Food Poisoning

[toptuan]

After avoiding it for nearly a year--BAM!--laid low by a virulent pathogen from a little food vendor cart I'd never visited before (never again). I had gone against my better instincts when I saw the messy food cart and surly character of an "I don't care" sort of worker. Well, it seems that the food was as dirty as the cart and her apron!

But my question is: When you're hit by the nausea, diarhheah, and sometimes headache and fever, what seems to help? I prefer avoiding pills, but will take if desperate!

Immodium ID, although it does plug up the gusher, seems to worsen my nausea. A nurse from my home country reccomends: "BRAT" to stop the diarrhea. B=bananas, R=rice, A=applesauce (I just mash up some apples as best as I can), and T=tea. Seems to help, along with bedrest.

Other simple, but effective remedies?

And what about the "oh-god-I-could-just-die" nausea? Any suggestions from fellow-stricken expats?

Edited January 27, 2007 by toptuan

[londonthai]

a lot of water with a pinch of salt and sugar - you don't have to each.

[Jamie]

Using things like Immodium when you have food poisoning is not a good thing. It slows your bodies ability to flush the offending bacteria from your body. It's best to let it run its course but make sure to take in enough liquids and electrolytes. Of course if things don't get better in a few days, or you end up with bloody "outwash" you need to get to a doctor.

I had a bad case after eating some mussels in a restaurant while I was in Chicago for a meeting. Two days of hel_l, followed by a bumpy plane ride and a 4 hour car drive with not too many rest areas.

[sendbaht]

"BRAT" to stop the diarrhea. B=bananas, R=rice, A=applesauce (I just mash up some apples as best as I can), and T=tea."

BRAT... looks like it would be perfect and work along with lots of rest... I'll never forget this but hope I never need it.

Thanks for the insite and I wish you well.

[chiang mai]

Doctors recommend one 250 gram Ciprofloxyn (antibiotic) tablet during the first twelve hours - it halves the recovery time. Loads of fluids to stay hydrated although there are mixed views on whether immodium is appropriate. Some doctors suggest letting the waste material run through the system to cleanse it provided you continue to drink lots of fluids. I can personally atest that the above regime is very effective.

[yeti]

Rehydrating drinks, Gatorade like, can find in any pharmacy.

[Stekmer]

I've generally gone for rest and fluid replacement as a first line.

I carry some electrolyte replacement sachets that I mix with bottled water. These are readily available from any/most pharmacy in Bangkok etc and it's worth having a few on hand.

If I have to keep moving then I will use some Imodium but prefer to try to get what ever is causing the problem out of my system.

If it persists for more than a couple of days then I'll get to a pharmacy and just ask for some antibiotics for diarrhea and possibly an antiemetic for the nausea.

I guess prevention is fairly important but ..... I've had as many problems eating at restaurants as I've had from street vendors.

[Naam]

Doctors recommend one 250 gram Ciprofloxyn (antibiotic) tablet during the first twelve hours

I can personally atest that the above regime is very effective.

i don't doubt the effectiveness but i doubt the size of 250 grams

[miruph]

In those cases 250mg Ciproflocyn per day is less.Two times a day would be better.Or in combination with Cotrimoxazol 1g(contains Sulfamethoxazol 800mg and 160mg Trimethoprim)2times a day a half and of course electrolyte.You can double up within the first days.Take min.7 days!

That saves my live in India.

All the best

Mike

[dash]

The treatment is agens dependent- different "stuffs" make different symptomes. Could be virus,bacteria, protozoa, an organic or inorganic toxin or just a (radioacitv) element.

[flifsh1]

500 mg of cipro immediately, tons of fluid, get an IV if its been over 12 hours and you cant keep anything down, repeat the cipro in 12 hours, and do not take anything to plug your hole, let it all get out! Much better out than in - the system is trying to rid you of the poison so let it do so. There is a miracle drug that should be injected in the butt asap from any nurse at any clinic - or if you are brave enough do it your self, but must be injected into deep tissue - Nospa, also known as Buscopan. It will stop the stomach spasms and relieve the tension and abdominal pain - it works wonders and then you can get some sleep.

[mr_hippo]

Take antibiotics only if advised by a doctor, people take too many antibiotics; your body will build up a resistance to antibiotics and when you really need them, they will be about as effective as a packet of M&Ms

Buscopan is not a miracle drug but it will help with stomach cramps and discomfort. Please do not give yourself, or let any unqualified person give you, an intramuscular injection. Not very effective in the early stages of diarrhoea.

Most pharmacies stock ORS - oral rehydration salts - could be useful to keep a few packets at home or make your own. Two simple recipes - 300ml warm water, 1 teaspoon of sugar and 1 teaspoon of salt (the warm water will help the salt and sugar to dissolve quicker), alternatively - one can of 7up, allow it to go flat and add a teaspoon of salt.

