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    Travelers' Advisory

    When going abroad this summer, a little advance planning can go a long way to help you sidestep disaster, diarrhea -- and sheer rage.

    Attacking Montezuma's Revenge

    A bad case of diarrhea can be your worst travel nightmare, but here's one possible preventive. A dietary supplement called probiotics is now on health food store shelves, and is widely touted to provide your gastrointestinal system with Lactobacillus reuteri cells -- which might help stave off diarrhea.

    Europeans have been taking the stuff for years, says Steven Peikin, MD, of Cooper Health System in Camden, N.J. "If you lived in Scandinavia, you wouldn't think about going anywhere without taking your probiotics," he tells WebMD.

    Probiotics help maintain a healthy balance of "friendly" bacteria in the digestive tract, says Peikin. "Probiotic bacteria can squeeze out any pathogenic bacteria your body gets exposed to -- like bacteria that cause traveler's diarrhea, antibiotic diarrhea, yeast infections, possibly even food poisoning."

    The pill form marketed as "Probiotica" is a concentrated dose that contains some 100 million bacteria cells. "The key to protection is getting lots of cells," Peikin tells WebMD.

    Start taking probiotics for at least one week before your trip, and continue at least one week after your trip, he advises. "Really, you can take it any time. You never know when you might get some bad bacteria, especially if you're going to be traveling, eating out a lot, going to be on antibiotics, or just for general health benefits. You may be improving your immune response at the same time."

    Note: Even though probiotics may prevent diarrhea, you can't always count on it, says Peikin. "You still have to adhere to the usual principles: avoiding water, ice, fruits. This is an extra insurance policy."

    Vaccine for Traveler's Diarrhea

    A promising diarrhea vaccine is also in the works. Like a triple-scoop ice-cream cone, this vaccine is designed to protect against shigella, campylobacter, and E. coli bacteria.

    "It looks very good, very promising," Stephen Keith, MD, tells WebMD. In early clinical trials, the vaccine has proven effective in generating an immune response against shigella and campylobacter. More trials will show whether it actually provides protection.

    If the entire vaccine receives FDA approval, it will likely be a pill taken for two weeks before departure and would provide protection against most bacterial causes of traveler's diarrhea, says Keith.

    "This is a big deal," Keith tells WebMD. "So many people have the story of spending their whole vacation looking at the beach vs. being at the beach. We're talking about some 25 million Americans."

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