Whether you call it Delhi Belly, Montezuma’s Revenge, traveller’s diarrhoea or a tummy bug, there’s no escaping the fact that a nasty case of the trots can take the shine off your holiday faster than you can say “where’s the toilet!”
After more than 25 years as a registered nurse, my travel buddy Mo has seen more than her fair share of patients struck down with Delhi Belly! Here’s what she has to say about holiday tummy, how to prevent it, and what to do if you do get it!
What is Delhi Belly?
Traveller’s diarrhoea is one of the most common health complaints among UK tourists, according to the NHS, affecting up to 50 per cent of travellers.
What are the symptoms of Delhi Belly?
The most common symptoms are diarrhoea, fever, vomiting and stomach pain.
What causes holiday belly?
Viruses, bacterial organisms (including E. coli and salmonella), and parasites such as Giardia can cause stomach upsets. These spread by consuming contaminated food and water, and tummy bugs can easily be passed from person to person too.
Sometimes, a dodgy tummy is self-inflicted; too much alcohol and sun can be a significant cause.
How long will an upset tummy last?
While most cases of sickness and diarrhoea on holiday don’t last for more than three to five days, it’s painful and worrying when it does strike. So, it pays to be prepared, because if you end up with the runs, you’ll feel like the world is falling out of your bottom (literally) and you’ll barely feel capable of dashing to the toilet.
As you won’t be able to move far from your bed for a few days, you might also miss out on activities you’d planned and paid for in advance, plus you might be unfit to travel.
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PRECAUTIONS TO TAKE TO AVOID DELHI BELLY
Get travel insurance
Travelling without insurance is foolish and could be a very costly mistake. While the cost of healthcare in other countries varies widely, if you need to stay in a hospital, the bill will snowball at an alarming rate.
My dad broke his ankle badly while holidaying recently in the US and his 10-day stay in hospital could have been ruinously expensive. Luckily, his comprehensive travel insurance policy covered all of his medical expenses, plus the cost of flying him home, accompanied by a nurse, as he was confined to a wheelchair for weeks.
Travel insurance is relatively inexpensive, so wherever your journey takes you, don’t risk going without a travel insurance policy. I use World Nomads, who cover everything from delayed or cancelled flights, to lost luggage or theft, and medical treatment plus repatriation too, if needed.
What to Do Before you travel
Here are the things that you can do, both as you prepare for your trip and while you’re away, to prevent Delhi Belly spoiling your holiday.
Prepare a first aid kit
Just in case you get ill when you’re away, pack some anti-diarrhoeal tablets such as Imodium (Loperamide) and rehydration salts such as Dioralyte in your first aid kit. It can also be quite useful to carry a thermometer.
If you forget to take some, a chemist in your resort should be able to give you over the counter medicines but expect to pay a lot more than at home.
“Catching a tummy bug while away from home is horrible. My worst experience of this was on my first solo trip to Egypt, in the middle of the Western Desert! It was painful and uncomfortable for more than three days, and it changed my attitude when it comes to travel. Now I always have a supply of Dioralyte and Imodium in my bag, just in case.”
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No vaccines can prevent Delhi Belly; but, you might need other vaccines for your trip, including hepatitis A, typhoid, yellow fever etc. Depending on where you’re going, you might also need to take malaria tablets. Check out the guidance on the NHS Fit for Travel website and get advice from your doctor about eight weeks before you travel.
Prepare your stomach
Be kind to your stomach and take probiotics, as these do seem to help prevent tummy upsets. If you don’t fancy a supplement, try probiotic-rich foods such as kefir, kombucha, kimchi, sourdough bread or yoghurts containing live cultures instead. If you’re going to take a probiotic supplement, make sure to start on the day of travel and keep taking them until you return.
What to do while you’re away
Here are a few simple things to keep in mind to help you avoid Delhi Belly while on your trip.
The simplest, most effective way of stopping bugs from spreading to you or other people is to wash your hands thoroughly, especially before eating. If you can’t wash them, use a hand sanitiser.
Watch out when handling cash, as both notes and coins can be incredibly grubby – the perfect breeding ground for nasty bugs! Pay electronically wherever possible, and use a hand sanitiser after handling cash!
Drink bottled water
When you’re unsure of the purity of the local supply, you should avoid tap water. Locals might be able to drink it without any problems, but your stomach may not have the right bacteria to prevent you from getting sick. Don’t even use tap water to brush your teeth!
Avoid ice in your drinks
Hold the ice as it’s made with tap water!
Don’t eat raw or undercooked food
Freshly prepared, well-cooked food, served hot, is generally safe but as a rule of thumb try to avoid uncooked meat, fish or eggs, and consider swapping your salads, which may have been washed in unclean or contaminated water for cooked vegetables instead.