If symptoms persist over 24 hours - see a doctor.

[Rowdyman]

My first 5 trips to Thailand I got "food poisoning" (diarrhea, cramps, vomiting) ever single time and on one trip got sick twice. Nasty nasty sickness. Needless to say I was desparate to find out what I was doing wrong. This is what I did and have not been sick for the last 3 trips (knock on wood!). Not sure which one is the likely cause but one or more is. I suspect #1 was the cause. PS: I always ate in restaurants and never the food carts, although I know of people that eat at food carts regularly and never get sick.

1) Stopped ordering mixed drinks at restaurants and bars. This eliminated ice as one cause and one other thing: glasses are washed with tap water and never dried before making the drink, so I thought this could be a cause. Yep, I know, ice with a hole in it is supposed to be made with purified water, but I think sometimes this might not be the case. I just order beer, pop and soda in the bottle now.

2) Eliminated at ice cream at the beach from the venders.

3) I try and eat only at restaurants that are western owned as cleanliness may be better. Not 100% sure they are cleaner but just making sure. I have gradually been cheating on this rule as many thai food restaurants are thai owned and the food better.

Once you get sick, a agree with the answers to skip antibiotics but must replace electrolytes and water. If you can eat and you should try, the thais recommend a very thin type rice soup for nutrition. I always started feeling better around 36 hours and was up and around walking outside and eating almost normally again at 48 hours, but weak. But if not getting better after 48 hours, I would try and get a doctor to come by.

[Cuban]

Trust what your body tells you, when I have been ill I can just drink water (if it goes on for a few days I will add a little sugar and salt) and rest if possible for a day, sleeping is ideal. The worst part I find is turning down people's offer of food or "help", just leave me alone with a shower and toilet.

If forced to travel (I recently drove 1,000 km while sick) have replacement clothes and a clean up kit for accidents to hand.

Bland food - fresh plain boiled rice and plain yoghurt if you feel you need something to eat will not do any harm and can be thrown back up if need be.

I tend to avoid drugs unless the illness lasts three days or more, but a few aspirin with your water during the day can aid sleep.

Most people will know if it's a simple case of bad food or if it's more serious and requires medical attention; really bad smells, aversion to light, delusional thoughts/images, blood coming out of places it shouldn't.

[prighas]

Take antibiotics only if advised by a doctor, people take too many antibiotics; your body will build up a resistance to antibiotics and when you really need them, they will be about as effective as a packet of M&Ms

Buscopan is not a miracle drug but it will help with stomach cramps and discomfort. Please do not give yourself, or let any unqualified person give you, an intramuscular injection. Not very effective in the early stages of diarrhoea.

Most pharmacies stock ORS - oral rehydration salts - could be useful to keep a few packets at home or make your own. Two simple recipes - 300ml warm water, 1 teaspoon of sugar and 1 teaspoon of salt (the warm water will help the salt and sugar to dissolve quicker), alternatively - one can of 7up, allow it to go flat and add a teaspoon of salt.

If symptoms persist over 24 hours - see a doctor.

I must agree with you.

I have had at least 3 food poisoning incidents in Thailand - most of which were related to eating some sort of seafood. At one instance, I had to sleep one night at the hospital. Normally cramps are either felt at stomach or at the lower part of the stomach - bowl. I think there are 2 treatments depending where the pain, if any, is. Buscopan, Gastrimut, and electrolyte (after severe vommitting) have always helped me tremendously.

[leisurely]

Touch wood, I have never had food poisoning here. Both my girls have though, I found the most effective thing was sipping blood temp. fluids and for the nausea chewing ginger (Crystalised for palatability). I am not sure I would give any drugs, I would be concerned about whether the cause was viral and the dna changing making it harder to treat. Nor have I ever given them anything to bung them up. A doctor in India once advised us it is better to let it come out than sit and fester in your guts.

[backflip]

Most antibiotics are only effective when they enter the bloodstream. Try "Xifaxan" (generic: rifaximin) - it remains in the gut, killing the bacteria throughout the digestive system.

[toptuan]

As the OP, thanks much for all this collective wisdom. I intend to definitely bookmark this thread for the next (god forbid) gastric adventure.

I also had a nurse tell me to avoid any dairy products (especially something like yogurt) because the natural bacteria in aged dairy products (especially) tend to aggravate the problem. I'm not a medical professional, but seems logical.

