Bali Belly Prevention: One word. Travelan.

When I say I’ve experienced Bali Belly all over the world, I’m not joking.

Hubby rarely gets it.

I must have a hyperactive immune system to even the most minute amount of any pathogenic material.

✔️   2013: Thailand

As soon as we landed in Bangkok, Thailand, we went to a local restaurant to enjoy a meal. About an hour later everything was coming back up in the open-air bathroom where everyone could hear.

Yikes. Super embarrassed. Welcome to Thailand!

✔️   2014: Mexico

We were staying in an Airbnb in Playa del Carmen. Hubby said he found a highly-rated taco stand. Yum! Let’s do it. Two carnitas tacos later I wasn’t in agreement with that rating. Thumbs down.

Probably was the cilantro. Nothing will test a marriage like everything coming out of both ends. I almost needed an IV that night.

✔️   2017: Peru

Hubby and I were staying at a cute boutique hotel in the Sacred Valley on our way back from Machu Picchu. The usual owner of the hotel was out of town, and her backup staff was in charge. We were exhausted from all of our travel and elected to enjoy a meal on property.

Hours later the dreaded cramps and waves of nausea started, and it was a long night curled up on the bathroom floor in the fetal position.

✔️   2018: Japan

Japan is my favorite country in the world. We ate everywhere from street food to a high-end sushi-ya. So when I passed a sign at Narita International Airport in Tokyo that boasted this is the last place to get great sushi before you fly out, I couldn’t resist.

Oh, I regretted that decision. That 16-hour flight walled up in the bathroom is something I will never forget. Apologies to all the fellow passengers. At least I made it to the bathroom.

✔️   2023: Oaxaca

We are huge foodies, so we were super excited to try all the unique cuisine during our 6 days in Oaxaca. Hubby and I did a cooking class and enjoyed a little food tour after a trip out to Hierve el Agua. No problem.

On the last night, we dined at a wonderful restaurant that now has 1-Michelin star (which I won’t mention). This decision almost ended my trip back to the U.S.

The source of my distress was Pozontle, a Mexican ceremonial drink that is hard to find. It’s made from water (yeah yeah, I know, but this was a HIGHLY-RATED restaurant), panela, cacao, and corn.

Ok, so why do I share all this TMI?

To demonstrate I’ve had a lot of experience dealing with Bali Belly!

Alright, now the fun part.

Is there a way to prevent those dreaded cramps, diarrhea, and vomiting?

Maybe.

Ironically, the one place I did not get Bali Belly was Bali.

And I attribute that to my secret travel weapon,  Travelan.

Travelan is bovine colostrum aka cow’s “early” breast milk right after giving birth.

They harvest the colostrum from New Zealand dairy cows that have been immunized to produce high levels of antibodies against E.coli.

E. coli is the most common pathogen of Traveler’s Diarrhea.

Weird, right? Not really when you think about it.

Human colostrum is super important when a baby is born to help build up their immune system with all those good antibodies and nutrients.

It would make reasonable sense then that colostrum could have a “supportive” effect on the digestive system and increase immune response.

The antibodies in Travelan’s colostrum bind to that bad E.coli trying to ruin your holiday and inhibit it from attaching to your intestines.

Sounds good, but if you are like me, show me the medical evidence!

Although there are no large scale studies, there are several randomized control trials demonstrating significant efficacy (up to 90% protection!).

Bless those volunteers who intentionally consumed E.coli to see if this will work.

Bovine colostrum MAY even reduce the frequency of diarrhea if you are already infected with E.coli.

However, Travelan is NOT meant as a treatment for traveler’s diarrhea, which they clearly state.

The well-regarded Memorial Sloan Kettering Cancer Center (MSKCC) does an excellent job summarizing the possible benefits of bovine colostrum and providing references.

I have tested Travelan out in two countries: Indonesia (Bali and Komodo) and Mexico.

According to the CDC, the highest risk areas for traveler’s diarrhea are Asia, Middle East, Africa, Mexico, and Central and South America.

My husband and I just got back from an epic trip to Bali and Komodo Island. 

Guess what?

This is one of the few times I did NOT get traveler’s diarrhea aka the dreaded Bali Belly.

Yeah, it shocked me too. Especially after I kept reading about people getting Bali Bally in all of my Bali Facebook groups I joined right before the trip.

I made the decision to take Travelan BEFORE every meal even if it looked like a “nice place.”

Pop 1 tablet BEFORE a meal.

I would pop 2 tablets if I was really worried. I haven’t experienced any side effects, but do not take if you have a dairy allergy or are lactose intolerant.

They also recommend taking Travelan 48 hours before a trip, but I haven’t tried that yet.

No problems on our 11-day Bali trip even with eating lettuce and other vegetables (of course at a highly-rated boutique Bali hotel)!

I also took Travelan when I was eating all the tacos in Mexico City, and again to my surprise, no traveler’s diarrhea!

Not even one grumble during my entire 7-day trip in Mexico City.

After Mexico City, we went to Oaxaca and took a cooking class in a local’s home and enjoyed street food in a market during our Hierve el Agua tour.

