J Travel Med. 2018 May 1;25(suppl_1):S38-S45. doi: 10.1093/jtm/tay013.
This is a review of some of the non-pharmacotherapeutic interventions in travellers diarrhoea (TD) looking particularly at the role of pre and probiotics, the evidence behind water purification and the impact of advice given and its adherence by travellers.
A systematic review of the research completed under section using the listed key words and searched using the databases of Google Scholar, Journal of Travel Medicine, QxMD, ReadCube and The Knowledge Network.
Travellers' diarrhoea and use of pre/probiotics: There is no significant evidence to suggest the benefit of using pre or probiotics to prevent or treat TD. A new second generation of B-GOS prebiotics shows some potential in preventing the incidence and symptoms of TD but lack high levels of graded evidence. Recent reports from the biotics industry suggest that a review of the above issues is being addressed and in the future more robust studies may be completed. The evidence behind water purification and diarrhoeal disease: Evidence suggests there is no direct correlation that water purification has an impact on diarrhoeal disease, although some studies underline the value of water purification. The use of bottled water is questioned as being unreliable due to the inconsistencies of microbiological safety. With new water purification products and methods being introduced a benefit could be found for publishing effectiveness against pathogen groups to improve comparison. Are travellers given good sanitary advice and do they follow it? The advice given to travellers by non-clinical sources is unregulated and not a statutory obligation of a reservation to travel. Within the clinical sector the advice provided and the outcomes of advice provision do not correlate with a reduction in TD as a variance can occur by travellers' changes and behaviours towards the advice given. Following recommended advice and consuming higher risks foods do not correspond directly with levels of reported TD, suggesting attitudes and practices deviate away from this advice when travelling.
本文综述了旅行者腹泻（TD）的一些非药物治疗干预措施，特别关注了益生菌和益生元的作用、水净化的证据，以及旅行者获得的建议及其遵循情况的影响。
使用列出的关键词对研究进行系统综述，并使用 Google Scholar、旅行医学杂志、QxMD、ReadCube 和知识网络数据库进行搜索。
旅行者腹泻和益生菌/益生元的使用：没有证据表明使用益生菌或益生元预防或治疗 TD 有益。新一代 B-GOS 益生元在预防 TD 的发病率和症状方面显示出一定的潜力，但缺乏高等级的证据。来自益生菌行业的最新报告表明，正在对上述问题进行审查，未来可能会完成更多的严格研究。水净化与腹泻病的证据：有证据表明，水净化与腹泻病之间没有直接的相关性，尽管一些研究强调了水净化的价值。由于微生物安全性的不一致，瓶装水的使用受到质疑，因为其不可靠。随着新的水净化产品和方法的引入，针对病原体组的有效性进行发布以提高比较的好处可能会被发现。旅行者是否得到良好的卫生建议，并且是否遵循这些建议？非临床来源向旅行者提供的建议不受监管，也不是预订旅行的法定义务。在临床领域，提供的建议和建议提供的结果与 TD 的减少不相关，因为旅行者的变化和行为可能会导致这种差异。遵循推荐的建议和食用高风险食品并不与报告的 TD 水平直接相关，这表明在旅行时，态度和行为与这些建议不符。
