Avoiding stomach ailments is critical to a successful vacation.  We often tell our clients to avoid fruits and vegetables without a peel and to drink bottled water and avoid ice in countries where we know there are water safety issues.  As a general rule, we also advise that you avoid any raw fish if you are traveling internationally (except for certain parts of Japan).   This includes sushi, ceviche or other forms of raw fish. The consumption of shellfish, specifically clams, oysters and mussels can also increase your chances of intestinal distress by up to 20 times according to the National Institute of Health.  Did you know that a surprising percentage of Europe’s shellfish come from bays and lakes that are seriously polluted? Also keep a look out for food that has been exposed to flies, food that may have been touched with unclean hands and cold foods not kept below 40 degrees or cooked foods not kept above 140 degrees especially at food stalls and markets. Better to be safe than sorry!