A frequent India visitor shares her tips to prevent an upset tummy – and what to do if despite your precautions, trouble strikes!!!
A street food vendor in Old Delhi, India. Photo: Arterra/UIG via Getty Images
Mention you are planning to travel to India and chances are that someone is going to gleefully point out that you will inevitably be struck with Delhi Belly, possibly even as the aircraft touches down on Indian soil!
But it is completely possible to have a fantastic time in India and not get diarrhoea. Of course no-one can guarantee this but I’ve been to India about 10 times and had almost no problems at all. In fact, the worst 'digestive problem' I've ever experienced happened to me in France. These things can strike anywhere!
It is true however that in countries where there are issues around clean water and food hygiene (including lack of refrigeration facilities) you do have to take some common-sense precautions to minimise the risk of emergency dashes to toilets (or worse still, emergency dashes when there are no toilets to dash to).
So here’s my Frequent Traveller’s Guide to Avoiding Frequent Toilet Visits...
1. DON'T PANIC
First of all, a few bouts of diarrhoea do not necessarily mean you have got a very serious bug such as giardia or salmonella. Change of diet (eating a lot more tropical fruit, food cooked in ghee, spices and so on), heat, stress, jetlag and plain tiredness can all result in an upset stomach. So if this is all that is happening don’t panic – you are most likely not about to become seriously ill. Even multiple bouts over a couple of days, as long as they are not accompanied by stomach cramps, fevers or passing blood, are not uncommon.
2. PREVENTION IS BETTER THAN CURE
… otherwise known as: “Don’t drink the water. Really, just don’t”!!
Sometimes no matter how careful you are you will come into contact with contaminated food or water. But there are ways to reduce the risk. First of all, don’t ever drink or even clean your teeth in local water unless you are specifically told tap water is safe (even then I often err on the safe side). Stick to bottled water, or if you are worried about the environmental impact of this, drink only boiled water (you need to boil the water for one minute up to 2000 metres in altitude, or three minutes if you are higher) or use other approved purification methods. Avoid ice in drinks too unless waiters can assure you their ice is made from purified water (but again, I would be careful there too).
And if you like singing in the shower, try to desist, at least while on holiday…
3. KNOW WHAT YOU'RE EATING
One of the joys of travel is being able to try different foods. The good news is, you don’t have to skip these in order to stay healthy. You just need to be careful when choosing your food and where to eat it. I also feel you are better off eating hygienically prepared traditional dishes than stick to western foods that local cooks might not be so adept at cooking.
If you want to be really sure, don’t eat street food. But if you can’t resist just make sure what you eat is hot and cooked in front of you. A compromise is to choose vegetarian treats like vegetable samosas or freshly baked chapatti.
If you crave an ice-cream, India does have top quality commercial ice cream which is usually fine as long as it has been refrigerated properly. If your ice cream feels soft or the shop doesn’t look like it has a high turnover of stock give it a miss. Avoid cream freeze machines.
Buffet food which may have been heated, cooled and then heated up again can be a recipe for tummy troubles. Even rice can be dodgy if it has been heated up several times.
Going vegetarian – absolutely no hardship in India where there are fantastic vegetarian dishes – suits some visitors as meat and poultry are common sources of bugs. Some people also steer clear of fish, especially if they are not within easy reach of the sea – meaning fish could be subject to long, possibly unrefrigerated travel time.
Samosas, sizzling hot and straight out of the pan, are delicious. Photo: Jill Worrall
And if trouble strikes...
1. Again, don’t panic.
2. For straightforward diarrhoea keep hydrated. If you can’t stomach rehydrating salts, water or even fizzy drinks will do. Avoid food if at all possible for a day – you probably won’t feel like eating anyway. This gives your digestive system a chance to recover. You can easily make your own rehydrating mix – just dissolve half a level teaspoon of salt and six teaspoons of sugar in a litre of clean water.
3. When you do start eating again take it easy and stick to bland foods such as plain boiled rice, potatoes or plain bread. Bananas seem to be good too. Then slowly reintroduce the full range of food again over subsequent days.
4. If you are travelling, especially on a bus or plane, medications containing Loperamide (such as Imodium) is a lifesaver. But to put it bluntly diarrhoea is better in than out so don’t take too much of it!
A Southern Indian chicken masala in preparation, more herbs and spices ready to add. Photo: Jill Worrall
5. If you have any other symptoms or the diarrhoea simply doesn’t stop after a few days then you should seek medical help. Here again, don’t panic. India has some world-class medical care which, other than in isolated areas, tourists can access.
6. Maintain scrupulous personal hygiene with frequent hand washing and use of hand sanitiser. A cultural note: be discrete with the sanitiser if you are eating in a private home. Imagine how you would feel if you had guests for dinner and everyone got out their sanitiser out at the table before tucking in.
Take a few common-sense precautions and you have every chance of travelling through India with no problem. In fact, because the food is fantastic, your biggest concern may well be putting on weight rather than losing it through sickness!!! Happy travels...