Dr. Doni Wilson explains why traveling can be a challenge when you have a digestive disorder, and shares 6 tips for staying well when you’re far from home.
Many of my patients tell me they have trouble when they travel, as they feel they have no control over what to eat and they end up feeling sick. This is especially true for those with a history of digestive issues, like IBS (irritable bowel syndrome) and leaky gut.
Like these patients, I also have a history of IBS and leaky gut, both of which started at a young age. But even though I’ve worked diligently to heal my digestive issues over the years, I still take precautions and give a lot of forethought to what I am going to eat whenever I travel, to make sure my trip isn’t ruined by tummy trouble. In fact, I just returned from a two-week trip to India and Sri Lanka and managed to stay well the entire time.
In this article, I’m going to share the steps and precautions I’ve learned from listening to my own body and from working with thousands of patients over the years, so you too can enjoy traveling without the worry of digestive distress.
But before we talk about strategies, let’s make sure we’re on the same page about the terms “IBS” and “leaky gut.”
I conducted a Facebook Live session on January 18 on this topic. If you want to tune into the next session, please “Like” my page: https://facebook.com/drdoniwilson.
What Is IBS and What Causes It?
IBS is a common diagnosis when a person experiences gas, bloating, constipation alternating with diarrhea, and abdominal pain that is not from a different known cause. Because many doctors tend not to offer much advice on how to minimize the symptoms, people who have been diagnosed with IBS often feel they are “on their own” when it comes to figuring out what to eat – and what NOT to eat – to avoid discomfort.
Studies show that a high percentage of people diagnosed with IBS have fructose intolerance.1 This means their bodies have a decreased ability to digest fructose (fruit sugar), as well as other sugars, starches and fibers. To help people with fructose intolerance, a research team at Monash University in Melbourne, Australia developed “the low FODMAP diet.”
FODMAP stands for fermentable oligo-, di- and monosaccharides, and polyols. That’s quite a mouthful! To make it easier to understand, the main categories of foods that tend to aggravate IBS are:
- Fructose and fructans (in wheat and prebiotics)
- Lactose (a sugar in milk and milk products)
- Galactans (in beans and lentils)
- Sugar and sugar alcohol (such as xylitol and sorbitol)
Even with fructose intolerance, a person can usually consume some amount of FODMAP foods; but when starting to follow a low FODMAP diet, it is best to be strict with your choices. Then, as you feel better, you can gradually add and experiment with different foods, to determine the amount your body can handle without causing IBS symptoms.
Another common cause of (and condition associated with) IBS is Small Intestinal Bacterial Overgrowth (SIBO). With SIBO, the bacteria that normally grow in small quantities in the small intestine begin to overgrow. Constipation, a common symptom of IBS, tends to make such overgrowth even more likely.
Food that is not digested well, emotional stress, and food poisoning also make you more susceptible to SIBO and IBS – and SIBO can lead to leaky gut (which we’ll discuss next).
If you suspect you have SIBO, you can do a SIBO breath test that measures the gases produced by the overgrowing bacteria. If you do have SIBO, it’s a good idea to follow the low FODMAP diet.
The diet can then be modified further to eliminate all starchy vegetables and grains (as they can feed the overgrowing bacteria) until your gut bacteria are back in balance.
Read more about IBS in my 2-part series on the top causes of IBS.
What is Leaky Gut and What Causes It?
Called “intestinal permeability” in medical literature, leaky gut is when the cells that line the intestines become unhealthy, causing undigested food and other substances from within the intestines to leak to the area just outside the intestines.
Leaky gut is caused by many factors including stress, pesticides, medications, gluten, and imbalanced gut bacteria. If you already have leaky gut, coffee and alcohol can make it worse.
Nearly everyone with IBS has leaky gut, but not everyone with leaky gut has IBS. Most of us have likely had some degree of leaky gut at some point in time. It’s especially important to address leaky gut if you have an MTHFR SNP and/or methylation issues.
I think of it as a spectrum from mild, to moderate, to severe. The more severe the condition, the more likely you’ll feel unwell when you travel and foods will upset your digestion.
