81

Montezuma's revenge, Aztec two step, mummy's tummy, or Cairo two-step in Egypt, Kurtz Hurtz in Uzbekistan, Bombay belly or Delhi belly in India.

A case of the sh-- or Hershey Squirts or The McSh-- in North America, Down Under Butt Chunder in Australia, Karachi crouch in Pakistan, Suryavarman's Revenge in Cambodia.

Kabulitis in Afghanistan, holiday tummy in United Kingdom, Bali belly in Bali, or Taghazout Tummy in Taghazout or Kathmandu quickstep in Nepal.

Beaver fever in Canada, Thailand it's Thai-dal wave. Peacekeepers to Arabic-speaking countries have called it yalla yalla (Arabic for "fast, fast").

In Central Asia, it was ridiculous, with every second backpacker walking around with toilet paper on them, regularly having to make a 'run' for it. In Egypt, half my tour group got sick, by the time we'd converted into a mobile pharmacy!

Regardless of what it's called, what's the best way to try and prevent it?

  • 6
    Umm, don't eat bad food! – hippietrail Oct 3 '11 at 20:04
  • 9
    I don't want to see the Google Image Search results if I look up "gastrointeritis prophylactic". – hippietrail Oct 3 '11 at 21:25
  • 5
    Especially if you turn off the SafeSearch ;) – RoflcoptrException Oct 4 '11 at 8:09
  • 3
    Also see Is tea and coffee on the street safe to drink in India? - much of the advice here applies here too as "Delhi belly" is often caused by suspect fluids than anything else. – Ankur Banerjee Oct 4 '11 at 8:45
  • 3
    All questions like this would be better discussed if people would distinguish more between novel conditions, and actual diseases. Any time you travel you will be exposed to some bacteria and other things you are not used to that do not bother the locals. But sometimes you will be exposed to things like cholera that seriously do affect the life-long locals too. @KateGregory well points out that Giardiasis is not something you can "get used to" after you have been in the region a while. Food "tainted" by some local biota may become safe when you adapt, food "tainted" by hepatitis will not. – Colin McLarty Feb 20 '16 at 16:02

12 Answers 12

60

Basically, you can't.

The world is full of gastro-intestinal (GI) diseases, even in developed, First World nations. There are some decent steps to trying to minimize your exposure:

  1. Properly cooked foods. Everything heated to a proper internal temperature (depends on the dish, check the USDA's site for guidelines), no sampling the raw chicken dish, etc.
  2. For fruits and veg, if you can't peel it, don't eat it. A tremendous number of GI outbreaks are due to fruit and veg, rather than meat. This includes things like salads - since you can't really peel lettuce, avoid it.
  3. Check if the local water is safe. When in doubt, assume it isn't. You can stick to bottled water, though there's always the distinct chance its being bottled from a contaminated source. Coke/Pepsi etc., and beer are good alternatives. Little known fact, the Coca-Cola company is hugely involved in clean water programs worldwide, because they need it for their product.
  4. Ice. Ice is bad. Its probably made using the local tap-water, and there are many beasties that can survive an encounter with an ice machine.

But when it comes down to it, nearly every traveller makes some sort of safe-eating "mistake" fairly frequently, whether they realize it or not. At the end of the day, your best bet is to talk to your travel physician, and see if you can get a prescription for an antibiotic. Using that in combination with something like Imodium will probably keep your trip mostly on track - shutting down the problem long enough for the antibiotics to treat the source. Unless of course its viral - norovirus, rotavirus etc. In that event, best of luck.

And if it does happen? Stay hydrated. You're losing salts and water, they need to be replaced.