[londonthai]

yes, water with a dash of lemon, salt, sugar is the best.

however, if you have used antibiotics (end especially those which stay in the gut only and don't work through the blood - as somebody suggested earlier) after the illness is gone you have to have milk products to get back your intestinal flora. Without these flora your digestive system can't work properly

[ZEAK]

Just got hit with some food posioning. I take activated charcoal that you can find at any chemist here 3 times a day, and some Brufen for the fever and the body aches. One day later I am 90% better, but still taking the charcoal. It is natural and very good at removing nasties from the body, and a hel_l of a lot better than antibiotics. Those I consider as a last resort. Another thing, you should not eat during it, just sip weak tea and drink water. Digesting food is work for your body, work that it should not do when it is fending off an attack. Just keep the little troops well hydrated and well rested.

http://www.earthclinic.com/Remedies/charcoal.html

Best

Oh yeah, your stool will be, well, black as coal. Dont worry about it, thats the charcoal leaving your body with all the nasties!

Edited February 24, 2007 by ZEAK

[Mid]

What regimen helps?

Hydration

[Jamie]

As the OP, thanks much for all this collective wisdom. I intend to definitely bookmark this thread for the next (god forbid) gastric adventure.

I also had a nurse tell me to avoid any dairy products (especially something like yogurt) because the natural bacteria in aged dairy products (especially) tend to aggravate the problem. I'm not a medical professional, but seems logical.

Interesting. I've heard the opposite. The bacteria you find in yogurt Lactobacillus bulgaricus, Lactococcus thermophilus and Lactobacillus acidophilus are all very beneficial bacteria that are found naturally in the human gut. They compete with the bad bacteria.

[Sheryl]

With the exception of very small children and the elderly (and immunosuppressed), food poisoning although highly unpleasant isn't likely to be dangerous and will pass. The mainstays of treatment are:

*** Fluid and electrolytes: drink a lot of fluid. Ideal fluids are coconut water, ORS (packets bought at pharmacy) and sports drinks like Gatorade. Thai-style nam minaw or nam som (lemon or orange juice with sugar and salt) are also very good. Basically, you need a lot of water with sugar (enough to be slightly sweet to the taste) and salt (enough to be just barely detectable), preferrably also some potassium (fruit juices and coconut water have it). ***

Vomiting should be controlled as otherwise you won't be able to take in enough fluid. Plasil or other brand of metoclopramide is widely available and effective. Take with just a small sip of water and do your best not to vomit for at least half an hour afterwards; once it takes effect you will then be able to take fluids and other meds as described below.

If despite taking plasil (anti-emetic) you are unable to keep down enough fluids then better head for a hospital. The simple way to know if you are keeping down enough fluid is the amount and color of your urine. If it is small in amount and dark (tea colored), you are dehydrated and need more fluid. If you are peeing regulalry and the color is clear or very light yellow, your hydration is OK.

If there is fever, take paracemol.

Try to tough out the stomach cramps and diarrhea as they help speed recovery by getting the toxins out, but if the cramps are just too much, take 1 tablet buscopam (it is available in tablet form).

No harm in activated charcoal and it may help if it doesn't make you too nauseous.

Anti-diarrheals are not advisable.

Antibiotics are not necessary unless the diarrhea contains blood, or fever persists for more than 24 hours, in which case see a doctor.

During the acute phase limit food intake to toast or crackers. As it gets better, any bland food.

Street vendor food is OK if it is cooked right in front of you, but food that has been sitting out on a cart should be avoided or else cooked before eating. In this climate, bacteria grows very rapidly in pre-cooked food.

[FunkyGuru]

I know my reply would be a bit of shocker to the conventional thinking lot here. What has so far worked bulletproof for me is ...

eat slices of white bread. No toasting, no butter, no nothing. Just straight out of the pack. Stuff yourself as much as you can.

Before you fall of your chairs laughing and / or ruling my idea as bizarre, listen the reason.

Usually the nausea is result due to hyper activity of your liver, trying to get rid of the micro organism that got into you in the first place. The problem starts when the bug doesn't get thrown out and liver keeps pumping those acids to flush it out. You get the nasty nausea.

Now eating slices white bread acts as fluid absorbing sponge. It sucks in and contains all that fluid and semi fluid which is creating clutter in the stomach and rest of the problem of food poisoning. Result, you stabilize sooner than you expect.

Taking anti biotic will not give such instant relief as eating white bread. Thats my 2 satang worth advise from personal experience and experiences of hundreds of others who followed it and benefited.

[cheshiremusicman]

After avoiding it for nearly a year--BAM!--laid low by a virulent pathogen from a little food vendor cart I'd never visited before (never again). I had gone against my better instincts when I saw the messy food cart and surly character of an "I don't care" sort of worker. Well, it seems that the food was as dirty as the cart and her apron!

