Food to avoid

Hi all,

I am visiting for 20 days in October, Delhi for 10 then Goa for 10, as a 1st timer in India, what food should I avoid to stop me getting a dodgy stomach?

Also if i do get the runs, what local medicine is the best?

Cheers

Darren UK

Only drink bottled water.

We have a whole thread on this, Mogi.

Top of the list: ice cream, except in a busy place with a big turnover --- because power cuts may mean it has melted and refrozen. Salad, or anything else that might have been washed in tap water (or perhaps not washed at all is worse!). Fruits that you do not peel yourself. Anything not freshly cooked....

But, If that microbe has your name on it, there's not much you can do

Ah, yes. The Microbe of Predestination. If you are on the move, Immodium. If you are having a rest day, live for 24-36 hours on tea, a drink I believe the English are slowly warming to, and a dry chapati. If you've planned well, you'll have a hotel room with a balcony overlooking the street. You'll love what you see (in between visits to the bathroom), so it won't be a wasted day - one fabulous Indian human drama every 45 minutes or so.

Carry Flagyl with you in case the situation turns out to be giardia. You can Google the clues - they're pretty unmistakeable.

Bacon
having seen the pig toilets in Goa wouldn't reccomend bacon and egg for your breakfast!!

@Darren

• Basic Rules: Care in what you eat and drink is the most important health rule; stomach upsets are the most likely travel health problem (about a third of travellers in a two-week stay experience a mild stomach upset) but the majority of these will be relatively minor. Don’t be paranoid; trying the local food is part of the experience of travel. Homestays are a great place to really tuck into the food, as it is prepared fresh and with care, so is the most hygienic and safest to eat.

• For Westerners, it is important to adjust your personal hygiene to suit the different Indian environment. There are some common sense precautions to keep in mind. Clean your teeth from purified/bottled water rather than straight from the tap. Be extra careful with your health in climatic extremes: keep out of the sun when it is hot, dress warmly when it is cold. Avoid potential diseases by dressing sensibly; you can avoid insect bites by covering bare skin when insects are around, by screening windows or beds and by using insect repellents. Wash your hands thoroughly or use an anti-bacterial gel before eating.

• Water. The number one rule is don’t drink the tap water and that includes ice. If you don’t know for certain that the water is safe always assume the worst. Reputable brands of bottled water or soft drinks are generally fine, although in some places the practice of refilling bottles with tap water is not unknown. Only use water from containers with a serrated seal, not tops or corks. Take care with fruit juice, particularly if water may have been added. Milk and yogurt are generally fine. Tea or coffee should also be OK, since the water should have been boiled, and the majority of the drink will be milk.

• Food. There is an old colonial adage that says: ‘If you can cook it, boil it or peel it you can eat it...otherwise forget it’. Salads and fruit should be washed with purified water or peeled where possible. Ice cream is usually OK if it is a reputable brand name, but beware of street vendors and of ice cream that has melted and been refrozen. Thoroughly cooked food is safest but not if it has been left to cool or if it has been reheated. Shellfish such as mussels, oysters and clams should be avoided as well as undercooked meat, particularly in the form of mince. Steaming does not make shellfish safe for eating. It’s a good sign if a restaurant looks clean and well run and if the vendor also looks clean and healthy. In general, places that are packed with locals, will be fine, while empty restaurants are questionable. The food in busy restaurants is cooked and eaten quite quickly with little standing around and is probably not reheated.


A medical response to diarrhoea - stay hydrated - something like Gastrolyte or Hydralyte (these are available as fizzy tablets - take some with you) is the best option. Antibiotics to kill the bacteria include ciprofloxacin or azithromycin or norfloxacin. You can get these without prescription in India. Loperamide (or immodium) is just a stopper, but can be useful if you have to travel.

Amoebic dysentry - incredbly unlikely. Tinidazole or Metronidazole.

Giardiasis - more likely that amoebic dysentry - same drug response.


If you arrange a comprehensive traveller's medical kit before you go, it will (should) include all you need.

Well said DrRudi Mogi- I agree just treat food the same as you do at home and drink bottled water. I was very worried about food but turns out for me the spice was the hardest thing. I have a very very low tolerance and got severely sick because I coudnt eat anything. Even if you say no spice or I am allergic its still hot. I say its the most amazing flavor I have ever had.... for 3 seconds till it gets hot lol I packed so much meds and didnt end up needing any of it. Use common sense and defiantly try as much food as you can expecily if you can handle the heat, nothing beats India when it comes to great food.

On the move – very nice.

Immodium maybe not so very nice. Immodium works, but it locks you up tight with all the nasty stuff still inside, including the bacterium you'd as soon void.

We find Pepto Bismol, or your local equivalent bismuth tablet, to work better except under the very worst situations. Take two Pepto Bismol at the first sign of trouble, take more as the directions indicate over time, and it will allow you to control yourself safely but still permit you to get rid of the bug when it's convenient. Indeed, I ( who have a dicier stomach than distaff) pop a Pepto at the very first uncomfortable stirrings if we know we're about to travel, and it keeps me steady.

The only problem with Pepto is that, after prolonged usage, your tongue turns black. Actually, this is a bit of a giggle – and it's especially useful if you find yourself possessed of the need to throw a Maori Haka.

Best, course, to take all precautions against getting the bug in the first place. We find that alcohol based hand sanitizers available in squeeze bottle in gel form, are very helpful, allowing you to scrub hands anywhere. before eating.

sprehealfe

Nice post Dr Rudi.
Advice from our travel doctor says that if you are struck down with more than a minor case of the runs, swallow a Loperamide and then Norfloxacin to treat the problem. The Loperamide binds you up so that you don't expel the Norfloxacin. We've taken it with us every trip but haven't yet had to use the stuff. Nice to know it's in the bag, though.
What do you think the quality of the local Norfloxacin is like? Far cheaper to buy it in India than here.

Well put hfot, there are a number of ailments that have different treatments and getting it mixed up can be a mess. Baccillary where the symptom is essentially the cure comes to mind (been there). Judging solely from my experience almost all came from different food & clime. Once I avoided the Amrikan fetish of attention to the bowels I got on with the work & life..

My take: Do not carry heavy-weight antibiotics and self-diagnose severe infections: go to a doctor. There are plenty of them. If you feel somehow better about it, go to a posh private hospital, although you will end up paying more and may have to wait longer to be seen.

I don't understand why travellers and travel advisers tend to ignore the local medical facilities: there's nothing wrong with them!

The reason is that sometimes you are too weak to see a doctor or get up off your bed to visit a hospital. I was extremely happy that I had packed Cipro when I had food poisoning a few years ago.

Nick,
I don't think it's a matter of ignoring the local doctors, it's just a hassle getting to see one the same as it is just about everywhere else in the world.
We tourists are on a limited time in India so I guess if we carry the necessary medication it is quicker and easier to do the job yourself.

TD, yes that's true. Going out for anything is not much fun if you need to be within two minutes of the toilet.
Not really. It is infinitely easier to see a doc, same day, in India than it would be to get into your British NHS surgery. Here, you don't have to prove to a receptionist that you are about to die!

We took all the precautions and I still got sick, but it didn't spoil my trip to India. I agree with Nick-H, there's nothing wrong with local hospitals. I carried meds with me but things were getting really bad so I headed to the hospital (with my hubby, the hotel manager and taxi driver's help!) Dr sorted me out in no time and I felt much better by the next morning. Sometimes the Dr can speed along your recovery.

Mogi, the best thing I think is to be careful but also to enjoy yourself. If you're constantly stressing about getting sick you won't enjoy all the yum food.