Anything with the word “revenge” in it can’t be good. Traveler’s diarrhea, often called Montezuma’s revenge, is the most common illness travelers face. It can turn a long-planned trip into several days spent close to a bathroom.
I’m Joseph Alban, a Doctor of Acupuncture and NCCAOM Board Certified Herbalist, and I’ve practiced Chinese medicine in New York City for 20 years. I also have a sensitive stomach when I travel, so this topic is personal for me. Below is the travel herb kit I pack myself and recommend to patients, plus how to tell which herb fits your symptoms.
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How I Learned to Pack Herbs for Travel
Before a trek in Peru, while I was still in graduate school, I was worried about getting sick. I had gotten sick in other countries before and wanted to avoid it this time. I didn’t yet have much experience treating traveler’s diarrhea, so I asked my favorite teacher, Dr. Kejian Xiao, a master herbalist, what to bring.
Her answers have stayed in my travel bag ever since, on trips to Mexico and elsewhere. The key lesson was that there is no single “best” herb for traveler’s diarrhea. The right choice depends on what your symptoms look like.
What Causes Traveler’s Diarrhea?
Traveler’s diarrhea usually comes from bacteria, viruses, or parasites in contaminated food or water. Bacteria are the most common cause. Symptoms typically start within the first week of a trip and include loose or watery stools, cramping, nausea, and sometimes chills or fever.
In Chinese medicine, we look at the overall pattern rather than the germ alone. Some people get a “cold and damp” picture: mild discomfort, loose stools, and chills. Others get a “damp heat” picture: urgency, burning, cramping, and stronger symptoms. These two patterns call for different herbs.
Choosing the Right Chinese Herb for Your Symptoms
Huo Xiang Zheng Qi: For Mild Stomach Upset
Huo Xiang Zheng Qi translates to “Patchouli Formula to Correct the Qi.” It’s my first choice for mild to moderate travelers diarrhea. Take it as soon as you start feeling off, rather than waiting for symptoms to build.
This is an aromatic formula. It warms the stomach and supports digestion with pungent herbs like patchouli (huo xiang), perilla leaf (zi su ye), and ginger. Perilla leaf and ginger are both served with sushi, a traditional pairing that adds flavor and is thought to help protect against foodborne illness.
Huo Xiang Zheng Qi is a very safe formula. It comes as pills or as a liquid. The liquid form usually contains alcohol, so choose the pills if you avoid alcohol. In some people it can slow digestion a bit.
Huang Lian Su (Berberine): For Stronger Symptoms
For more severe diarrhea with burning, Huang Lian Su may be a better choice. It’s an extract of the herb huang lian, and its main active compound is berberine. Berberine has strong antimicrobial properties and also helps regulate the immune response. Research has shown that berberine can help stop diarrhea.[1]
Huang Lian Su is very bitter and cold in Chinese medicine terms, and it can cause constipation, so it’s not meant for long-term use. Berberine is not recommended during pregnancy or breastfeeding, and it can interact with some medications. For a fuller look at this herb, see my complete guide to berberine.
Acupressure for an Upset Stomach on the Road
Acupressure is free, needs no packing, and can ease symptoms while you wait for herbs to work.
- Stomach 36 (Zu San Li): Four finger widths below the kneecap, one finger width toward the outside of the shinbone. Massage firmly for one to two minutes on each leg for stomach pain and to support digestion. More on Stomach 36.
- Pericardium 6 (Nei Guan): Three finger widths above the wrist crease, between the two tendons on the inner forearm. This is one of the best-known points for nausea. More on Pericardium 6.
Recovering Your Digestion After Getting Sick
Regulating your stomach after an episode of traveler’s diarrhea is also important. My favorite formula for this is Curing Pills (Kang Ning Wan). They’re mild and help regulate digestion, ease bloating and nausea, and help your stomach get back to normal.
For some people, digestion doesn’t fully recover. Traveler’s diarrhea is a recognized trigger for post-infectious irritable bowel syndrome, which can bring lasting bloating, irregular bowels, and abdominal pain.[2] If your digestion still feels off weeks after you get home, acupuncture and Chinese herbs can help. Acupuncture is also very effective for constipation, which sometimes follows a bout of diarrhea or a course of berberine.
Simple Ways to Prevent Traveler’s Diarrhea
Herbs work best alongside common-sense prevention:
- Drink bottled or properly treated water, and skip ice unless you know its source.
- Choose foods that are cooked and served hot. Peel fruit yourself.
- Avoid most raw salads, unpasteurized dairy, and food that has been sitting out.
- Wash your hands or use hand sanitizer before eating.
- Pack your herbs in your carry-on so you have them from day one.
My Travel Herb Kit Checklist
- Huo Xiang Zheng Qi pills, for mild stomach upset
- Huang Lian Su (berberine), for stronger diarrhea with burning
- Curing Pills, for recovery, nausea, and bloating
- Oral rehydration salts
Heading somewhere high? There are also good herbs for altitude sickness.
When to See a Doctor
Most traveler’s diarrhea resolves on its own within a few days. Seek medical care right away if you have:
- Blood or mucus in your stool
- A high fever
- Signs of dehydration, such as dizziness, very dark urine, or little urination
- Symptoms lasting more than a few days, or getting worse instead of better
In these cases, a physician may recommend conventional treatment. Children, older adults, pregnant travelers, and people with chronic illness should be especially careful about dehydration.
Frequently Asked Questions
What is the best Chinese herb for traveler’s diarrhea?
It depends on your symptoms. Huo Xiang Zheng Qi suits mild upset stomach with loose stools and chills. Huang Lian Su (berberine) suits stronger diarrhea with burning and urgency.
Can I take Chinese herbs to prevent traveler’s diarrhea?
Many travelers take Huo Xiang Zheng Qi at the first hint of stomach upset rather than every day. Ask your herbalist about the right approach for you and your trip.
Is berberine safe to take while traveling?
Berberine is safe for most adults for short-term use. It can cause constipation and interact with some medications, and it isn’t recommended during pregnancy or breastfeeding.
What are Curing Pills used for?
Curing Pills (Kang Ning Wan) are a gentle formula that helps regulate digestion, nausea, and bloating. I recommend them for recovering after a bout of traveler’s diarrhea.
Why is my digestion still off after traveling?
Some people develop post-infectious IBS after traveler’s diarrhea. If symptoms last weeks after your trip, see a healthcare provider. Acupuncture and Chinese herbs can help restore normal digestion.
If your digestion hasn’t been the same since a trip, we can help. Learn more about Chinese herbal medicine at Alban Acupuncture, or schedule an appointment at our Upper West Side office.
This article is for educational purposes only and does not constitute medical advice. Ask your healthcare professional before taking herbal supplements.
References
- Yue SJ, Liu J, Wang WX, et al. Berberine treatment-emergent mild diarrhea associated with gut microbiota dysbiosis. Biomed Pharmacother. 2019;116:109002. doi:10.1016/j.biopha.2019.109002
- Klem F, et al. Prevalence, risk factors, and outcomes of irritable bowel syndrome after infectious enteritis: a systematic review and meta-analysis. Gastroenterology. 2017;152(5):1042-1054.
