Keep my IBS'd gut happy in Gurgaon, India

August 10, 2019 5:06 PM

I will likely be going to Gurgaon (India) next month for a work trip. I am looking for advice on how to protect and prepare myself for the inevitable gut distress, especially as someone with IBS-D. I'll have a generous enough expense account to look for safer food and drink, and have good insurance with international coverage. What I don't have is a lot of time to do extensive research on what to pack and how to assess my food options. Help me get quickly up to speed!

I have IBS that manifests most often as diarrhea. I go through phases and right now it's dormant, but I know that almost every American experiences some amount of gut distress when visiting India. I will be working most of the time so I need to be able to prevent as much as I can, and get through the worst case symptoms enough to work afterwards.

I know some basics like:
* use hand sanitizer
* avoid food carts
* avoid ice, salad/raw veggies, and anything washed with tap water
* maybe avoid fresh juices?
* never ever drink tap water
* use bottled water for brushing teeth
* make sure bottled water is sealed before drinking

Any other food or drinks that I should avoid? Anything I should look for in restaurants to determine if it's safe to dine there? (and if you have recommendations of places to eat for dinner, I will take those too!)

I will have a decent budget for this trip so I will be staying in a well-regarded business traveler hotel and able to eat in nice restaurants or via hotel room service. I'm working on getting a driver so I can get around easily if there's an emergency.

Are there supplements or prescriptions I should get and start taking ahead of or during the trip? I have been told to take Pepto for a week before and all throughout the trip (not sure what dose and how often, though?), and to bring electrolyte powder and Immodium. I plan to visit my doctor for vaccines and will ask for an antibiotic and anti-emetic. What else?

posted by joan_holloway to Travel & Transportation around Gurugram, India (21 answers total)

FYI— I’ve travelled frequently to India and never gotten sick. I follow most of your rules but I also eat only vegetarian when in India. There is a wide enough range of well cooked veg options to make this not difficult. My logic is that it offers less chance of contamination.

If you’re not used to spice, ask for no spice or little spice. When choosing a restaurant, look for ones which are busy.

I would absolutely avoid beef, pork and prawns, even if on offer in your hotel. The people I know who have gotten sickest in India were eating western meat dishes prepared in their hotel.
posted by frumiousb at 6:26 PM on August 10, 2019 [1 favorite]

And yes, avoid juice unless you know for certain no tap water has been added.
posted by frumiousb at 6:27 PM on August 10, 2019 [3 favorites]

Seems kind of obvious but make sure the food you eat is very hot (temperature).

Get ye some rehydration salts to have on hand! I got food poisoning in Istanbul and these saved me.

It's hard to know in India if the water bottles you buy are truly safe because people will fill used bottles with whatever water and reseal them so they seem new (I guess there is some kind of heating/sealing mechanism), so be aware of that as well. If you wanted you could get some water purifying tablets, never used them myself though. Also, make sure you're up to date on your hepatitis shots, although I realize you didn't ask about that specifically.
posted by erattacorrige at 6:39 PM on August 10, 2019 [2 favorites]

India is a bit overrated in the food danger department. Mostly it's roulette. But sure, avoid tap water, salads, ice cream. My only advice is eat at places where a lot of locals are eating at the moment you walk by. That frumiousb knows people who got sick mostly from hotel food does not surprise me. I was there for two months about 10 years ago, had both vegetarian and meat dishes (depended mostly on the city / region I was traveling through at the time) and I had no problems.
posted by MillMan at 6:40 PM on August 10, 2019

I also have significant GI issues and have gotten ill to the point of hospitalization on several of my trips to Asia despite following reasonable precautions.

I would say 1. Don’t skimp on anti-diarrheals, comfort care, etc. 2. Take your symptoms seriously. I kept not wanting to blow things out of proportion and felt embarrassed that I was getting sick when other people were not. I would have been better served by seeking care sooner.

Despite this I had an amazing time each trip and I wish you the best of luck.
posted by jeszac at 6:43 PM on August 10, 2019

Start taking a good probiotic (like Culturelle) for two weeks before and every day during the trip. Stay away from anti-diarrhea medications if you can, they will just prolong any issues...
posted by NoDef at 8:07 PM on August 10, 2019

Raspberry Cordial. Or anything with actual raspberry juice in it. There’s an enzyme in raspberries that for some reason stops Bali belly (or the equivalent gastro distress) in its tracks. It’s a well known enough cure that in Australia, cordial manufacturers have now started making powdered raspberry cordial to make it easier for tourists to pack instead of having to take a bottle of the stuff on holidays. I tried this trick a few months ago in Bali and it was like a miracle cure. The brand we use was Cottees, I’m not sure what you have where you are.
posted by Jubey at 8:13 PM on August 10, 2019 [1 favorite]

