Traveler’s diarrhea in India and how to prevent it

If you are traveling to India then you have to take certain precautions. India is not the cleanest countries of the world – in fact far from it. Most international tourists to India might suffer from something called Traveler’s Diarrhea (TD).  According to the “Centers for Disease Control and Prevention” up to 70% of travelers will suffer from it.

It is mainly caused by eating food and drinking water that is contaminated by germs including bacteria, viruses and parasites. The agent causing traveler’s diarrhea is none other than E Coli, Campylobacter jejuni, Shigella and Salmonella. High risk areas include the countries of Asia where India and Nepal is high on the list. In fact, the term Delly Belly is another name for traveler’s diarrhea in India. Clinical symptoms include mild cramps and loose stools to severe abdominal pain, fever, vomiting, and diarrhea with or without blood.

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Foreign tourists in India having a chaat
Foreign tourists in India having a chaat. Photo by Felipe Skroski

How can you prevent traveler’s diarrhea in India…

Indians do not use toilet paper and hence they wash their back side with their left hand. Read more about Indian toilets here. If the hand is not washed properly, then this is a health risk to others. If those preparing food in restaurants do not wash their hands then this is a serious health issue not just for travelers for locals too. Although many decent restaurants particularly those serving foreign restaurants would make their staff wear gloves before asking them to prepare food but I wouldn’t bank on this. Poor hygiene is one of the very reasons foreign travelers to India are advised against trying street food.

Here’s a street food guide for India if you really wanted to try.

Always carry an alcohol based hand gel sanitizer and use it generously. A recent study showed that travelers who used hand sanitizers reported reduced frequency and occurrence of diarrhea and vomiting compared to those who did not use the gel. The researcher’s conclusion was that the use of hand sanitizer is associated with a reduction in the incidence of traveler’s diarrhea and vomiting. Always clean your own hands before eating. This may be common sense but it’s very important in a country like India.

In addition, you must make sure that you eat in restaurants that look busy. This way, you know that it’s a popular restaurant and they have a high turnover of raw materials for preparing their food. What this means is that the materials that they have are fresh.

There are no vaccines to prevent travelers’ diarrhea but nonetheless, those travelling to India are advised to get their Hepatitis A, Cholera and Typhoid vaccines that can prevent food related and water-borne infections.

Always drink bottled water in India. Always select food and beverages carefully before eating.

Here’s a bottled water buying guide for India.

Research has suggested that those who consume probiotics are less prone to traveler’s diarrhea. Probiotics are supposed to help restore the natural balance of the gut bacteria (friendly bacteria) when it is disrupted. They are mainly present in yogurts and as food supplements in the form of tablets. But then there is no clinical evidence to support this. You might consider talking some of these before coming to India.

Prophylactic antibiotics are effective in the prevention of prevent traveler’s diarrhea but it not recommended that travelers take this before coming to India. It seems to be too much of a risk.

It doesn’t mean all travelers to India will get traveler’s diarrhea, it simply means that you have to be careful. If you practice good personal sanitation and hygiene measures and watch what you eat and drink, you will be fine.

You might wish to buy my book below for more health tips for your travels.

India Travel Health Guide: Health Advice and Tips for Travelers to India

27 thoughts on “Traveler’s diarrhea in India and how to prevent it”

  1. India is not among dirty countries now, Swaach Bharat Abhiyaan is going on in India which is a mass movement started by current PM of India(Mr. Modi) according to it cleanliness is responsibility of all Indians and not only Governmnet Cleaning Boys. We all should keep our country clean. Also India is having Digital India Week so India is coming out as a good country.

  2. in another country it is very difficult for a tourist to get used to food and water, so problems with the stomach, your article is good, but such problems may occur not only in India

  3. Good article it difficult to maintain health while traveling in India. Every one should take precautuions during long travel and trips.

  4. Thankyou for sharing this article,i would like to add -rather than expecting good food.we should always try to carry some nonperishable stuff with us in case of emergency and if we are out of storage,we can always prefer fruits over snacks and junk food….At least in india this is better option

  5. Hello!
    Ave bakeng SA Ho kopanela sehlooho Sena, K ce ne ho occupy lebeletse molemo food.we lokela eketsa -rather TLA rata Ho Ho Ho Lula kids tswela Pele Ba Ga Ga bang tabeng EA boemo Sepakbola Le Ba Ba.

  6. My experience in India was always to take normal precautions, but at the end of the day I feel like it’s just the luck of the draw. On one trip I made I to Mumbai for a week, I never had any problems and then a few months later I came back and was struck done with stomach bugs. And here’e the thing: On the trip with no problems I ate at many street stalls and less ‘clean’ looking places. Then on the next trip, I was only eating in five star hotels because it was a business trip. And guess what? That’s when I got sick. So like I say, it’s the luck of the draw in my opinion.

  7. Very helpful insight for peoples who like to travel. One thing that I like to mention is that probiotics, you mentioned in the article, is a good solution for these travel related issues if you use proper strain, Most of the peoples are using probiotics without checking which strain they need and which strain is present in the supplement. So, probiotics can only help u if you take its right species and strain.

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