anything for now, because it won't last anyway. I'll manage.

But where is the line?

Dr. Marcin Roszkowski:

I won't be mean here. I will say that the line is fluid. First and foremost, common sense.

If we are advised to see a doctor if we have infectious diarrhea and it lasts longer than 10 days, and we feel great and it doesn't bother us much, then we shouldn't look for a hospital immediately, urgently.

However, really prolonged diarrhea, diarrhea with very violent symptoms, very severe abdominal pain, a high temperature, say 40 degrees, or very unpleasant things in the stool in the form of blood, these are signals that it goes beyond normal traveler's diarrhea.

Dariusz Litera:

And here's the alarm. We definitely need to seek advice.

[00:06:01] What to take in a travel first aid kit for gastrointestinal problems?

Dariusz Litera:

Okay. Are there any remedies we should have in our medicine cabinet if we're going to such an exotic location?

Dr. Marcin Roszkowski:

They would be useful. I would divide them into three groups.

The first group includes medications that slow down intestinal function slightly. If you have mild diarrhea, without any severe pain or fever, and it's simply not as usual, a drug like loperamide can do the trick.

For children, we have other forms, such as Smecta. It's also worth taking something for constipation. And a third remedy, in the digestive tract category: I would take an over-the-counter heartburn medication. These remedies often come in handy when traveling.

[00:06:52] Who is particularly at risk of dehydration and complications?

Dariusz Litera:

Are there any groups that are particularly vulnerable to these types of illnesses? Food poisoning, gastrointestinal issues?

Dr. Marcin Roszkowski:

Yes, of course. These will be small children who dehydrate very quickly. If we're traveling with such a young patient, the child will endure, say, 12 hours of diarrhea or vomiting before medical intervention is required.

An adult can last a little longer: 24 hours, sometimes 36 hours. So, in a child, 12 hours could be a problem.

Seniors. Seniors is a broad term. It could be a senior over 65 who paraglides, or a 50-year-old who is already in a difficult condition. People with chronic illnesses, especially gastrointestinal diseases and colitis. Pregnant women.

Dariusz Litera:

Well, here all poisonings and things like that are a risky matter.

Dr. Marcin Roszkowski:

Unfortunately, they can lead to miscarriage or premature birth.

Dariusz Litera:

We have to be very, very careful. But I also think there's enough awareness here that we don't choose such exotic destinations.

Dr. Marcin Roszkowski:

We also pay attention to what we eat. Dairy products, for example, can contain listeria, which is very dangerous for pregnant women and for people in general.

Dariusz Litera:

And here, indeed, we must approach this with even greater caution. It's worth asking, it's worth reading, it's worth watching, it's worth it.

Dr. Marcin Roszkowski:

It's worth listening to before you leave.

[00:08:05] Regular medications and diarrhea. What should patients know?

Dariusz Litera:

What about ongoing medication for digestive issues? We have people with conditions that require regular medication, and these medications often prevent symptoms. But here we have food poisoning. These two things aren't always reconcilable. What does a doctor recommend in such a situation?

Dr. Marcin Roszkowski:

There's no universal solution for these people. Some medications can increase dehydration. Other medications may be less well absorbed during diarrhea, making them less effective, and this can lead to serious complications.

It's impossible to give everyone clear, definitive advice on what to do in such a situation. These are individual matters.

I think people taking medications are reasonably aware of what they're taking and what side effects will occur if they don't work well. In that case, it's worth seeking medical advice.

Dariusz Litera:

Then is it worth changing the time of taking this medicine?

Dr. Marcin Roszkowski:

This question is difficult to answer because diarrhea, by definition, is a rapid intestinal transit. Food passes through our body very quickly. This means loose stools, watery bowel movements, more than three times.

It can be morning, noon, or evening. And when should you decide when to take your medication? There's no one-size-fits-all advice here either. It's definitely worth considering.

Dariusz Litera:

This means that medications taken regularly may simply not work as they usually do.

Dr. Marcin Roszkowski:

Or make the situation worse.

[00:09:13] How to reduce the risk of gastric problems while on vacation?

Dariusz Litera:

Doctor, are there any tips that can reduce the risk of gastrointestinal problems? Are there any general rules we should follow that will make me safer? Besides washing our hands more often, we're trying to explore the world and try new things.

Dr. Marcin Roszkowski:

I wouldn't discourage you from trying new flavors. We don't drink tap water, we avoid ice made from tap water, and we wash our hands.

There are also certain foods that should generally be avoided, especially those that aren't refrigerated. Mexican guacamole, for example, is classified as such, as are some salads.

This is common sense. It's not medicine, it's common sense.

Dariusz Litera:

Sometimes the euphoria of vacation overshadows our common sense.

Dr. Marcin Roszkowski:

Especially when there is an unlimited buffet.

[00:10:09] Conversation Summary and How-To Materials

Dariusz Litera:

Such situations also happen, and we should anticipate them. However, somewhere in the back of our minds, we need to keep in mind that anything excessive may not be good, healthy, or beneficial for us.

Today's guest on the CO NA TO TWÓJ ELEKARZ podcast was Dr. Marcin Roszkowski. Doctor, thank you very much for these pre-holiday meetings. I think many of these tips will be useful in the coming weeks.

Dr. Marcin Roszkowski:

Thank you very much for the conversation. I wanted to add that it's impossible to tell everything in this format. I think the editor will provide a written version.

Dariusz Litera:

The guidance materials will appear both on the foundation's website and on www.twojlekarz.net, a place many patients turn to for information from a trusted source. Thank you again.

Dr. Marcin Roszkowski:

Thank you very much.

Key takeaways for patients

• Food poisoning while traveling may be related to dirty hands, contaminated food, water, improper food storage and contact with a sick person.

• It's a good idea to drink bottled or boiled water while traveling. This also applies to water used for brushing your teeth.

• Ice can be made from tap water, so it is better to avoid it in places with uncertain water quality.

• Fully cooked foods, especially meat and eggs, are a safer choice than semi-raw foods.

• Washing your hands for about 30 seconds is important because the soap needs time to act on microbes.

• Alcohol does not protect against foodborne illnesses. During diarrhea, it may worsen symptoms and prolong recovery.

• In case of diarrhea and vomiting, it is crucial to replenish fluids, especially in hot weather.

• Alarm symptoms include prolonged diarrhea, very rapid symptoms, severe abdominal pain, high fever, and blood in the stool.

• Young children, seniors, people with chronic diseases, people with gastrointestinal diseases and pregnant women should be particularly careful.

• In case of diarrhea, medications taken regularly may be less well absorbed or worsen the situation, therefore an individual approach is needed in patients on chronic treatment.

• When traveling, it is worth using common sense, choosing food carefully and avoiding products stored outside the refrigerator.

Information about participants:

Guest: Dr. Marcin Roszkowski, A family medicine specialist with many years of experience in primary care. He also works with patients in the treatment of obesity and in the broadest sense of preventive healthcare.

Presenter: Dariusz Litera, medical editor, health communications specialist, and creator of the podcast CO NA TO TWÓJ ELEKARZ. He has been involved in patient education for years, conducting interviews with specialists in various fields of medicine.

ATTENTION!

This material is for educational purposes only. It does not replace a medical consultation. If you experience any disturbing symptoms, consult a doctor.
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