Severe leaky gut can also predispose you to histamine (allergic) reactions, because the immune system gets triggered when it sees substances leaking outside the intestines into the blood stream.
Even without digestive symptoms or full-blown allergic reactions, leaky gut means your body is more likely to react to certain foods and to cause issues in other areas of your body (besides your digestion).
We call these reactions “food sensitivities,” and they are often triggered by the foods you eat most often – such as gluten and dairy.
When addressing leaky gut, it is best to have a food sensitivity test done to find out which foods you need to avoid. Find the food sensitivity test that I recommend here.
Read more about leaky gut in my comprehensive 16-part series.
Traveling with IBS and/or Leaky Gut
When you have a digestive disorder like IBS or leaky gut, your goal should be to minimize the causes, and support your body to heal. This is ESPECIALLY important when you travel. Unfortunately, when we travel, we tend to shift into “holiday mode,” where we want to relax, celebrate and “treat ourselves.”
We want to be spontaneous, and don’t want to say “no” when others offer us food and drink. But when you have IBS and/or leaky gut, failing to plan or pay attention to what we are eating can make vacation time a truly unpleasant experience. Many patients with IBS/leaky gut tell me they don’t want to travel anymore, because it’s just not worth the pain and suffering.
I believe the key to enjoying travel when you have digestive disorders is to plan ahead. When you know you are going away, start working on healing your digestion, at least a few months before your trip.
Then, when you are getting ready for your trip, carefully follow my travel guidelines, based on the acronym TRAVEL:
- T – Take food with you
- R – Rehydrate
- A – Awareness
- V – Vitamins and supplements*
- E – Expectations
- L – Locate foods you can eat
Let’s go through these six travel tips one by one:
T – Take food with you
Always bring lots of foods and snacks to eat on the journey to your destination. If you’re going on a long flight where meals will be served, check in advance to see if the airline permits you to request special meals, such as gluten-free (I haven’t seen a FODMAP-friendly meal on a plane yet).
Even if they do serve a meal you can eat, bringing your own food will ensure you are never “high and dry” when you get hungry in-flight or on the road.
On shorter flights, you could bring a small cooler bag or box, if you wish to bring home-cooked foods. If you do, make sure the ice packs are frozen solid when you arrive at the airport, so security doesn’t take it from you, and so the food remains cold throughout the flight (if you have histamine intolerance, it is best to avoid leftovers and consume only fresh food).
Be sure to bring enough food to last the entire journey, including any train, bus or car travel after you get off the plane. It’s a good idea to have something you can eat when you reach your destination too, especially if you don’t know whether stores or restaurants will be open when you arrive.
Bring a supply of non-refrigerated foods to eat during your stay. You will want to select foods according to your food sensitivity test results (because gluten and dairy food sensitivities are most common, it is best to bring foods that are free from these triggers, even if you haven’t yet been tested).
It’s a good idea to look for the word “paleo” on food packaging, because paleo foods are always free of gluten, dairy and sugar. You also need to consider foods that trigger SIBO and/or histamine, if you know these are part of your digestive problems.
Whenever I travel, I always bring a variety of nut-based foods, as they require no refrigeration and they work best for my body.
Here’s a list of things I brought with me on my last trip:
- Protein bars made of nuts and/or seeds and/or dried fruit (without added sugar) – My latest favorite is Two Moms in the Raw
- Loose nuts and seeds, such as a “trail mix” (watch out for added sugar)
- Almond butter in packets, either plain or with maple syrup – such as by Justins
- Nut-based cereal (add hot water, which you can get on an airplane or hotel) by Wild Ways
- Grain-free granola (paleo version, such as PaleoKrunch) that I can eat with my hands or a spoon
CAUTION: Even if you don’t have a serious nut allergy, nuts CAN trigger histamine. Pay attention to how you feel after eating nuts, and avoid them if you notice they make you feel worse in any way.
- Pea protein powder – It can just be mixed in water. You can drink it on the plane or in your hotel room. You can find three different flavors of pea protein powder in my online store, as well as samples if you’d like to try first.
