Delhi Belly
 

Sorry if the title is not politically correct- no offence is attended only I couldnt think of another term for it. My bf has just been told he will have to do his first business trip to India later this summer however he has never been there and is worried about getting "ill" and he has been teased by his mates about getting this condition. I can't seem to find any definitive advice anywhere that matches except for only drinking water from a bottle, any other tips? :confused:

Thanks,

bring (or buy when he gets there) some pepto bismol tablets or similar over the counter treatment.

if he doesnt have a strong stomach: dont use ice - in anything. dont eat street food. Even when eating in a "good" restaurant he should hope the staff have washed the food and their hands at least once that day. be very careful to only drink from NEW and sealed bottles/cans. wash hands.

oh, and bring (or buy when he gets there) some pepto bismol or similar treatment.

pretty much the same advice given to anyone travelling to any other developing country.

Will he need a prescription for the pepto bismol?

There's a number of recommendations to make - some are common sense, some verging on the paranoid, but really, it's down to the individual and the state of their immune system (i.e. someone who spends their life spraying antibacterial spray on everything will likely fare worse than someone with a bit more balance).

However, what I would suggest, based on my own experience (I go out there every few months):

• The general principle is that, even if something isn't dirty, the bacteria present are not the ones that your body is used to, so you can't just go by eye alone, at least not for the first week.
• Be very aware of water. If you're buying bottled water, check it's sealed, and try to master the art (as you'll see locally) of drinking from a bottle with a slight gap between it and your lips.
• Be aware of indirect sources of water. Ice is a classic - but also think of what things could be washed in - whether the food itself (raw salad ingredients) or the vessel. Also look for water sprays - sometimes used to cool outdoor diners.
• Vegetables are generally a safer bet than meat (although a lot of meat will be fresher than at home). And there is a wealth of great vegetarian food available in India - don't overlook it just because you're used to having meat twice a day at home. I normally do this for the first couple of days of every trip (although it's often so good that I keep going...)
• People have different opinions and tolerance to spice - and of course there are different kinds of 'heat' (chilli, mustard, pepper, etc). Some people will tell you to lay off spicy food altogether - I'd say only do this if you are not at all used to it at home. There's nothing sadder than a dish that's supposed to be spicy with all the spice removed. That said, you may want to give the Andhra Country Fish a wide berth for the first few days. And you may wish to build up your tolerance (I do this, but mostly because my colleagues out there know how much I enjoy spicy food and have been know to test me...)
• Be aware of your personal hygiene - wash your hands well, always with soap, and don't bite your nails or put objects near your mouth, even if you have subconscious habits like this. Bear in mind that you may only get a spoon with some meals, and bread instead of rice (particularly in the north) so you'll be using your hands at some point.
• I don't like antibacterial products for everyday use. However, a small bottle of gel is useful for those situations where you can't get to wash your hands somewhere sanitary.
• Beware of buffets. You don't have to avoid them completely (they're insanely popular) but be aware how often dishes are being replenished and how hot they are. Lukewarm food sitting open for hours is not a good thing.
• If you do want to avoid spicy food, there is a lot of less spicy Chinese-style food available, as well as 'continental' food (i.e. European, usually banded together, and heavy on the Italian). These are often presented in 'multicuisine' restaurants, too.
• If you do get a sense of security later on in the trip, and fancy some street food or drink, do be careful. Look for how the food is covered and handled, how popular the place is, and - this is my pet obsession - how the serving utensils are cleaned. Disposable is usually safest, and metal can be very well cleaned, but the water may not be the cleanest. I once picked up a giardia infection (which lasted 6 months plus) due to a glass which I later found out had been rinsed in dirty bay water...
• Don't be paranoid. And don't miss out on some quite wonderful food - one of the best things about any trip to India. It's not uncommon to suffer a slightly upset stomach for a few hours - and it's not the end of the world if you do. Take imodium (or any other brand of Loperamide) to have readily at hand - but any common medicines can be easily found in pharmacies (and mostly given out a lot more freely than in the UK...)

I was in Mumbai for a week and did not get stomache ills, but I was vigilant. No ice, no uncooked food, only bottle water, even when brushing my teeth. Kept mouth closed in the shower.

One of my colleagues who spent a great deal of time in India swore by using Pepto Bismol prophylactically, taking some before every meal.

If your bf is going to be touring, tell him to be cautious of buying bottle water from street vendors. Check the seal before walking away. It's not unheard of for them to re fill bottles.

Oh, and do make sure you're up-to-date with all travel immunisations (Hep A/Typhoid combined is good for India) and any general immunisation boosters (Polio/Tetanus/Diphtheria). And, of course, antimalarials - go straight for atovaquone-proguanil (e.g. Malarone, but the much cheaper generic is equally effective) and by-pass the older ones.

Ask your doctor to write you a prescription for antibiotics so that you can take the antibiotic with you. If the worst happens, treatment can begin right away instead of trying to find a doctor/pharmacist while the symptoms are still underway. :eek:

Bring a small electric pot capable of boiling water in case you need to brush your teeth/have a tea/etc and there's no bottled water you trust.

Close your eyes in the shower. Don't even rinse your mouth with water from the sink/shower.

Look for thoroughly cooked food.

FWIW, Pepto-Bismol isn't really a household name in the UK, where the OP is located, although it is available, unlike in many other parts of Europe.

Unlikely to wash in the UK - antibiotics are not prescribed prophylactically or available OTC - their use is tightly controlled for public health reasons.

If you do want to go down this route, broad-spectrum antibiotics like Ciprofloxacin are readily available OTC in India.

I usually get a course of Cipro from my doctor before I go. I have not been to India but have traveled all over SE Asia and have gotten very ill a couple of times.

In India, I've never had a problem getting antibiotics from pharmacies even if without a prescription and they are cheaper than in the US or even parts of Europe (even for those who pay a small copay). Probably because I seem like an educated foreigner, they don't care as much about prescriptions.

Most of the Cipro I've used has come from India and was used in India. I merely walk in, ask for the antibiotic I want at a reputable pharmacy, and then pay cash and they hand it over.

Skip the Antibiotic routine and ask your Doctor for an RX for the equivalent of Levsin(Hyoscyamine) or Lomotil (Diphenoxylate with Atropine). Both are antispasmodic medications that help with urgency in use of a WC/Restroom/Bathroom. Lomotil is a controlled substance here in the US but many doctors will quickly write an RX if you tell them where you are traveling.
As others have said most of the problems people experience are from foreign flora not a harmful bacterial infection. Your body will adjust in time if affected at all.
Wash hands, use sealed bottled water & be careful with your food choices.

Thankfully, my doctor trusts me not to take antibiotics needlessly. My Cipro pills are still in the bottle unused, as my visits to India have gone well. :)

I'll likely request a fresh bottle before my next visit.

moving to the India forum
 

thanks

squeakr

co mod TS/S

If you want an antispasmodic in the UK, I would suggest getting OTC Hyoscine (Buscopan is the best known brand).

If you want to get a prescription for these without a diagnosis of IBS, I suspect you'll need to see a doctor privately (which is very much not the norm) and pay the full amount for the drugs.

Personally, I think this is overmedication, but each to their own, of course. My favourite prescription in India for an upset stomach is curd rice...