Diarrhoea

[p1p]

Siamese Squirts - Bangkok Belly - Thai Trots - Racha Runs.

Advice for those in need of rectal reconditioning.

There was a recent post asking for advice in the case of severe diarrhoea. Much of the advice given was helpful but some old myths were repromulgated.

OK. Let's lay some mistaken beliefs to rest and try to put Rama's Revenge where it belongs.

A simple way to differ dysentery from diarrhoea. Both comprise frequent, watery stools. Dysentery stool movements will contain blood and bile, diarrhoea will not. I shall use diarrhoea to refer to both in this post.

Firstly, try not to take any drugs that will block you up, put a cork in it if you will, (Immodium, for example,) unless you have some need to travel or be away from toilet facilities. These drugs often do more harm than good because they keep the cause of your diarrhoea within your body, rather than allowing it to be expelled.

Common causes of diarrhoea range from poor nutrition, simple food poisoning, (bad food), viral infections or gastric flu, an infection of the gut caused by amoebas, giardia or various bacteria, worm infections, allergies to food or other medication, malarial infection, Ebola(!), laxatives or simply eating too much, particularly heavily seasoned or greasy food.

You should not run off to a pharmacist to request antibiotics, they may be unnecessary and can often result in more harm than good, particularly if the cause is not bacterial.

Most diarrhoea can be successfully treated without recourse to a doctor however a doctor's advice should always be sought in the following cases:

If the diarrhoea has lasted for more than four days in adults or one day in children.

If the patient is dehydrated and not able to take rehydrating fluids, (electrolyte beverages), or vomiting up everything given orally.

If the patient is severely malnourished.

If there is a lot of blood in the stool.

If the patient is otherwise unwell, HIV, infirm elderly or an infant.

If has the patient a heart or other condition where sodium may be contraindicated.

If has the patient has been in an area where there is known or suspected incidence of cholera and lastly, if the patient insists they need a doctor's advice.

Apart from the above cases, as long as rehydration is ensured, diarrhoea is very seldom dangerous or life threatening for normally healthy people.

Why rehydrate and what is the difference between rehydration and just drinking lots of liquid, water, beer or whatever?

To simplify the explanation, when one suffers from diarrhoea one loses a lot of liquid in the stool. One may also vomit up liquid, and sweat it out. This liquid will carry important electrolytes required by the body. When one rehydrates, one must replace not only the liquid, but the electrolytes too. If they are not replaced it will alter the strength of electrolyte solution in the body, which can in severe cases cause the body to go into shock, which can be fatal. The most important electrolytes to be replaced are Sodium (Na) and Potassium (K) and these are not found in sufficient quantities in a standard glass of water.

Beer, tea, coffee and other alcoholic beverages etc. should be avoided because none contain the required electrolytes and they all act as diuretics, causing further dehydration.

Sachets of dried electrolytes are available at pharmacies to mix with water but you can make your own rehydrating fluid if you wish. You need to add Sodium and Potassium salts to a liquid you can safely drink. So take a 1 litre bottle of clean drinking water and add ½ teaspoon of table salt. If you have sea salt, it is better, but ordinary table salt will do. If you have it, add ¼ teaspoon of baking soda (Sodium Bicarbonate) or, if that is unavailable, add ¼ more teaspoon of salt. This has given you your sodium content.

To this you should add 2 teaspoons of sugar; in order of preference, raw, brown or white, or you can use honey but beware of allergic reactions in some people. This will provide energy. Taste the mixture; it should be no saltier than tears.

You now need to add the required potassium which you can get by adding ½ a cup of orange or coconut juice or ½ a mashed banana.

(A quicker way to make instant rehydrating fluid is to add 1 teaspoon of salt to a 1½ litre bottle of Pepsi Cola and shake well, but colas contains caffeine, which could be contraindicated.)

Take this liquid constantly throughout the day and night, in small sips. You should aim to drink at least 50% more than you lose through your stool. You should also try to eat, but steer clear of any dairy foods, any heavily seasoned foods, fried or greasy foods.

Do not touch any alcoholic beverage until you have recovered and be careful with raw foods.

In Thailand we have one helpful medicine available over the counter if you do not wish nature to take its course:

Disento tablets contain small amounts of Kaolin, (china clay) to help solidify the stool and agents to treat the most common causes of diarrhoea; amoebas, some bacteria, worms etc.

You should normally allow the diarrhoea to run its course for a couple of days, taking rehydration liquid constantly, before you start taking any treatment. If there is no improvement after a day or two, take two Disento tablets. If there is no further improvement, take one tablet every three to four hours for no longer than one day. If no improvement is noted, go to a hospital but do not allow any treatment to be prescribed until a stool sample has been tested and the true cause of your sickness is known.

[Guest IT Manager]

After seeing the results my son achieved from using 2 meds that P1P gave us, I am happy to try anything he brings along. Incredible.

Bearing in mind they say you have been in South East Asia too long if you don't have the runs every morning, and having forgotten the squirts 6 years or more ago, I guess everyone is different.

Now... where is the plug?

[p1p]

Thank you for your confidence!!

[syd barrett]

Nice informative post P1P. Immodium stops minor diarrhea but I agree it's better to get the badness out, I ususally drink lots of tea and eat bananas, to cure my belly-rot.

[the gentleman]

After seeing the results my son achieved from using 2 meds that P1P gave us, I am happy to try anything he brings along. Incredible.

I missed that IT, what was that?

[ThaiAdventure]

Nice informative post P1P. Immodium stops minor diarrhea but I agree it's better to get the badness out, I ususally drink lots of tea and eat bananas, to cure my belly-rot.

Tea is a diuretic and shouldn't be used when dehydrated. Water is the only solution to prevent dehydration (did you see what I did there....solution. It's a punny ol' world eh?)

[andy50]

when i was in phuket last year, i was talking with 3 english guys (expats running a bar)they reccomended swallowing a small amount of lime cordial ,(neat )after eating ,to kill off any bacteria in the stomach.sounds like it might work

[p1p]

I fear those guys were pulling your @#$@. Lime cordial will be as useful as a spoon of sugar. Tooth rot & energy - that's all.

A half litre of fresh lime juice, now that's different. Especially if it is liberally dosed with finely minced garlic and chillies.

[andy50]

so thats why they were smirking!

[Guest IT Manager]

After seeing the results my son achieved from using 2 meds that P1P gave us, I am happy to try anything he brings along. Incredible.

I missed that IT, what was that?

One is a tea that I cant remember the name of the other is something derived from an algae, which I forget what to call.

I am looking for a memory sopportive medication P1P , Any ideas?

[Guest ka1234]

I fear those guys were pulling your @#$@. Lime cordial will be as useful as a spoon of sugar. Tooth rot & energy - that's all.

A half litre of fresh lime juice, now that's different. Especially if it is liberally dosed with finely minced garlic and chillies.

Or take one shot glass of lime and one shot of Baileys. Pour into your mouth and mix.

[translator]

Take one Ranidine tablet - one nidol tablet daily.

Available any thai quack. cheap and effective. Kills bacteria, dead......

Stay of the dairy products, smoking and beer - only increases the problem

[p1p]

Ginko Bilboa is always helpful, as is ginseng if you have memory problems. Both the Jaiogulan and Spirulina I gave you will help too, particularly the spirulina.

[dr_Pat_Pong]

A bit short on substance ( so to speak )....we'll let it die