- Fresh or dried fruit – Eat with caution, because depending on your degree of fructose intolerance, SIBO and histamine intolerance, you may only be able to have a small amount. I suggest trying less than ½ cup of whole fruit (1/2 an apple for example) or up to 2 tablespoons of dried fruit in one sitting.
- “Treats” – It can be tempting to choose from the array of sweets and treats offered on airplanes and in hotels. I find the best way to resist those temptations is to bring my own safe treats, such as dark chocolate. If you are a chocolate lover (like me), find a dark chocolate that is gluten- and dairy-free, and not sweetened with cane sugar. My latest favorite is from Hu Kitchen.
- Protein bars or “jerky” that are chicken, turkey or salmon based, such as from the company called Epic.
R – Rehydrate
All our bodily functions – including our digestive system – work best when they have adequate water and electrolytes to work with. When we are dehydrated, we become more susceptible to constipation, diarrhea, and difficulty digesting food.
It is common to become dehydrated while traveling. The lack of humidity in the air on airplanes depletes us of hydration more than being on the ground. Caffeine and alcohol consumption – which often increases when we travel – can make us even more dehydrated.
To make sure hydration does not become an issue for your digestive system, I recommend drinking filtered water frequently while you are traveling. Don’t over indulge in caffeinated or alcoholic beverages that deplete you more.
If possible, add electrolytes (powder or liquid) to your water to your body rehydrate more efficiently. Best to bring a liquid or powder-form of electrolytes. I don’t recommend choosing “electrolyte beverages” which often contain unwanted sugar.
A – Awareness
Know your body – and your limits. Each person with IBS and leaky gut has unique reactions and needs. It is best to work with a naturopathic doctor who can help you get to know your “safety zone” in terms of which foods you can eat and how much you can tolerate in one sitting.
Don’t start eating foods that you know don’t work for you just because you are traveling. Again, it can be tempting, but you’ll probably regret it the next day. Just the fact you are traveling is already putting stress on your body; you can minimize the stress by sticking to foods you know your body can handle.
Know how much food you can tolerate in a meal – and stick to it. Often the best way to prevent over-indulgence is to eat half of a meal and see how you feel after 20-30 minutes. You can save the rest of the meal to eat later, if you want. Remember, anything you eat must be digested. If your body can’t keep up with what you are putting in, you are likely to feel unwell later.
Be aware of things that are likely to make you ill, regardless of whether you have IBS, such as:
- Unrefrigerated dairy (don’t eat it – ever!)
- Unfiltered water OR raw fruits/vegetables/salads that may have been washed in unfiltered water.
V – Vitamins and supplements
Bring vitamins and supplements with you, so you can take them throughout your trip. These are the products I bring to help keep my digestion functioning well:
- Digestive enzymes – Take one every time you eat, to ensure what you eat is digested. This way, you get the nutrients you need, instead of a negative reaction. I also offer these enzymes in a discounted package with my Leaky Gut Support Powder.
- Leaky gut healing nutrients and herbs – I bring leaky gut healing powder and ARA powder (both of which help with intestinal health) mixed together in a Ziplock bag, so I can add them to a protein shake.
- Probiotics –Support the good bacteria in your large intestines (and prevent bad bacteria) by taking a probiotic. However, if you have SIBO and/or histamine intolerance, you may need to avoid lactobacillus and instead take a soil-based probiotic. It is best to work with your naturopathic doctor to determine the best probiotic for your current health situation. Be sure to read the label: some probiotics require refrigeration, some are okay without refrigeration for up to two weeks, and others do not require refrigeration at all.
- Additional vitamins, according to your current needs, such as a multivitamin, methylation support, adrenal support, thyroid support, immune support, iodine, and antioxidants. The idea here is to provide your body with the same support it gets at home AND give it extra support to help it deal with unexpected infections, toxins, and stress we might be exposed to while traveling.
TIP: Click the link on the products above to see them in my store, or visit DrDoniStore.com, where you can also set up auto-shipping to be sure you always have what you need.
E – Expectations
Setting your expectations and intentions ahead of time can also help prevent both digestive issues and emotional stress. Before you even walk out the door, as well as throughout your trip, set an intention for how you want to feel and what you want to experience on your trip.
