Preventative diarrhea meds for Turkey?

Our MD recommended we take over the counter PeptoBismol tablets three to four times a day while traveling to more exotic locations. It worked on our trip to Egypt and Jordan. Our tour mates suffered with diarrhea but not us! The doctor uses it himself when traveling to those places.

Like Suki, I also took (chewed up) two Pepto Bismal tablets a few minutes before almost every meal during a two week trip to Egypt in 2022. This has been my practice for years and has, I think, helped prevent issues when in Mexico and in Turkey. During the Egypt trip I also took a Travelan tablet every morning before breakfast. The latter was, I think, suggested on this forum and I ordered that OTC medication on the mega-website Axxxzon. The box says "high in the antibodies that can help support and maintain your gastrointestinal and digestive function and health." I managed to stay well although another member of my small tour group, who ate the same foods that I did - more or less? - did develop, let us say, digestive issues. I also assiduously avoided all raw veggies and fruits unless it was something that I could peel myself, although I did eat the salads served on our dahabiya boat, where I was assured that all fruits and vegs were washed in purified water.

I read this on Sarah Murdoch's blog awhile back.
The regimen starts before you travel to risky areas for intestinal troubles.

The Traveler's Diarrhea Companion

Travelan! That’s it, that’s what we brought to Turkey. Thank you so much!

Just got back for Istanbul. I did take 2 pepto Bismal with each meal for a few days and then decided I didn't need it. ( it can cause constipation) No problems. I did drink bottled water but did shower and brush my teath with hotel water.

We were in Turkey last month. We enjoyed several meals (at local restaurants and a dinner cruise), no problems at all. PS - I don’t drink tap water anywhere when traveling.

I'm allergic to Lomotil so I need to be quite proactive. I've used the pepto bismal (generic) regime for 35 or so years. Prior to that, every time I went to Mexico I'd get a minor bout of illness. Like recommended in the article from Adventures with Sarah, I've added the probiotic. My MD said the probiotic would be beneficial to me and many others as an aid to preventing GI bugs and GI issues more related to changes in diet and routine. I'm going to look into adding the charcoal.

As a side benefit, I think the pepto bismal prevents the heartburn I sometimes get with more adventurous travel eating.

I found what I used on our trip to Turkey: Symbiotics Colostrum Plus Chewable tablets. They are very similar to Travelan which should work well for any riskier meals in Bulgaria. I’ll report back after our trip in May.

Their past 2 weeks, drank bottled water, brushed teeth with hotel water. Not aware of any issues within our group

We are now heading to Bulgaria
I took the RS Best of Turkey tour in 2022 and the RS Best of Bulgaria tour in 2023.

In Turkey, I drank only bottled water and used it to brush my teeth. I ate everything in our hotels and during group meals, including fruits and veg. I ate street food from local vendors. I took stomach meds the first few days and didn't need them for the rest of the 3+ weeks.

In Bulgaria, I used tap water to brush my teeth, had drinks with ice, and ate everything in our hotels and during group meals, including fruits and veg, as well as meals during 12N on my own. I took stomach meds 2 or 3 times during my 3+ weeks.

So, I was far less cautious in Bulgaria to achieve the same result.

Looking at the Adventures with Sarah page on preventing traveler's diarrhea. Would folks consider Turkiye a "high risk" country? I'm onboard with using the probiotic and the pepto bismal tablets, and we won't be drinking the water. Not sure about the need for the charcoal. For those that have given the activated charcoal a try, what strength did you use?

Thanks

My husband and I each took one Symbiotics tablet every day on our Turkiye tour. We drank only bottled water, ate adventurously, and we had no stomach or intestinal issues. About half the tour group was not so fortunate, so it pays to be cautious.

We also did the Symbiotics and bottled water again on this year’s Bulgaria tour and we were fine.

Would folks consider Turkiye a "high risk" country?

If you were to ask my friend who went on the Best of Istanbul and Best of Turkey tours with me, she would say yes. She got very sick about mid-way on the 2nd tour. Her over the counter meds did not relieve her symptoms and she could barely get out of bed until her prescription meds kicked in.

