The holiday season means we are often out of the house more than normal. Eating out at a family member's or travelling for a holiday can leave us at risk of food poisoning, stomach flu or travellers diarrhoea.
Those of us with compromised digestive systems, such as when we have SIBO, or anyone who has previously been exposed to food poisoning, can find themselves feeling mighty unwell when others around them are fine.
We’ve pulled together some easy tips from some of the world’s top specialists in gut health on how to avoid food poisoning over the festive season to keep you feeling great and free from nasty bugs this season.
1. support your system before you go
Dr Nirala Jacobi recommends supporting your system before you travel and says one of the best ways to prevent food poisoning is to enhance the natural antimicrobial activity of stomach acid (HCL), bile, and enzymes which are produced to help us digest foods and kill foodborne bacteria.
She recommends using digestive aids like herbal bitters and HCL Betaine, antimicrobials like Berberine and Rifaximin and additional supports like Melatonin (considered a prokinetic which can support the motility of the small intestine) and Saccharomyces Boulardii, a beneficial yeast with many digestive benefits.
One role that your stomach acid performs is to help prevent harmful organisms from entering the intestines. Nutritionist Angela Pifer recommends supporting your system by taking one capsule of HCL Betaine, which is around 500-600mg of HCL Betaine, with each main meal.
In between meals, she recommends taking 50-60 mg of Oregano Oil (twice a day). This is an antimicrobial and it helps knock down unbeneficial organisms between meals. Dr Nirala Jacobi does advise that HCL Betaine is not recommended for those with a known history of gastritis.
Before your trip, Angela Pifer recommends that you trial the HCL Betaine and the Oregano for a day or two to make sure that these do well with your digestive system. She does advise not to open the HCL Betaine capsule and take less as it must be taken in the capsule.
2. follow your diet protocol
Dr Nirala Jacobi recommends sticking to your current diet protocol and working with your practitioner to determine how to eat while you are away.
Nirala says, if that proves too hard then it’s a good idea to download the Monash University Low FODMAP app, which gives green lights on foods with low fermentable fibres. This is not a specific diet for SIBO, but it will do in a pinch.
3. ask for a special meal when flying
Dr Nirala Jacobi recommends you consult with your airline for any travel with a meal service. Though none currently have a low FODMAP diet, all airlines cater to certain diets and these can differ.
For starters, request no dairy and gluten and see how amenable they are for specific food requests.
She also recommends you take ample snacks in case you can’t eat much of what they serve: boiled eggs, nuts, almond meal pikelets, rice cakes with almond butter and cut vegetables are all good travelling foods.
However it is important to note that many countries have strict custom laws which prohibit bringing fresh food into the country, so you may have to throw out your leftovers upon arrival.
4. only drink bottled water
Drinking water can be unreliable in underdeveloped countries at best, or contaminated at worst.
Gastroenterologist Dr Leonard Weinstock recommends that if you are in any doubt at all to stick to bottled water, and ensure that the seal is intact.
That includes brushing your teeth and washing your face with bottled water.
5. avoid street food
Both Dr Leonard Weinstock and Dr Nirala Jacobi have concerns over street food and advise that you are wary of it.
It can look and smell delicious but can be bursting with nasties that can leave you very sick. Particularly in developing countries, street vendors may not have access to running water or hot water to sanitise their crockery, cutlery and glasses.
Food can often be left to sit in the sun without refrigeration, making it a perfect breeding ground for bacteria.
6. be strict with your sanitisation
Dr Leonard Weinstock recommends that washing hands regularly, and especially before eating, helps to ensure that you are less likely to contract or pass on a c.difficile infection or develop diarrhoea.
Taking Saccharomyces Boulardi (a non-pathogenic yeast) or colostrum powder is recommended by naturopath Natalie Cruttenden, both of which are used for preventing and treating travellers diarrhoea.
7. don’t eat food that has been sitting out
Dr Leonard Weinstock also recommends avoiding food that has been sitting out, in particular, potato salad. The problem with food like this is that you have no idea how long it’s been sitting there.
If food has been left uncovered it could have had flies on it as well, making it a perfect place for bugs to lurk. It’s always best to eat something that has been freshly prepared.
8. only eat cooked food
When ordering out, choose only cooked meals. Angela Pifer recommends refraining from eating at the salad bar or having sushi.
If you are eating with family, pay attention to how things are being stored and shared during the holiday meal. For example, if a mayonnaise dip has been out since breakfast, and the bowl that contains it has not been placed on a bed of ice, then this isn't a good choice for you.
Or, if the stuffing was cooked by being placed in the bird, then do not eat the stuffing (setting aside, of course, that this was made garlic and onion free).
9. reduce the risk of traveller’s diarrhoea
Natalie Cruttenden says the risk of developing travellers diarrhoea is reduced by taking Lactobacillus rhamnosus GG.
However, it must be refrigerated though so you’ll need that mini bar to keep it in.
10. make a plan and stick to it
Be clear with people, be they your server or your family, that you’re sticking to your gut protocol. You need to ensure that they are aware that when you say you can’t have something that it’s not about being fussy, it’s part of treating your illness.
Restaurants want to make you happy so don’t feel uncomfortable about asking about ingredients, ditto with friends and family, no one wants to make something that someone can’t eat.
Tell them all about the amazing things you eat now and you might find your meal is completely SIBO friendly.
11. if you do experience food poisoning
Angela Pifer says Activated Charcoal is her 'must have' survival item when it comes to food poisoning. She recommends at the first hint of food poisoning, take 2 capsules, then wait 2 hours and take 2 more. This will bind the toxins and this reduces the overall effects on your system.
Please note, if you happen to vomit after taking activated charcoal, it will be black. Your stool will also look black. Though visually, this looks quite disturbing, this is simply the charcoal and it isn't doing any harm to your system.
Although this can all seem a little daunting at first, once you have your plan in place to ensure good gut health while you travel you’ll find that you can relax and enjoy the holidays without stress. Here’s to Happy Holidays and good gut health in 2017.
about our contributors
Dr Leonard Weinstock is Board Certified in Gastroenterology and Internal Medicine. He is President of Specialists in Gastroenterology and the Advanced Endoscopy Centre. He teaches at Barnes-Jewish Hospital and is an Associate Professor of Clinical Medicine and Surgery at Washington University Hospital of Medicine. An active lecturer and investigator, he has published many articles and research studies.
Angela Pifer, SIBO Guru, has had a thriving clinical practice for the past 11 years, working clinically as a licensed Certified Nutritionist. Specialising from the start in functional gut disorders, for the past 4 years her practice has focused solely on SIBO. As the SIBO Guru, instead of chasing symptoms, she helps patients get to the root of their illness.
Natalie Cruttenden is a naturopath with over 20 years clinical experience. Having worked as a Registered Nurse at the Royal Women's Hospital, which proved invaluable for her naturopathic practice. Natalie's lifelong interest in nutrition has lead her particular focus in digestive health seeing many people with SIBO, food intolerances and other gut related issues.
Visit Natalie Cruttenden's website
Dr Nirala Jacobi is recognised as Australia's leading SIBO specialist. She is the founder of 'SIBO test', an online SIBO testing facility. Dr Jacobi offers Skype consultations, which can be organised via her website. Her website is full of useful information and resources, including the fantastic article from which we have used extracts here. The link to the article and this very useful site can be found below.
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