  • 35
    The whole reason the Chinese drink so much tea is because the water is unsafe for drinking, and boiling the water sterilizes it. This is even in the better-developed parts, such as Hong Kong. One time I made the mistake of using tap water to take an aspirin for a headache, and then very soon I had TWO problems. – fluffy Oct 3 '11 at 22:06
  • 2
    Okay point for taking along antibiotics, but if you take those you should most definitely take some packs of electrolyte salts which you can mix in water in order to keep hydrated. And very important too is to make sure to take pro-biotic medicine after the misery is over, otherwise your stomach will have a hard time getting back in shape and it's even easier to have "yalla yalla" again (or any other illness in fact). – Pitt Nov 30 '12 at 17:20
  • 3
    @pnuts: That's how I got it in Egypt, I was careful to only drink bottled water but figured the small amount of water used to wet my toothbrush couldn't hurt. Learnt my lesson! – Pyritie Jun 26 '15 at 12:00
  • In most countries, if you're in an up-market restaurant paying Western prices, you needn't worry about drinking the water or having ice: they'll have a decent water purification machine. – Richard Smith Nov 1 '15 at 20:19
  • 4
    Be careful with the Imodium Antibiotics combination. If it is viral (in some countries it is more likely to have some viral stuff - e.g. trekking in nepal and using the (cleaned) spring water there) you become a bioreactor if you use Imodium. – Gnusper May 10 '17 at 11:51
22

Some elementary precautions:

  1. Drink no water or other liquid unless it has been boiled or bottled or canned. Be careful using ice; it may have been made from tap water.

  2. Avoid eating at roadside food stands; sanitation levels are low. Avoid eating any place where there is evidence of poor sanitation, e.g. flies. Stick with the better restaurants, or with "home cooked" food.

  3. Don't eat anything that hasn't been cooked or peeled immediately prior to eating. That includes bread, unless it is fresh bread, or just unwrapped.

  4. Be careful with utensils. Wash them in boiled, or at least very hot water.

  5. Carry pills for dysentery and similar ailments.

10

My friend and doctor also told me to take some malt liquor (eg. vodka or whisky) with me and have a shot after a meal. It's supposed to help you also with digesting as well as prevent some "stomach sensations".

9

To memorize and teach it (your kids etc.):

Wash it, peel it, cook it, or forget it.

You have been warned about ice made from tap water. You will often find yourself in situations where "coke" is understood, "no ice" is not. Learn these 2 words in the language of the country you board.

6

Specifically related to Egypt (but may be relevant in other countries):

I was told by an Egyptian tour guide that one of the things that causes illness amongst British tourists is the richness of the food especially fats/oils and sugar content as this is much higher then we are used to. So his advice was to avoid all Egyptian food and stick to plain 'western' foods if at all possible.

Obviously tap water is to be avoided but having said that a (British) friend of mine worked out in Cairo for several years and claimed that he could drink the water!

  • 9
    If richness of food is to be incriminated, Delhi belly would be present at a high level in the USA. – mouviciel Oct 5 '11 at 7:48
  • 6
    You will often find travellers that have remained in the location for a while (and locals) can drink the water with no problem, because after their initial encounter their bodies and immune system have adjusted to the local environment; so just being told by locals the water is fine is not reason enough to trust it; if your visit is short and it is not worth suffering a night to adjust, better to stick to bottles. – moonshadow Feb 4 '13 at 19:40
  • 1
    I got the same warning (years ago, when it was not commonly used in my country) for olive oil in Italy. – Jan Doggen Aug 10 '16 at 12:38
  • When I was in Egypt, it was the "western" foods that caused the problems. When we ate local produce and meals there was much less of an issue. – Laconic Droid Nov 23 '18 at 16:02
5

I would add:- sterilize your hands frequently and always before eating. If you distrust the water, use an alcohol gel.

5

One of:

  1. Peel it

  2. Boil it

  3. Throw it away

Only drink bottled water that has a seal on the cap (they can refill the bottles). Bring hand sanitizer (with a high alcohol content).

  • 3
    And always crush the bottle before throwing away. This helps in preventing refilling of the bottle. Just my 2 cents. – noob Jul 30 '14 at 5:16
  • 1
    +1 for saying to check the seal. I've seen street vendors in India openly refilling water bottles from a tap. – Richard Smith Nov 1 '15 at 20:09
4

While these steps are certainly inconvenient and inhibiting, there is no easier way to really be sure to avoid the Delhi belly:

  • Get an ozonizer and take it with you in your luggage. Immerse fruits, vegetables, dishes, and other food-related items in water and ozonize them before consumption.

enter image description here

You can also ozonize the drinking water itself. Ozonization will kill nearly all harmful organisms from the water and from the surfaces of items immersed in the water. It's better if you use filtered water for this. If you use tap water for this, ozonize longer, and splash some bottled water over each item before use/consumption.