She and I thought we were following the same regime: drink and brush teeth with bottled water, don't drink tap water. I needed over the counter meds a couple of days early in our tours and was fine after that. Hard to say what got her.

I was in Turkey for 2 1/2 to 3 weeks, and never took any medicine and I was fine. And I ate just about everything. Street food, food from kiosks, restaurant food, and loved it all. But I will say I have never had any stomach issues, so I really think it depends on the person.

If you have a tenancy towards diarrhea or stomach issues, then I would definitely suggest taking something.

@CWSocial, any advice for hot beverages? Is it ok to have tea and/or coffee?

If the water has been boiled, then yes, it will have killed off the bad stuff.

ETA: the CDC recommends a rolling boil for 1 minute, 3 at altitude.

https://www.cdc.gov/healthywater/emergency/making-water-safe.html

Has anyone used a portable UV light filter for treating tap water when travelling? Are they worth the price. Will they deal with everything that might make you sick?

Trying to decide about drinking the hotel breakfast coffee, tea and juice. Do restaurants sell bottled water, or bottled beverages? I'm assuming wine would be ok.

Yes, restaurants sell bottled water and soft drinks. You can also buy bottled water in mini markets - bigger bottles cheaper than small ones, and both cheaper than you're used to at home or other big cities.

Bottled water is available absolutely everywhere in Istanbul. The Turks drink it, too. You can go in a supermarket in a totally residential neighborhood and find a large stock of bottled water. At the other extreme, you'll probably find a least one little shop on each city block in commercial districts selling bottles of cold water for less than the equivalent of $1. The only thing you'll find more of in Istanbul than places selling bottled water is street cats.

I was recently in Istanbul and never took any medication for digestive issues. I ate fresh fruit, salads, meat, dairy and all without any issues whatsoever. Personally, unless you are particularly prone to digestive problems I wouldn't bother worrying about preventative medication, it just seems unneccessary and doesn't come without its own issues if taken regularly.

Thanks for the responses. I was more thinking about beverages in a restaurant or at my hotel breakfast in terms of water and ice. My husband loves tea and that is usually prepared with hotter water than coffee is, or at least it should be, but still unless the preparer uses bottled water, I'm not sure it is considered safe for those of us not used to the water in Istanbul. I wouldn't say I'm prone to digestive issues, but I've had minor/moderate problems every time I've been to Mexico and haven't used a preventative regime (although I haven't been to Mexico in many years).

I wouldn't say I'm terribly concerned, its just that after 3 days in Istanbul we are starting a cruise and I'd prefer to not start it with belly issues.

It's common to see large bottles of water or the breakfast beverage table at hotels in countries where tap water isn't considered potable, though I can't absolutely guarantee that every hotel provides bottled water in the breakfast room. I'd be really surprised if a quality hotel did not. Two-liter bottles of water are dirt-cheap even when bought at retail prices.

In Albania, another country where one is advised not to drink the water, one of my hotels provided an open carafe of water at breakfast. I had no way of knowing whether it was bottled water or tap water, so I started taking my own bottled water to breakfast. My hotel rooms had mini-fridges, so I was able to keep cold water available at all times.

The conventional wisdom is that hot beverges are safe, but I am not a doctor.

Ice could be dicey. It's impossible to know the source of the water used. In my experience, bottled water was usually served cold in Istanbul; I don't remember being offered ice. That doesn't mean it isn't available. I'd expect bars to have ice, but I'd consider it a bit risky.

There are street stands in Istanbul selling fruit juices squeezed on the spot. I'd guess those juices aren't cold, but I don't know for sure. I occasionally bought bottled orange juice from a supermarket cold case.

I drank lots of tea in Istanbul, my hotel, cafe's, restaurants and little stalls all without issue and presumably using tap water. As for ice, I don't generally drink anything with ice so it's never been a concern. Cold, bottled water can be found everywhere. I also drank freshly squeezed pomegranate juice and orange juice, these were served at room temperature, without ice and no stomach issues whatsoever.