Be careful at the buffet
Buffets can also be a bit of a danger zone as, unless you can ensure the food is fresh, it might have been lying around for a couple of hours. Many people avoid street vendors because they worry about contamination or the quality of the food, however more often than not they cook it fresh in front of you and have a high turnover of food so it may be better than buffet restaurants.
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Watch out in the pool!
Time spent in swimming pools is one of the most common reasons why people get Travellers Tummy. In a busy resort, with lots of people using the pool, remember that some of those folks may not have the same hygiene standards as you, and some may be nursing a nasty holiday sickness!
Swallowing water from hotel pools or showers can put you at risk of getting Delhi Belly. Stay safe by keeping your mouth closed while you’re swimming and showering!
Street food rules
Only eat street food when you have seen someone cook it, and stick to dishes that are both piping hot and fresh because heat kills bugs. You won’t go far wrong if you watch where the locals eat and buy what they do.
If in any doubt about the freshness or quality of the meat on offer, choose the veggie option!
Avoid Western food
While it may be comforting and familiar, Western food may not be as good as the local food, and it probably won’t be much like you’d expect it to be at home.
WHAT TO DO IF YOU GET SICK
In most cases, traveller’s diarrhoea doesn’t need medical treatment.
These tips will make you feel better quickly:
Hydrate! Hydrate! Hydrate!
Lots of travellers get tummy problems. Most are not harmful, but you should drink plenty of water to avoid getting dehydrated.
The main symptoms of dehydration are dizziness, a feeling of weakness; you might even faint through a lack of hydration. It’s most important to drink plenty of fluids to avoid lack of fluid in your body.
As a rough guide, drink at least 200mls after each bout of diarrhoea (extra fluid in addition to what you would typically drink!). If you struggle to keep water down and suspect that you are becoming dehydrated, you should seek medical advice.
Doctors recommend drinking at least two glasses of water after every loose motion. Adding oral rehydration salts to the water you’re drinking will help even more. As part of your travel planning, buy a couple of packets of the supplements at home and take them with you.
For the first few of days, be kind to your tummy and try not to eat anything (you probably won’t feel like it anyway). Stick instead to bottled water, diluted fruit juice and weak tea. If you think you can manage something more, try a little clear soup. Once your tummy settles, you can try salted crackers, dry toast, plain boiled rice and plain noodles. Steer well clear of coffee and caffeinated soft drinks, as they will make you even more dehydrated.
Once you start to feel better, reintroduce your regular diet cautiously. Your tummy will still be sore and delicate, take it slowly with dairy, caffeine and high-fibre foods.
Take some medication
Some drugs can help speed up the recovery process. Imodium (Loperamide) is one of the most well-known ones. It won’t cure diarrhoea, but it will stop the belly cramps and enable you to keep water down. While it’s great medication, it’s only a temporary solution, and you should stop taking Imodium after 48 hours.
Rehydration salts such as Dioralyte are also beneficial and are easy to carry with you. They are sold in sachets and contents are added to water. They won’t stop or reduce diarrhoea. However, the small amount of sugar and salt helps the water to be absorbed better from the gut into the body.
Pepto-Bismol is another popular remedy for diarrhoea. It tastes awful, but it can help to ease Delhi belly.
Get Plenty of Rest
The best way to get better is to get lots of sleep. Keep as cool as possible and don’t try to do anything strenuous. If it’s hot, use a fan, air conditioning or a cooling, damp cloth to bring your body temperature down.
When to see a Doctor
Your tummy bug should only last a couple of days; however, if you don’t feel better after 3-4 days, it’s time to go to a doctor. If you have blood in your stool and a fever higher than 39℃, see a doctor straight away.
Pro Tip: Only take antibiotics for Delhi belly if you have severe diarrhoea with blood and a very high fever. The only person who should prescribe antibiotics is a doctor.
HOLIDAY BELLY FAQs
Q: Is it OK to fly with a tummy bug?
A: If you have a holiday tummy, getting on a plane will be unpleasant for you, and you could risk the health of other passengers, including those who are elderly or very young. Visit a doctor and get a letter to say that you’re unfit to travel, which you can give your insurance provider.
Q: Am I infectious?
A: Yes. Traveller’s tummy is infectious. Take care not to share towels, and make sure to clean your bathroom thoroughly each time you’ve used it.
Q: Can I use the swimming pool?
A: You shouldn’t use a swimming pool for two weeks after a case of Delhi belly
WHEN YOU GET HOME
Despite all these measures, if you got Delhi Belly bug while you were travelling, the best thing you can do when you get home is to try to support your healthy gut bacteria through a proper diet. Try to eat lots of fibre and probiotic-rich foods and consider taking a probiotic supplement for a couple of weeks.
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Have you ever been struck down by Delhi Belly? What remedies do you swear by? Is there anything we’ve not covered her? Let me know in the comments if you’ve got a horror story or a special remedy to share!