Protocol · Gastrointestinal Health
Traveler's Diarrhea Prevention and Treatment Protocol
Saccharomyces boulardii and Lactobacillus GG are the core of this stack, with 6 supporting supplements. Each row gives the amount the protocol lists and the grade our evidence database holds for that supplement in Traveler's Diarrhea Prevention and Treatment.
We are re-verifying the studies cited on protocol pages; only confirmed citations are shown.
The stack
8 supplements · none graded yet
| Grade | Supplement | Amount listed | Why it’s in the stack | Evidence on file | Shop |
|---|---|---|---|---|---|
| Primary stackThe core of this protocol | |||||
| Saccharomyces boulardii | Amount listed: 250–500 mg (5–10 billion CFU) daily, starting before travel and continuing during trip | Probiotic yeast with strongest evidence for preventing and treating traveler's diarrhea | Not graded yet | ||
| Lactobacillus GG | Amount listed: 10–20 billion CFU daily during travel | Well-studied probiotic strain; some evidence for traveler's diarrhea prevention | Not graded yet | ||
| Supporting stackListed as additions to the core | |||||
| Zinc | Amount listed: 20–30 mg daily during diarrhea episode | Reduces duration and severity of diarrhea; supports immune function | Not graded yet | ||
| Oral Rehydration Salts (ORS) | Amount listed: As needed to replace fluid losses | Essential for treating dehydration from diarrhea; WHO recommended | Not graded yet | ||
| Berberine | Amount listed: 400–500 mg three times daily during acute episode | Antimicrobial and anti-diarrheal properties; traditional use for intestinal infections | Not graded yet | ||
| Bovine Colostrum | Amount listed: 200–400 mg daily during travel | Contains immunoglobulins; studied for prevention of E. coli traveler's diarrhea | Not graded yet | ||
| Activated Charcoal | Amount listed: 500–1,000 mg as needed during acute episode (separate from medications) | May help bind toxins; traditional use for acute diarrhea | Not graded yet | ||
| Ginger | Amount listed: 250–500 mg as needed | May help with nausea that often accompanies traveler's diarrhea | Not graded yet | ||
Shop the evidence-backed picks
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Each opens third-party tested products, matched to the dose above where we can.
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How this protocol works
In plain language
Traveler's diarrhea (TD) is the most common travel-related illness, affecting 30-70% of travelers to high-risk areas depending on destination. It's typically caused by bacteria (especially E. coli), but can also be from viruses or parasites.
HIGH-RISK DESTINATIONS:
- South Asia, Southeast Asia
- Africa
- Central and South America
- Middle East
SYMPTOMS:
- Sudden onset of loose stools (>=3 per day)
- Abdominal cramps
- Nausea
- Sometimes fever
- Usually lasts 3-5 days without treatment
PREVENTION:
- 'Boil it, cook it, peel it, or forget it'
- Avoid tap water, ice, raw foods, street vendors
- Bottled or treated water only
- Hand hygiene
- Probiotics before and during travel
TREATMENT:
- Hydration first priority: ORS or clear fluids
- Loperamide: For symptom relief (not if bloody diarrhea or fever)
- Antibiotics: For severe cases (azithromycin or fluoroquinolone)
- Bismuth subsalicylate: Can help treat and prevent
WHEN TO SEE A DOCTOR:
- Bloody diarrhea
- High fever (>101.3°F / 38.5°C)
- Signs of dehydration
- Symptoms lasting >3 days
- Severe abdominal pain
Saccharomyces boulardii* has the strongest evidence for prevention - start 5 days before travel.
Oral Rehydration Salts* are essential for treatment - prevent dehydration.
Zinc* can reduce duration and severity of diarrheal episodes.
Expected timeline: Most TD resolves in 3-5 days. Prevention with probiotics should start before travel.