I always popped a Travelan before a meal.

Again, no problems.

Feeling my wheaties, I made the choice not to take a Travelan on our last night in Oaxaca when we dined at a well-regarded restaurant that now has 1-Michelin star.

I had a drink known as Pozontle as discussed at the beginning of this blog post.

At 2 am, the dreaded waves of abdominal cramps, nausea, sweat, and vomiting crept over my body.

I seriously have no idea how I made it on that plane home the next day.

As it was almost my turn to go through the security line at the airport, I turned to my husband in a cold sweat and told him there was no way I was going to make it.

After walking through the detector, the agent wanted to pat me down.

The next thing I know I am darting for the trash can unloading whatever was left in my stomach. Surprisingly, they allowed me to get on the plane.

I must not have been the first person going through this unpleasant event, lol. Now I can laugh at the humor of this situation, but at the time, there were no smiles.

Luckily, it only lasted 24 hours but the abdominal distress can last up to a week and sometimes months if caused by a protozoal pathogen.

Would this unfortunate event have been prevented by taking Travelan?

I don’t know.

All I can tell you is when I took it, no problems, and the one time I didn’t, there was a problem.

Travelan is NOT a bulletproof vest and may not work for everyone.

You still NEED to practice good hygiene and food safety precautions.

✔️   Always wash your hands before eating. I carry a travel-sized alcohol-based hand sanitizer (>60% alcohol) in my purse anywhere I travel.

✔️   Always drink bottled water, and always brush your teeth with bottled water. Do not drink tap water. Keep that mouth closed in the shower.

✔️   Never order a drink with ice cubes unless you know they are using CLEAN water.

✔️   Only consume well-cooked food that is made to order and served hot right away. This point is super important.

During our time in Bali, we learned the locals often cook a meal in the morning, and then it sits around during the day.

The Balinese don’t eat together and just eat whenever they are hungry. According to the USDA, leaving food out at unsafe temps (think buffets!) is one of the main causes of food-borne illnesses.

✔️   If you can’t peel it like a banana, avoid it. I normally follow this rule.

However, we stayed at two high-end hotels while in Bali (Munduk Moding Plantation Nature Resort and Uma Kalai), and they served some of the most delicious vegetables.

I wouldn’t have done this anywhere else, but I trusted they used clean water to wash their produce. I still took Travelan in case. No problems.

✔️   Keep those hands away from your mouth and eyes, just like you learned during Covid. Those hands are little germ factories.

Alright, so you didn’t take your Travelan, and now you have waves of diarrhea and vomiting after consuming contaminated food or water.

What are you going to do?

First, always consult with a medical professional. I don’t know your history, co-morbidities, or travel history.

I will share though what I do when I am in that horrible situation. 

The most common complication of traveler’s diarrhea is dehydration.

Anytime I travel I carry zero sugar Gatorade packets. They are small and portable. Add to water and replace those electrolytes.

When we were staying at Komodo Resort in Indonesia, I noticed they had something called Pocari Sweat in our room’s mini fridge.

Intrigued, I looked it up. It’s a Japanese drink that also contains electrolytes to help you hydrate. That should do the trick too!

Dehydration is no joke and can progress rapidly to confusion, muscle cramps, dizziness, headaches, etc. Take it seriously.

Otherwise, you are going to need IV fluids in a hospital.

If you are in a situation where riding this out in the comfort of your hotel room is not possible, then consider taking Immodium.

It does not treat the infection, but it slows down those muscle cramps so you are not pooping as much. Great if you have to hop on a plane or bus and ride the ride.

Do not use though if you have BLOODY diarrhea or FEVER.

Ask your PCP or Travel Clinic for an antibiotic prescription such as Azithromycin in cases of severe traveler’s diarrhea.

Antibiotic choice will depend on the destination and drug resistance patterns.

After my horrible case of traveler’s diarrhea in Oaxaca, I have also started to carry Zofran (Ondansetron).

This medication will help prevent nausea and vomiting on an airport agent as you walk through the security line. 

I haven’t used it yet, but it’s in my travel bag ready for action if needed.

Your stomach is in a highly irritated state.

This is not the time for hot sauce.

Go easy and stick with easy-to-digest foods such as bananas (B), rice (R), applesauce (A), and toast (T) aka the BRAT diet. 

Don’t start this diet though until you can first tolerate small amounts of water and clear liquids. Otherwise, it’s all coming back up.

Avoid dairy, raw veggies, fried/fatty foods, alcohol, and citrus fruits while your stomach is recovering.

I always outweigh the risks vs benefits in anything I try. 

Travelan has some great safety and efficacy data from several small studies. I realize larger studies are still needed, but the results are promising!

All I can say is when I took it along with normal hygiene precautions and following food safety protocols, I did not get traveler’s diarrhea when I was in Mexico City, Bali, and Komodo.

And the one time I did not take in Oaxaca, I got it.

For me, it was worth it! And yes, I will always take it when I’m traveling to Asia, Africa, and Central/South America.

You decide for yourself. Happy and safe travels!

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