But my question is: When you're hit by the nausea, diarhheah, and sometimes headache and fever, what seems to help? I prefer avoiding pills, but will take if desperate!

Immodium ID, although it does plug up the gusher, seems to worsen my nausea. A nurse from my home country reccomends: "BRAT" to stop the diarrhea. B=bananas, R=rice, A=applesauce (I just mash up some apples as best as I can), and T=tea. Seems to help, along with bedrest.

Other simple, but effective remedies?

And what about the "oh-god-I-could-just-die" nausea? Any suggestions from fellow-stricken expats?

If you don't mind taking tablets and if you REALLY have got food poisoining and not just a upset tummy eg throwing up from both ends at once then I suggest that you spend some 70baht and get a course of CYPROFLOXIN tablets from the pharmacists.

I came across this recommendation in the Daily Telegraph Doctors column about 12 years ago and he said that everybody should have them in their medical kit. The only way to obtain them at the time in the UK was to obtain a private medical prescription - about 350Baht and then buy them privately from the pharmacists. I went down this route and it cost - wait for it - a staggering 1750Baht in the UK. I was in Turkey on holiday some two years later and got salmonella poisoning ' I was really really ill' and I took the said tablets - one each 6 hours for 24 hours and within that time I had completely recovered. They can save you days or even weeks of agony.

I later purchased some 20 tablets in Goa (India) over the counter for about 60Baht and recently did the same her in Thailand for 70Baht. Suggest that you buy the 500mg size.

[thommo46]

My thai g/f at the time had severe case of the runs,she told me to go to 7/11 buy bottle of pepsi and salt,put half a teaspoon of salt in glass of pepsi and drink.Amazingly it worked.Tried same on another person and it worked.When I got back home to Australia one of my friends had same problem 2 days of it everytime he ate off to the loo.I told him to try salt and pepsi.Saw him 2 hours later after eating no problem.As has been statedin other posts it could be the sugar and salt.

Thommo

[ZZZ]

Just got hit with some food posioning. I take activated charcoal that you can find at any chemist here 3 times a day, and some Brufen for the fever and the body aches. One day later I am 90% better, but still taking the charcoal. It is natural and very good at removing nasties from the body, and a hel_l of a lot better than antibiotics. Those I consider as a last resort. Another thing, you should not eat during it, just sip weak tea and drink water. Digesting food is work for your body, work that it should not do when it is fending off an attack. Just keep the little troops well hydrated and well rested.

http://www.earthclinic.com/Remedies/charcoal.html

Best

Oh yeah, your stool will be, well, black as coal. Dont worry about it, thats the charcoal leaving your body with all the nasties!

Agree 100%, active charcoal have saved me many times. 10-15 tablets dissolved in a glass of water and nausea, stomach cramps and the lot is normally gone within half an hour. Never travel without it.

[hotgeekus]

no expert but have researched as my g/f just had another 'episode'....

*lots of water, electrolites (no gatorade, as it has tons of sugar, so try to avoid)

*no fruit juice (certain make you go poo faster, not a smart idea)

*BRAT diet, as before

*let it run its course......

regarding the issues of why....

Ice machines are a huge part of the problem, but it does not matter what machine it is from. What matters, is what the water supply that is attached to the ice machine is from. If not on UV filtration or good filter (usually not replaced), I would avoid.

Ice cream is a no no, as ice cream is not a problem, but the scoop is sitting in water which has scooped the last three thousand scoops, so it is just passing the cooties to you

If not sure, stay away from seafood, and make sure it is boiled in front of you, ie. curry. It can sit, but it has to be boiled for a few minutes (above 70 degrees) before you get it. Also, if it is boiled and your rice is cold, you are getting sick from the rice (maybe he didn't wash his hands after he took the dump..)

[PhilHarries]

3) I try and eat only at restaurants that are western owned as cleanliness may be better. Not 100% sure they are cleaner but just making sure. I have gradually been cheating on this rule as many thai food restaurants are thai owned and the food better.

The worst dose of the squits I ever experienced in Thailand came from eating farang food at a farang managed restaurant. No matter how good the management is it's the staff that do the cooking and unless supervised 100% of the time sooner or later they will cut corners (it happens in restaurants the world over).

I just avoid the spicy dishes, drink loads of water/electrolyte and let nature takes it's course. Immodium should only IMO be taken if you are going to ba away from the necessary facilities. A colleague was medivacced out of Viet Nam with severe gut problems that were put down to taking Immodium for too long.

btw it was liver, bacon, mash, peas and gravy that gave me the runs so I guess I did ask for it.

[Luckydog]

Eat some boiled rice with a drop of lemon on. That's what the Greeks swer by and so do I.

Don't take any more Emodium. If it persists you will have to go to a Quack for some test and Antibiotics.