Iron is well known for being constipating. I've had IBS-D for years, and about 3 years ago was quite anemic. I added iron supplements for that and it helped get things under control. I don't take it regularly but find if I am having an attack, it helps to settle things down quickly. IANAD, so obviously you probably need to research how it might work with your body and other medications.
posted by Ftsqg at 8:14 PM on August 10, 2019

A probiotic containing Saccharomyces Boulardii is worth a look.
posted by Iris Gambol at 8:48 PM on August 10, 2019 [2 favorites]

The New York Times medical writer, Jane Brody, recommends taking a couple Pepto Bismol tablets before every meal when traveling internationally.
posted by Elsie at 8:58 PM on August 10, 2019 [3 favorites]

Get zofran (nausea meds) and get an antispasmodic. (Hyoscyamine) I dunno how I would deal with IBS spasms and flares without my hyoscyamine. I also take peppermint leaf capsules before meals as it's a natural antispasmodic. +1 for OTCs like pepto (I like the pills or chewables), gasx, and beano.
posted by Crystalinne at 10:51 PM on August 10, 2019

Seconding eating vegetarian in India! You will enjoy it as a tasty experience and be less likely to have trouble.

If you do have a couple bad days, just about everywhere will have yogurt & rice available.
posted by sixswitch at 11:57 PM on August 10, 2019

- You can buy a travel water purifier. I'd look into those.

- You can travel with some food that you know is easy for you to digest.
posted by amtho at 12:59 AM on August 11, 2019 [1 favorite]

Why not prepare your own food? This is assuming where you’re staying has a stove but you could also bring a portable hot plate to prepare what you know you can tolerate.
posted by Young Kullervo at 6:55 AM on August 11, 2019

Thirding the vegitarian recommendation. As someone who is very much *not* a vegitarian at home, I was pleasantly surprised that I missed meat not at all while I was in India. And meat is one of the most likely vectors for GI issues.

"No meat" is one of the big rules that my colleague has when he takes groups of students to study in India.
posted by Betelgeuse at 7:02 AM on August 11, 2019

Cholera vaccinations are also effective against other gut infections. I got the Dukoral oral vaccine on recommendation of a doctor before traveling to India a few years ago, had no gut problems there despite not being perfect on food safety.

One month should be enough time for the immunization to kick in, but of course consult a doctor about side effects of the vaccine in combination with IBS-D.
posted by Triton at 8:19 AM on August 11, 2019

Nthing vegetarian. Many restaurants just divide food into veg and non veg. Which animal? Who cares?

That said Gurgaon is super modern and you will likely be fine. There's even a microbrewery.
posted by doiheartwentyone at 1:59 PM on August 11, 2019

Response by poster: Thank you, everyone! I was already planning to eat only vegetarian because I prefer it over non-veg Indian. I'm glad to hear this will make things even safer. I have a water purifier and tablets from backpacking, and didn't even think of bringing them. I will take the med suggestions to the travel medicine clinic.
posted by joan_holloway at 3:39 PM on August 11, 2019

+1 for the recommendation for saccharomyces boulardii. It isn’t a normal probiotic, it’s actually a type of yeast that was originally discovered as a folk medicine treatment for cholera. It has since been found to be useful in treating many kinds of diarrhea, including IBS-D, and I know multiple people personally who have had good effects from it. Here is a study about saccharomyces boulardii and IBS-D.
posted by hungrytiger at 6:24 PM on August 11, 2019 [1 favorite]

One India specific thing I don't see above: It's heartbreaking to have Indian food without them, but NO CHUTNEYS. They will be on every table at every meal and you will have no idea what went into them.

Also seconding making sure your hot food is very hot. I'm a little surprised to see everyone else recommending vegetarian (as a defense against stomach troubles). When we visited, we were fine eating meat because it has to be cooked thoroughly and it is easy to tell if it's not. The one time we got sick was from a lukewarm lentil soup at a friend's house that later it turned out we both thought was suspicious but were too polite to decline.
posted by yeahlikethat at 6:39 AM on August 12, 2019

The only time I got sick in India was after eating in a very fancy hotel. Otherwise I ate strictly from food carts, which meant the hottest food possible, cooked right in front of me, over fire. I also ate at small 'hole-in-the-wall' restaurants that were personally recommended to me. But mostly food carts. Just a data point.
posted by thegreatfleecircus at 9:24 AM on August 12, 2019