GERD/Endoscopy/Colonoscopy

[ThaiBob]

I have been diagnosed with GERD. 10 days ago I went to Bangkok Hospital Pattaya emergency with severe heartburn (thought I was having a heart attack). Saw the gastroenterologist the next day and have been on PrevAcid with good results for the last 10 days. She of course recommended follow-up procedures, first an endoscopy, and then a colonoscopy. The quoted costs weee 11,000 and 18,000 respectively. The quotes were inclusive; lab work, pulips (if any). Is this reseasonable or excessive?I know I am due for a colonoscopy. Thanks. 

[scubascuba3]

At RSH Healthcare in Bangkok i was quoted:

Gastroscopy 9,000 baht

Biopsy 1,000-2,000 baht

Colonoscopy 15,000 baht.

 

So your costs you quote seem reasonable surprisingly.

 

How did they diagnose GERD without doing the above? my doctor said they don't know for sure until they do the tests. I had suspected Gastritis

 

 

 

 

[ThaiBob]

10 minutes ago, scubascuba3 said:

At RSH Healthcare in Bangkok i was quoted:

Gastroscopy 9,000 baht

Biopsy 1,000-2,000 baht

Colonoscopy 15,000 baht.

 

So your costs you quote seem reasonable surprisingly.

 

How did they diagnose GERD without doing the above? my doctor said they don't know for sure until they do the tests. I had suspected Gastritis

 

 

 

 

I have all the classic GERD symptoms and have been responding so far to GERD medications. Perhaps that is why she is suggesting more, to be sure. I told her not at this time until we give the meds a chance. That's why the question about costs. Thanks. 

[scubascuba3]

I have all the classic GERD symptoms and have been responding so far to GERD medications. Perhaps that is why she is suggesting more, to be sure. I told her not at this time until we give the meds a chance. That's why the question about costs. Thanks. 

Is PrevAcid the same as Lansoprazole? it appears to be according to google. How much was it and how many mg?

I have been using 30mg Lansoprazole daily for 4 months and has been very effective. I've switched to Omeprazole and it isn't doing the job quite as well

[Kinnock]

It's the job of private hospital staff to 'upsell' services.

 

I'd say it depends on if you're worried there may be a more serious underlying cause - as acid reflux can just be diet or stress related, so they may be just adding more services to make more money.

 

I've noticed that if I don't mention I have full, corporate health insurance, then then they recommend fewer tests.

[ThaiBob]

24 minutes ago, scubascuba3 said:

Is PrevAcid the same as Lansoprazole? it appears to be according to google. How much was it and how many mg?

I have been using 30mg Lansoprazole daily for 4 months and has been very effective. I've switched to Omeprazole and it isn't doing the job quite as well

Yes. 680 baht for 14 tablets at SC drugstore on Rama IV in Bangkok. Omeprazole a fraction of the cost but less effective says the doc. 

[IvorBiggun2]

26 minutes ago, ThaiBob said:

Omeprazole a fraction of the cost but less effective says the doc. 

Horses for courses. Omeprazol works for me. And it helped with my Dysphagia. I have trouble swallowing boiled/fried rice.

 

Quote

 

Will omeprazole help with dysphagia?

It relieves symptoms such as heartburn, difficulty swallowing, and persistent cough. This medication helps heal acid damage to the stomach and esophagus, helps prevent ulcers, and may help prevent cancer of the esophagus.

 

 

Edited August 22, 2019 by IvorBiggun2

[Sheryl]

Those are extremely good prices, in fact they surprise me. Make sure that cost of IV sedation is included as might not be. These days colonosvopy at private hospitals is running 25-35 k and gastroscopy about 25k.

From symptoms alone cannot rule out gastritis / peptic ulcer disease (which is not same as GERD) hence the recommendation for gastroscopy which will give definitive answer and also test for presence of heliobacter pylori. Which if present requires additional meds.

Colonoscopy has nothing to do with it, but if you are due for a routine one anyway it saves time and money to do both at same time.

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[NCC1701A]

4 hours ago, ThaiBob said:

I have been diagnosed with GERD.

https://wakegastro.com/patient-info/gerd-diet/

 

GERD Diet – General Guidelines

• Stop smoking and chewing tobacco.
• Discuss your weight with your doctor. Lose weight if you are overweight.
• Do not overeat. Eat small portions at meals and snacks.
• Avoid tight clothing, tight-fitting belts. Do not lie down or bend over within the first 15-30 minutes after eating.
• Do not chew gum or suck on hard candy. Swallowing air with chewing gum and sucking on hard candy can cause belching and reflux.
• Use bricks or wood blocks to raise the head of your bed 6-8 inches.
• Do not eat/drink: Chocolate, tomatoes, tomato sauces, oranges, pineapple and grapefruit, mint, coffee, alcohol, carbonated beverages, and black pepper.
• Eat a low-fat diet. Fatty, greasy foods cause your stomach to produce more acid.
•  

[CHdiver]

5 hours ago, scubascuba3 said:

At RSH Healthcare in Bangkok i was quoted:

Gastroscopy 9,000 baht

Biopsy 1,000-2,000 baht

Colonoscopy 15,000 baht.

