I suppose it was only fitting during my gastronomic adventures in Europe that I developed a gastrointestinal illness. Of course, I can’t be sure exactly what caused it–a virus or a particular food–though I sensed it was unlikely a food-borne pathogen, since the symptoms were lower grade in intensity than what I’ve read about for E.coli O157:H7, campylobacter, and such
My sense was confirmed when, after a day-and-a-half of symptoms including fever and diarrhea, I visited a Pharmacie in Lisbon. These licensed dispensaries are all over the city, easily distinguishable by the official green neon cross over the store entrance. They are something akin to America’s old-time drug stores, before CVS and Walgreens drove them out of business—places where you can discuss your illness with a pharmacist and get serious recommendations about protocols and treatments for your problem, which may or may not involve prescription drugs.
I had been in to one of these places a day after arrival near where I was staying in an old section of Lisbon, to buy some sun screen, and had struck up a conversation with a young pharmacist, Alexander. When he heard I was from the Boston area, he told me that his secret passion was music and musicals, and how much he had enjoyed a recent visit to New York City.
So when my intestinal illness hit ten days later, I paid Alexander a return visit. He questioned me closely: Did I have nausea? Diarrhea? Both or just one? Fever? How high? How long had I had the symptoms? How was I limiting my diet?
When he was satisfied with the answers, he disappeared into a back room for several minutes. I could see him rummaging through some drawers. He returned with a package of 15 white capsules. Though all the information on the package was in Portuguese (the capsules were produced in Portugal), the product name, Bacibiotic Activ, suggested it was a probiotic. Alexander confirmed that it was. “I want you to take one of these 15 minutes before meals, twice a day. Even after you get better, finish them up.” The cost: about $18.
He advised me to avoid fried foods and roughage, and focus on white binding foods like rice and bananas. Eggs only if they were boiled or softly cooked.
In the U.S., of course, a consult with a Walgreens or CVS pharmacist would likely have pointed me to the display case for imodium or Kaopectate. Even if I specifically requested a probiotic option, the pharmacist likely would have known little, and would have had even less available to recommend.
The effect of the probiotic Alexander came up with was near instantaneous—within hours of taking the first capsule, my diarrhea reduced, my fever was gone, and I was much less uncomfortable. Within a couple days, I was pretty much back to normal, able to take full-day train trips around the area without fear of not having immediate access to a decent toilet.
The experience was yet another reminder that the traditional European relationship to bacteria in the diet and in the gut is much different than the American one. In Europe, bacteria are friends in many respects, while in the U.S. they are seen mostly as enemies.
Things are shifting, though. There is expanding recognition in America’s medical community of the importance of gut bacteria in good health and such. The Wall Street Journal reported recently on several venture-backed startup companies focused on analyzing individuals’ microbiome and offering dietary advice based on the results. I just heard an advertisement this evening on national TV for a probiotic….for sale in Walmart.
So this microbiome stuff is coming, to a store near you. In the meantime, Europe has an advantage by virtue of a very long tradition.