Hazel Wallace Food Medic on how to prevent diarrhoea and delhi belly

It’s the holiday curse everyone dreads, as so-called ‘Delhi belly,’ or traveller’s diarrhoea can ruin a trip away.

Now a doctor has shared her top tips for avoiding a gippy tummy when you travel abroad in a new post on her successful food and nutrition blog, which has nearly 260,000 followers on Instagram.

Dr Hazel Wallace, who runs The Food Medic blog and is also a junior doctor at University College London Hospitals in central London, says traveller’s diarrhoea can affect up to 6 in 10 holiday makers.

She recommends avoiding onions and garlic the day before you fly, preparing your gut by taking probiotics and by opting for freshly cooked street food while you are travelling instead of eating at the buffet. 

BEFORE YOU TRAVEL 

Dr Hazel Wallace, aka The Food Medic, confessed she has suffered from the dreaded ‘delhi belly’ on a visit to India so has shared her tips for avoiding diarrhoea when travelling abroad

Dr Wallace advises eating fermented probiotic foods before you travel to support your gut health such as (clockwise from top left): pickles, live yoghurt, kimchi, apple cider vinegar, pickled beetroot and sauerkraut

Dr Wallace advises eating fermented probiotic foods before you travel to support your gut health such as (clockwise from top left): pickles, live yoghurt, kimchi, apple cider vinegar, pickled beetroot and sauerkraut

Take probiotics: According to Dr Wallace, probiotics can be helpful in preventing diarrhoea when you travel.

She said: There are probiotics containing certain strains of bacteria (Saccharomyces boulardii and a mixture of Lactobacillus acidophilus and Bifidobacterium bifidum) that appear to be effective in preventing traveler’s diarrhoea. 

‘It is not something doctors routinely prescribe but it they are generally safe and appear to be effective. If you do wish to take a probiotic supplement, gut specialist dietician, Dr.Megan Rossi, suggests to start on the day of travel and stop on the day of return. If you don’t want to take a supplement you can stock up on probiotic-rich foods such as kefir (fermented milk drink), kombucha (fermented sweet tea), kimchi (fermented Chinese cabbage), sourdough bread and yoghurts which contain active, live cultures.’

Dr Wallace recommends not eating prebiotic foods such as onions and garlic the day before you travel as they can make you bloated and gassy while flying

Dr Wallace recommends not eating prebiotic foods such as onions and garlic the day before you travel as they can make you bloated and gassy while flying

Avoid prebiotics: Dr Wallace says you could try avoiding prebiotic foods such as onions and garlic, as well as during your travels, 24 hours before you travel as they can make you gassy and bloated.

She revealed: ‘Prebiotics are soluble fibres which are found in foods such as; artichokes, onion, garlic, chicory, asparagus, and leeks. However, one big thing to note is that these fibre rich foods can make you bloat and a little gassy which may be made worse when you fly. 

‘This is all down to physics because as the atmospheric pressure drops in the cabin, the air inside our gut expands to fill the space. To avoid feeling uncomfortable, and saving other passengers from potentially smelly farts, you can load up on these foods in the weeks before you travel but cut them down, or out, 24 hours before you fly so that you have time to digest them fully.’

What to pack: Dr Wallace advises packing anti-diarrhoeal tablets such as Lopermide, aka Imodium, and rehydration salts such as Dioralyte in case you do become ill. She also recommends taking a thermometer. 

WHILE YOU’RE TRAVELLING 

Dr Wallace (pictured on holiday in the Maldives) says you should avoid drinking the local tap water, including having any ice in your drink to avoid traveller's diarrhoea

Dr Wallace (pictured on holiday in the Maldives) says you should avoid drinking the local tap water, including having any ice in your drink to avoid traveller’s diarrhoea

Dr Wallace advises staying clear of the buffet as hot foods may have been left out too long

However she says that even though many people avoid eating street food, it can be safe to eat if it's been freshly and thoroughly cooked

Dr Wallace advises staying clear of the buffet as hot foods may have been left out too long. However she says that even though many people avoid eating street food, it can be safe to eat if it’s been freshly and thoroughly cooked

Wash your hands: Dr Wallace says this is still the simplest and most effective way of preventing the spread of bugs. If you don’t have access to water, she advises carrying hand sanitiser. 

Drink bottled or cooled boiled water: Dr Wallace says: ‘Even if locals drink [tap water]  without any problems, your stomach may not have the right bacteria to protect you from becoming ill. If you want to reduce the amount of bottles you buy, you can also try boiling the water and drinking it cool. This is the most reliable method of removing bugs, but will not remove dirt.’

Avoid raw or undercooked food – and stick to street food: Dr Wallace recommends sticking to freshly cooked street food instead of eating at the buffet in advice that may surprise some.

She said: ‘Freshly prepared, well-cooked food, served hot, is generally safe but as a rule of thumb try to avoid uncooked meat, fish or eggs, and and consider swapping your salads for cooked vegetables instead.

‘Buffets can also be a bit of a danger zone as, unless you can ensure the food is fresh, it might have been lying around for a couple of hours. Many people avoid street vendors because they worry about contamination or the quality of the food, however more often than not they cook it fresh in front of you and have a high turnover of food so it may actually be better than buffet restaurants.’

WHAT TO DO IF YOU ARE SICK 

Dr Wallace says it's important to rehydrate after a period of diarrhoea with rehydration salts (pictured) and by drinking plenty of fluids

Dr Wallace says it’s important to rehydrate after a period of diarrhoea with rehydration salts (pictured) and by drinking plenty of fluids

Drink plenty of fluids: Dr Wallace advises: ‘The most important thing is to make sure that you drink plenty of fluids to avoid lack of fluid in your body. As a rough guide, drink at least 200 mls after each bout of diarrhoea (note: this extra fluid is in addition to what you would normally drink). If you are struggling to keep water down at all and suspect that you are becoming dehydrated, you should seek medical advice.’

Take rehydration salts: ‘Rehydration salts are also very useful and are easy to carry with you. They are sold in sachets and contents are simply added to water. They won’t stop or reduce diarrhoea. However, the small amount of sugar and salt helps the water to be absorbed better from the gut into the body.’

Take an anti-diarrheal medicine: Dr Wallace says you can pick them up from any pharmacy if you forgot to pack some.

WHEN YOU GET HOME

Dr Wallace says it's important to support your gut health to protect against further bouts of diarrhoea even when you get home

Dr Wallace says it’s important to support your gut health to protect against further bouts of diarrhoea even when you get home

Support gut health: Dr Wallace said: ‘The best thing you can do when you get home is try to support your healthy gut bacteria through a good diet – lots of fibre and probiotic rich foods! 

‘You may also wish to try a probiotic supplement for a couple of weeks. Despite these measures, if you’re still having digestive symptoms after a couple of weeks after returning, please speak to your GP.’



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