March always brings patient appointments with questions about what to bring on vacation. Sometimes we discuss how to be preventative with our immunity in an environment like India or Pakistan, sometimes we discuss tips on managing jet lag or motion sickness, and sometimes there are questions about what to have on hand at an all-inclusive resort just in case traveller's diarrhea strikes!
Probiotics are one of my top 3 supplements to take on a trip anywhere! But what kind and why?
There are many different strains and for the longest time many thought the more billions of CFUs (colony forming units) the better the outcomes. While there are times more CFUs are desirable, there is ample evidence to show more is not better. The key is finding the appropriate strain of bacteria for the concern and/or goal.
The most common probiotic is lactobacillus acidophilus. It is great at protecting your gut from the bad guys. When the bad bugs attack, the gut lining becomes less healthy and nutrient absorption is decreased. The immune system is activated and an inflammatory reaction begins. The gut feels terrible and food isn't digested as well and your immune system has to work hard! This is a good maintenance probiotic for most people or to prep your gut before a trip.
However FOR a trip I prefer a temperature stable probiotic so not to worry about spoiling the efficacy. I look to a different strain, specifically sacchromyces boulaardi, which is actually a friendly yeast that functions like a probiotic.
In the journal Medicine, a 2016 study suggested that taking quality probiotic supplements help prevent and reduce your risk for traveler’s diarrhea. Saccromyces boulaardi has also been shown to decrease the duration of diarrhea in children and infants.
How does it work? First, it prevents gastrointestinal inflammation by interfering with the various pathogens that bind to digestive tract walls. It competes with those bad bugs for receptor sites on the intestinal walls. It prevents the bad bugs from attaching to the walls. Secondly, Saccharomyces boulardii enhances protective proteins of the immune system to target and destroy these same pathogens.