Amid increased travel, doctors suggest stomach precautions

As COVID-19 travel restrictions continue to ease, people plan to hit the road, airport, pier or train station eager to feed their curiosity and thirst for different regions and cultures.

Dr. Daniel Jamorabo is an Assistant Professor of Medicine in the Division of Gastroenterology and Hepatology at the Renaissance School of Medicine at Stony Brook University.
Photo by Jeanne Neville/Stony Brook Medicine

While these travelers may be enthused by the flavor of the unknown, their stomachs may not be so thrilled with these journeys, demanding attention at inopportune times or threatening to revolt with the biological equivalent of a magma eruption. .

Local gastroenterologists – stomach doctors – have urged travelers to take precautions when preparing for trips to exotic destinations, on cruises or even across the country.

“Depending on where people are traveling, they may need vaccines,” said Dr. David Purow, a gastroenterologist at Huntington Hospital. Some areas might have a higher incidence of cholera or traveller’s diarrhea, which is usually an E. coli infection, he added. People often call it Montezuma’s revenge.

Purow suggested checking the Centers for Disease Control and Prevention website initially, though the government organization that coordinated much of the response to the COVID-19 pandemic is considered a conservative organization.

Purow urged travelers to research whether pathogens are endemic to an area, which could include reading message boards. These panels, however, can be as reliable as most other material on the web, he said, meaning residents should use their own judgment as to the reliability of what they read.

Upset stomachs can come from a host of sources, including food that’s been out for an extended period or various forms of contaminated water.

“Always be wary of room temperature foods,” said Dr. Daniel Jamorabo, gastroenterologist and assistant professor of medicine in the Division of Gastroenterology and Hepatology at Stony Brook University’s Renaissance School of Medicine. . “That’s often how people get food poisoning. Listeria is common in dairy products, such as goat cheese.

The water

Often the source of stomach upsets that can put a damper on porcelain travel, water can cause problems for travellers.

Before becoming a gastroenterologist, Jamorabo himself traveled to Kenya, where he unwittingly caught the parasite Giardia, which also poses a threat to people who drink stream or river water when traveling from camping.

Jamorabo was sick for three weeks, which encouraged him on future trips to stick to bottled water while traveling for peace of mind.

When bottled water is not available, he suggests drinking boiled water or using purifying tablets. Some tablets can take up to two hours to purify a gallon of water, although others, which offer less protection, take 35 to
40 minutes.

Jamorabo said that salads or fruits, which are peeled or prepared with hard-to-follow water sources, can be
a problem.

He suggests asking residents if they have filtration systems in their homes or if they use bottled water.

Purow added that “if there are any concerns, use bottled water as much as you can.”

What to bring

Doctors have suggested that people tend to take stomach remedies with them when they travel, sometimes even taking them prophylactically.

Purow said some people bring probiotics, which “can hurt you and can decrease the chances of getting anything or shorten the duration once they’re acquired.”

Pepto Bismol and Imodium could also help prevent or treat stomach upset, especially for people who are anxious travelers and suffer from what is known as “traveller’s diarrhea”, the doctors said.

Purow warned that people could have black stools from some of these drugs, which could also be a warning sign of bleeding or a gastrointestinal ulcer.

Taking these drugs to relieve symptoms, however, is “fine” and will not “remove” the need to remove something from the body, Purow added.

One of the dangers of diarrhea is that it can cause dehydration as the body loses needed fluids.

Jamorabo suggested traveling with or researching Pedialyte as a way to restore hydration.

Regarding the dangers of going on cruise ships, doctors recommended being careful not to touch tongs or servers at buffets that many other travelers, who may have brought their own pathogens with them, could also have manipulated.

“On these cruises, it’s like traveling to a small town,” Jamorabo said. Stomach bugs can “spread like wildfire”.

“Always be wary of food at room temperature. This is often how people get food poisoning. Listeria is common in dairy products, such as goat cheese.

—Dr. Daniel Jamorabo


Even for those staying home, people may struggle with their stomach’s response to the strain on mental health created by COVID-19, the Russian attack on Ukraine, and worries about issues like the severe storm and global warming.

Stomach doctors increasingly referred their patients to psychologists and psychiatrists.

“Stress can exacerbate” irritable bowel syndrome, Purow said. Worries about the state of the world have “unmasked gastrointestinal symptoms for those who didn’t have them before”.

Purow has seen a significant rise in alcoholic liver disease as people stuck at home raid their own booze cellars amid health threats, shutdowns and economic uncertainty.

Jamorabo said more stressful times can lead to increased stomach-related discomfort or symptoms.

“We have to pay attention to what triggers people” to have panic attacks, nausea or diarrhea, Jamorabo added.

An undertreated mood disorder could worsen gastrointestinal symptoms.

Focusing on things that people can control can help soothe the stomach, such as sleeping well, exercising, and eating a healthy diet.

“Look within for your own sanity,” Purow suggested. Outlets such as vodka bottles don’t tend to help, while talking to friends and family and eating well can improve overall health, bringing relief and resilience to the digestive system.