Despite my long experience and best efforts, ‘Delhi belly’ got me

I’ve got the trots. It’s the full catastrophe, both ends, sudden eruptions in the middle of the night. It’s unusual, I’m a road-tested traveller, I tend to stay in decent hotels and I’m careful with what I put in my mouth. Stomach problems rarely come my way but there’s no such thing as total immunity. I’m not the only one though, at least half the group I’m travelling with are experiencing the same symptoms.

Even if you’re careful with what you eat in a foreign country, you could still fall victim to a viral stomach bug.Credit: iStock

Bali belly, the Turkish trots, the Rangoon runs, there are some countries in the world where the state of your bowels becomes the standard topic of conversation. According to the Travelers Diarrhea study published on the US National Library of Medicine website, diarrhoea is the most common travel-related condition, estimated to affect 40 to 60 per cent of travellers. The most common cause is the E. coli bacteria, thought to be responsible for about 30 per cent of cases, although salmonella, listeria and viruses such as the highly contagious norovirus, the scourge of cruise ships, are among other reasons for busy bowel syndrome.

In the case of a bacterial infection, the most likely causes are contaminated water, unpasteurised dairy products, undercooked meat or fish, food stored at unsafe temperatures or in an unhygienic environment.

I’m betting mine is viral rather than bacterial. The first to come down in my group fell sick just a few days into the trip. But only half the group is stricken with the same symptoms. We’ve all been eating the same things and there’s another group with the same problems who have just arrived at our hotel, coming from a different direction, and that suggests a virus.

I’ve been here before. There’s no quick fix to the diarrhoea and vomiting, it’s a case of waiting until my system has been flushed out, but there’s a tried and tested strategy in place. For the next two days, I’m dieting on plain boiled rice, bananas, black tea and water with sachets of rehydration powder. A friend suggested Coca-Cola with a teaspoon of sugar added as a cure for my nausea. More sugar in Coke? But when I try it, the glass of Coca-Cola fizzes madly with the added sugar but then quickly goes flat, and sure enough, I feel better. Lomotil fixes the diarrhoea symptoms so I can keep up with the group, but I still have acid reflux requiring a trip to a nearby pharmacy. Within a couple of days, I’m feeling about 80 per cent.

Avoidance strategy

Clean hands are a prerequisite when you sit down to eat. Wash them with soap and water or use hand sanitiser.

The bacteria that cause the trots can survive freezing temperatures, and ice made with unsterilised water can bring you down. In a posh hotel; the ice in your drink will probably be made with purified water – if in doubt, ask. If it’s a local bar, you might dispense with the ice and stick to what comes out of a refrigerated can.

Food should be cooked to order. Give it a miss if it’s been left sitting under glass or in a bain marie, possibly for hours.

Salads and peeled fruit carry a risk of infection unless they’re prepared in hygienic conditions. A quality restaurant or hotel is usually trustworthy, but you’d be putting yourself at risk ordering such items at a roadside warung in Bali or a dhaba in India.

Bottled water is available just about everywhere and while the plastic debris is a curse, apart from carrying your own bottle and refilling it with boiled water, and possibly chlorine tablets as well, there’s no good alternative.

If you’re prone to gastrointestinal problems, see your doctor before you depart as there are some over-the-counter medications available in Australian pharmacies or online that may help.

Some travellers take probiotics to help ward off stomach complaints, although the UK’s National Health Service warns, “There is not yet any convincing evidence that they are effective.”

The upshot

Travel long enough and no matter how careful you are gastroenteritis will come your way. Medications can help reduce the symptoms but you can expect to feel miserable for a couple of days. Eating bland foods that are easy to digest including dry toast, rice, bananas and chicken will help, and drink plenty of water, preferably with rehydration powder such as Gastrolyte. Avoid milk and other dairy, alcohol and coffee. In severe cases you might need to spend a few days in bed – don’t fight it, you’ll only lose. If it’s a pause in your holiday, when you’re feeling better press the reset button and make the most of wherever you happen to be with renewed vim and vigour.