Q: I am vacationing abroad and want to avoid having stomach issues. Should I ask my doctor for antibiotics just in case?
A: It’s not a good idea to use antibiotics as a preventive measure. Taking them when you don’t need them can kill off your gut’s normal microflora. And the drugs won’t protect you from viruses or parasites. That said, if you will be traveling to areas where traveler’s diarrhea is common, like Asia, Africa, and Latin America, it’s not a bad idea to have a stash of antibiotics (typically ciprofloxacin or azithromycin) with you. In most cases, they can quickly cut a diarrheal illness short.
Whether you actually take the meds should depend on the severity of your symptoms. Traveler’s diarrhea—which can mean an upset stomach, abdominal cramps, loose stools, diarrhea, or just excess gas—is typically caused by bacteria or viruses picked up from contaminated food or water. If your symptoms are fairly mild, it may be better to let the bug run its course. Using antibiotics for travel-related illness could disrupt a healthy gut microbiome or bring on side effects like dizziness or headaches.
But if you’re very uncomfortable, running to the bathroom multiple times a day, go ahead and take the medication, and as long as it’s a bacterial illness, symptoms should clear up quickly. (If your tummy troubles are caused by a virus, you unfortunately just have to wait it out.)
While there’s no foolproof way to fend off illness, there are some precautionary steps you can take while traveling to try to prevent GI problems. For starters, don’t drink tap water or put ice in your drinks. You may want to leave a little note next to the faucet to remind yourself to brush your teeth and wash your hands with bottled water, too.
You should also avoid salads and other raw-veggie dishes, as well as unpasteurized dairy products, and steer clear of fruits you can’t peel yourself. Follow the “rule of p’s”: Food is OK to eat if it’s peelable, packaged, purified, or piping hot.
Finally, some research has shown that taking Pepto- Bismol—two chewable tablets or two ounces of liquid—four times a day may help prevent traveler’s diarrhea. (It’s generally safe to do this for up to three weeks.)
Health’s medical editor, Roshini Rajapaksa, MD, is assistant professor of medicine at the NYU School of Medicine.