Delhi belly

In general, I hate pills and or anything that treats the symptoms rather than the causes... However, I occasionally make exceptions and one of those has been for cipro. It's a common drug prescribed for traveler's diarrhea. I have only had to use it twice. Once on my first trip here (short two-week visit), and then once on this trip (so far, 8 months).

I've never tried a lassi, but I can't imagine that when I'm sitting on the pot with a trash can in my face at 2am that a lassi is gonna do me much good.

most of these these suggestion are not only wrong but harmful.

If you have stomach problem already you can forget about malaria pills.

Here's what you should order to eat in India:
- boiled rice
- boiled veg
- boiled dal
- plain chapati

drink about 4+ liters of h2o per day.
eat some kela (bananas about 4-5 per day)
1 or 2 oranges.

avoid chai, coffee, chocalte, beer, greasy foods etc.

Sensi, we were talking about preventative measures. Since many people take malaria prophylaxis anyway (and there's choice in which type to take) I was simply suggesting that you might want to choose the ones that have the happy 'side effect' of protecting the gut aswell. I'm not generally a believer in taking medication unless you have to.

right, Nick, the probiotics I took do not need refrigeration....

read about them here acidophulus pearls

Do yourself a big favor and stay hydrated. Most people live with borderline dehydration, due to an intake of coffee and cola and not enough water. You've just spent 18+ hours on a plane, with its dry unhealthy air, so you arrive in India at a water deficit. Then your rhythms are askew, you're afraid of the food and water, and you're drinking sweet coffee and tea all day, plus there's the whole loo question -- so you are not drinking sufficient water and are increasingly dehydrated.

The result is that you can't handle spicy food as well, so you've got indigestion, which you assume is Delhi Belly (which it isn't). Nausea kicks in, which is the worst result of dehydration. Now you are weak and vomiting, believing it to be your natural reaction to the subcontinent. So you take a bunch of pills or bacteria cultures, when what you really need to do is increase and maintain your intake of bottled water.

Believe it or not, a real-live case of Delhi Belly (subcontinental microbes wreaking havoc on your system) is pretty rare. You would have to drink the local water (unboiled, unfiltered) or get it from some food washed or prepared in it (like coconut chutney at a roadside stall), but even then you might still be fine.

There are plenty of other traveler's ailments (indigestion, dehydration, heat exhaustion) that can tie your stomach in knots and keep you within a few feet of the bathroom. Guard against those, stick to bottled water, and you can avoid sickness completely.

I've only been to India twice, but I never, ever got sick. Not even a stomach ache, never any nausea. I was careful of where I ate, more so than what I ate -- spicey food doesn't bother me anyway.

Totally agree with Merchant -- stay hydrated. I probably drank a gallon of water every day. In fact, I felt better in India than I do here (not that I don't feel good here, I am very active and eat very healthy.) Frankly, before my first trip, I told myself over and over again that I won't get sick, I set my intention and that was it -- the mind is a powerful tool!

Advice would be stay clear of roadside vendors; There are several decently priced / low budget good eateries around the city which cater to good quality food.

The best way to get rid of the delhi belly is to actually starve the virus out and drink loads of a medicine called "Electoral" which is dissolved in water prior to intake

I got sick twice in my first two visits!

I'd certainly accept the possibility that YG is basically fitter than I was (or am) with a yoga-based lifestyle, and she is probably more careful what she eats even when not in India. Basic fitness helps a lot.

The first time... I ran out of the hotel restaurant and spent the rest of the evening sitting on the loo with a bucket in my hand. I was out and about the next day.

The second time... I don't think my system was quite ready for staying and eating in a local house and I had fever as much as the digestive stuff. This one did reduce what I did in the days, but being looked after by an Indian family was almost worth it.

The first time I went through an Indian holiday without any tummy upset I sufferred from something I ate in the plane home and my first week back in UK was spent in the loo

Now I live here... If I get an upset it is a 24hr mild thing hardly worth mentioning. I've had colds and flu that made me feel worse!

I'm tempted to edit Merchant's post into bold type ---but perhaps it would be an abuse of moderator's power . His advice is just so sensible.

Is kaolin and Morphine still availble i thought it was taken off the shelves in the late 70's early 80's due to the fact it is morphne and clearly advertised as such???

Oh yes... it isn't even a prescription item. Don't worry about the name, it has less opiate in it than a paracetamol*.

After a week of the runs (thanks Air Lanka; I was fine in India...) some years back I was recommended this by my GP rather than immodium etc and found it worked well.

I think the one that got banned was Dr Colis Brown's? That may have had enough opiate in it to affect people.

*not, I need hardly add, a proffesional opinion!

I echo everything Echo said- especially about eating only at busy places and washing your hands frequently.