  • Bring a small, portable induction cooker and a pot. Get takeaway food and boil everything yourself for several minutes before consumption.

enter image description here

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  • Always wash your hands and make sure they are also free of tap water before touching anything related to food.

The ozonizer and induction cooker are somewhat inhibiting while trying to enjoy a holiday. So I might prefer to take a chance rather than follow them. But if you really need to "avoid the Delhi belly", then I recommend using them.

2

Always wash your hands after handling money. Of course if you don't trust the water this is best done using some kind of hand sanitizer.

Why You Shouldn't Put Your Money Where Your Mouth Is (Wall Street Journal article)

1

I've been to China, Egypt, and Peru without any digestive upset. This advice is specialized for the type of travel I go on, tours organized by a competent tour company, and won't work for other situations:

Eat and drink only what is offered at the hotels, on the bus, on the boat, or at restaurants recommended by the tour director. This meant no street food in China :-(

Drink only the water that is handed out on the bus, placed in the hotel rooms and cabins, or on the tables at meals. Don't drink even apparently bottled water not from those sources.

Use hand sanitizer after each restroom visit and before each meal.

Tooth brushing took some care, using bottled water to moisten my toothbrush etc.

  • isn't bottled water bought from chain supermarkets fine though? – Formagella Aug 29 '16 at 13:57
  • @Formagella Depends on how well you trust the chain. An organized tour by a competent tour company should provide plenty of bottled water without going to supermarkets. – Patricia Shanahan Aug 29 '16 at 14:26
1

Assuming you're already infected and have the signs of a stomach disease, you may attempt to reduce the intensity of the symptoms. One recommendation I've heard from a couple of people is to take psyllium (Metamucil) supplements. Psyllium is basically soluble fiber and helps both with constipation and with diarrhea. It should also reduce other symptoms, such as excessive gas formation.

However it doesn't treat the underlying cause and shouldn't be considered a replacement for proper medicine, if it's needed for the particular disease one might be having. But it's nevertheless a good thing to have in your first-aid kit when traveling.

enter image description here

-2

I've been in a lot of places, ate everything in every condition, in Indonesia even forgot about not drinking tap water, never ever done something listed in these answers, and never ever ever had a single problem.

The only way to avoid Delhi Belly: improve yourself. Seriously, we as human being have a great potential for adaptation, we have huge resistances and can easily override most basic viruses like those that cause the problem listed above. But...we destroy all of this by never using our body; it's like a training, so to say.

So, I'm not suggesting to go eat poison or drink spoiled water, but at least let your body use its potential. Seriously, from some of the other answers: "never eat street food". Well, no. Eat only street food. You'll have your hell belly ONCE, your body will strenghten, and the next travel in a totally different country you'll eat stones without problems.

Human body has been engineered to highest level to allow us to do lot of things, but all answers above just put people in a cage that will shrink day after day, to the point that even eating spicy cooked at their home will hurt their stomach. Let your body do its magic, for god sake.

  • 1
    While I do agree with this kind of living at home, I do not feel it should be done in countries where diseases are nasty, strong and common. – Willeke Aug 16 '16 at 15:18
  • @Willeke, ok, a bit of intelligence is required, obviously: not saying to go to India and drink tap water or eat food in the dirtiest condition for the first time, but...seriously, there are people who do not eat street food at the Camden food stands for fear to get poisoned. I've got the luck to be tough when it comes to traveling and I love it, but too many people around are just ruining their defence mechanisms (and their holidays, subsequently) by not using them at all. – motoDrizzt Aug 16 '16 at 15:27
  • (just for fun: all those years, the only time I got a Delhi Belly has been this previous Monday, the 8th...for a caffe latte at Costa :-D And after a week...I still feel pretty bad, go figure :-DDDD) – motoDrizzt Aug 16 '16 at 15:29

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