If you will be staying with someone, “setting expectations” includes talking openly with your hosts, travel partner, or roommate. If you’re staying at someone’s home or traveling in an organized group, don’t try to be “polite” by not telling them your dietary needs; you’ll likely end up feeling unwell or frustrated at some point in the trip. Talking openly about your needs might also give permission for others around you to do the same for themselves.
As an example, while traveling in Sri Lanka, I decided to go on a camping safari overnight. When I arrived, the safari organizers had me fill out a form that included the question: “Do you have any food allergies or food preferences?” This gave me and the other people in the group the chance to express our needs, so the chef could modify their menu and keep everyone happy.
Communicating about your dietary needs can improve your experience when you’re traveling, but it can also help you connect more with local people. A good host will also WANT to make you feel welcome and healthy. Some of my best conversations on my camping safari were with the chef in the kitchen, discussing the ingredients in their local dishes.
L – Locate food at your destination
Even if you’re on vacation, consider cooking for yourself instead of eating out for every meal. Try to get a room with a kitchen, if possible. If that’s not an option, at least get one with a refrigerator.
This way, you can go to a local market, prepare foods you can refrigerate, and save the leftovers for the next day. Preparing your own meals is good for your digestion AND it saves you money. It also enables you to get out into the local community and see how they do business and what they eat.
Get to know what the locals make. Many traditional foods are already gluten-free – rice, fish, vegetables, and fruit, for example. You might discover something new that really agrees with you, which you might not normally eat at home.
In Sri Lanka, for example, people make a delicious flatbread made of coconut, which doesn’t need refrigeration and my body tolerates well. I bought a bunch of them to take along with me as I travelled; I ate them with nut butter on top, or simply ate them plain.
I’d like to leave you with these words of advice:
The more effort you put into healing your digestive issues BEFORE your trip,
the less difficulty you will have WHEN you’re traveling.
Please don’t feel trapped by your gut issues. Your digestion CAN heal. You CAN travel. If you give your body a good head-start before you leave on your trip, and use my T-R-A-V-E-L tips while you’re away from home, you’ll be able to enjoy your holiday, even if you have a history of IBS or leaky gut. I’ve seen it in my patients, and I’ve experienced it for myself.
If you suspect you may have IBS, fructose intolerance, SIBO, food sensitivities, and/or leaky gut, I absolutely recommend meeting with a naturopathic doctor who can help you sort through your health concerns and get to know your digestion better (I specify a naturopathic doctor because mainstream medical practitioners are less likely to test for and identify these issues).
If you don’t already have a naturopathic doctor who deals with IBS and leaky gut, you might wish to have a look at my Leaky Gut and Digestive Solutions Treatment Package. I have offices in New York and Connecticut, and I work with patients all over the world, via telephone or video call.
If you prefer to start making changes to your diet and lifestyle right away, before taking tests or contacting a practitioner, check out my The Stress Remedy Program, which includes products to support digestive healing (digestive enzymes, leaky gut healing powder, and probiotics), as well as pea protein shake powder. You’ll also receive daily emails to support you through the process.
To stay in touch and receive all my upcoming wellness articles, click here to subscribe to my ‘Weekly Wellness Wisdom’ newsletter. When you do, you’ll also receive my 35-page eBook A Guide to Adrenal Recovery as my gift to you.
Best wishes for a healthy new year and new you!
12th January 2018
*Please keep in mind that any and all supplements—nutrients, herbs, enzymes, or other—should be used with caution. My recommendation is that you seek the care of a naturopathic doctor (with a doctorate degree from a federally-accredited program) and that you have a primary care physician or practitioner whom you can contact to help you with individual dosing and protocols. If you ever experience negative symptoms after taking a product, stop taking it immediately and contact your doctor right away.
- Melchior C, Gourcerol G, Déchelotte P, Leroi AM, Ducrotté P. Symptomatic fructose malabsorption in irritable bowel syndrome: A prospective study. United European Gastroenterol J. 2014;2(2):131-7.