Some other advice-

- Do NOT drink lassis- they are usually made with local water.
- Do NOT eat anything frozen, like ice cream- the power gives out too often and you may eat soemthing that has gone bad, without knowing it.
- Do NOT eat anywhere that looks dirty.
- Do NOT eat anything that is meant to be hot but comes out lukewarm and don't be shy to send soemthign back that doesn't taste right.
- Do NOT eat anything that is left out uncovered- like pastries or anything like that.
- Do NOT brush your teeth with the local water, or wash your toothpaste with the local water.
- Inspect your water bottles and make sure they are new and have not been tampered with.
- Do NOT order dahl at a restaurant after noon- it can go rancid pretty quickly and they usually just make one large vat of it in the morning- the worse food poisening I've ever had was from rancid dahl.
- If your stomach starts to feel weird, take acidopholus and eat yogurt.
_ I wouldn't recommend taking antibiotics propholactycally becuase they can cause really nasty yeast infections- especially when taken prpholactycally.
- Take a prescription of Ciprofloxin with you just in case.
- Don't worry- you're not going to be there very long.

I have followed these guidelines the last 2 times I've been to India and did not get sick once.

AAKKK! NO! Paracetamol is a NON-opiate. It's sometimes combined with codeine, which IS an opiate, to control more severe pain but in and of itself it's not an opiate at all. It's just an analgesic (anti-pain drug).

Back on topic: a couple of other medicines that can be taken for the "runs": Lomotil, Kaopectate, and Pepto Bismol. These are available in the U.S. but I don't know about elsewhere.

I agree that Merchant's advice is very sound. Drink plenty of CLEAN water; eat well-cooked food and be cautious about meat - and if you're prone to getting indigestion easily even at home, go easy on unfamilar food because in addition to being spicy Indian food can be greasy which some people don't tolerate well; and follow the usual recommendations to avoid fresh fruits & veg unless you can peel them yourself.

The last is the hardest for me to follow and I have even broken down and eaten salads in India with no ill effect - all the while knowing that I could be doing something I'll regret. But - so far - I've only been mildly sick from food once in India - from a Chinese restaurant in Leh, where I suspect the food was undercooked or cooked at too low a temperature to kill bacteria, possibly because water boils at a lower temp at that altitude! But it was an honest-to-goodness bacterial infection because I had a low-grade fever and intestinal cramps, which fortunately cleared up in a day with no need for any medication, so it was obviously mild.

A few reactions...
Some of us swear by lassi, but I guess you have to be careful where you buy it.
A good rule. I learnt it the hard way. However, I've had several reccently with no ill effect...
Good idea anywhere in the world!
A hard one. I like my hot food hot. Most restaurants here don't see any necessity to keep it hot until it reaches your table
Youll find it hard not to notice the flies !
I'm sure you meant brush... Yep! I second that one too. One day you'll forget and take a big mouthfull of tap water. You'll go to bed worrying and probably have forgotten it by the next day!
And apply the if it tastes funny... rule. Remember, though, it is not mineral water, so don't expect it to taste like it came from a mountain spring!

Ciprofloaxin is a potent antibiotic, used to kill bugs where penicilllin has failed. Taking it without good reason (or not completing the course) could be bad news for you when you do really need it, or bad news for the person that the now-resistant bugs move on to when they have finished with you.

Doctors are easy to find, pharmacies are on every street (and, if you must do without a doc's advice, they will give you medicines without a prescription...). No way do you need to be medically self-sufficient here, and I don't understand why people think they have to pack an emergency drug kit.

OK, yes, I guess I do understand, becuse I used to too,when I didn't know the place

So... You come to India, fall in love with somewhere and want to stay for more than a quick holiday. Do you have to strictly observe all this stuff, not just day after day, but month after month?

No... At least if you are staying in the same area... I wash my toothbrush with tap water; wash the cups etc in tap water and then use; I don't steralise fruit before eating... But I'd never drink cold water straight from the tap. If you are travelling, I guess yo have to be stricter, as one areas bugs are not the same as another's, and immunity is the name of the game.

DZIbead... OK, I picked the wrong pill.

But Kaolin and morphine is very, very low on the morphine, and freely available off-the-shelf in UK (but not Chennai) chemists ---and very effective.

Gelucil is a vey good local tummy calmer.

I have had a severe case once. Normally I just have a minimal case which keeps me running to the loo 2-4 times a day (and Pepto, Immodium, etc. really don't help). I wonder if the minimal cases are caused by something in the water like a mineral, or perhaps it is a reaction to the ubiquitous peanut cooking oil?

The severe case was debilitating. I probably got it at a relatives house--eating raw paneer salad. No one told me it wasn't cooked!! Anyway I thought I was going to die. Felt like I had swallowed a box of razorblades. It was very painful and I could barely stand getting out of bed. The local doc prescribed something for me, which I took about twice a day. I can't remember what the name of the pill was but when I got back to Maryland I showed it to my doctor and she could not find the drug in the PDR.

Same trip, on the way home I stopped in France and caught a bug nearly as bad, probably from French cheese. I think the French version was Lysteria (common in their cheeses) and while the recovery was slow it didn't make me stay in bed long.

Portie