 

So your costs you quote seem reasonable surprisingly.

 

How did they diagnose GERD without doing the above? my doctor said they don't know for sure until they do the tests. I had suspected Gastritis

 

 

 

 

I do not want to thread fxxk, but Thailand is getting expensive. I did a Gastroscopy and Cononoscopy in Switzerland a month ago. Cost was 13'500 Baht (430 CHF). 

[Gulfsailor]

After being quite sick for a few weeks already and having many weird symptoms earlier this year I was recommended by a gastroenterologist at a private hospital on Samui to have a colonoscopy and gastro endoscopy to check if a cause could be found there. But first it was agreed upon to do some blood work to rule out some other common things.

 

While waiting for the blood results the insurance rep checked how was I was insured and then gave me the quotation; 145,000 Baht!!! The doctor could only do the procedure first thing next morning, as he only spends 2 days a month practicing in this hospital. I decided to first await the blood result before making a decision and really also didn’t want to spend all evening on the toilet, while already feeling <deleted>. The doctor tried 2 times to persuade me to go ahead with the procedure the next morning. I stood firm and said I would see how I felt in a few days and to see what the blood said. Upon realizing I wouldn’t accept, the doctor told me he never even sent my blood to the lab for the agreed upon tests and would now also no longer do this. If I wanted these tests done I had to see another internist the next day (by this time all these doctors already left for the day) and request them again and have blood taken again.

 

i just decided to first self medicate for an ulcer with triple antibiotics and a PPI. Along with plenty of banana shakes to ease the stomach symptoms, until I was back in my home country to have the doctors there rule out anything serious relating to all the other symptoms. 

 

Regardless of my rant; your quote seems very cheap compared to what I was quoted!

 

[uhuh]

Just now, CHdiver said:

I do not want to thread fxxk, but Thailand is getting expensive. I did a Gastroscopy and Cononoscopy in Switzerland a month ago. Cost was 13'500 Baht (430 CHF). 

As mentioned in another thread,  endoscopy is generally much more expensive in Thailand than in Europe. 

[scubascuba3]

 

 

 

 

Do not eat/drink: Chocolate, tomatoes, tomato sauces, oranges, pineapple and grapefruit, mint, coffee, alcohol, carbonated beverages, and black pepper.

 

Amazing how accurate that is for Gastritis too.

 

Although for example 2 coffees are fine, 3 aren't for me

 

 

 

[ThaiBob]

8 hours ago, Sheryl said:

Those are extremely good prices, in fact they surprise me. Make sure that cost of IV sedation is included as might not be. These days colonosvopy at private hospitals is running 25-35 k and gastroscopy about 25k.

From symptoms alone cannot rule out gastritis / peptic ulcer disease (which is not same as GERD) hence the recommendation for gastroscopy which will give definitive answer and also test for presence of heliobacter pylori. Which if present requires additional meds.

Colonoscopy has nothing to do with it, but if you are due for a routine one anyway it saves time and money to do both at same time.

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app
 

One thing I never understood about Thailand (or this hospital), is quotations for private payers like myself (insurance for emergencies or urgent care via Anthem Bluecross, no OPD) is less than insurance companies. Just the opposite in America where insurers jack up prices then claim the insured are getting a great deal because the price is lower. True also for auto body work here, I pay less my insurance company would pay more. I will get the colonoscopy in December as I have found out that price will still be available. I will check about IV sedation for the endoscopy. I find this forum invaluable. Thanks! 

[spornb]

Chulalongkorn has separate colonoscopy clinic costs including lab and pathology with two shot anaesthetic approx bht 10500

 

I have the bill

 

You are totally out no pain

 

They also have brocure

Edited August 24, 2019 by spornb

[ThaiPauly]

I used to have GERD.

 

It was pretty severe, I raised my bed on bricks, had endoscopys to have it confirmed.

 

I quit drinking alcohol 3 months ago and it is now mostly in remission.

 

I have had one attack in the last month. I still take Ranidine 150mg once a day before breakfast.

 

That's amazing, one less problem for me to worry about.

[DannyCarlton]

On 8/22/2019 at 11:35 AM, ThaiBob said:

She of course recommended follow-up procedures, first an endoscopy, and then a colonoscopy. The quoted costs weee 11,000 and 18,000 respectively. The quotes were inclusive; lab work, pulips (if any). Is this reseasonable or excessive?I know I am due for a colonoscopy. Thanks. 

Absolutely no reason to have a colonoscopy for GORD. A con. Unless the Lansaparzole isn't effective, no reaon to have an endoscopy either.

 

As Scuba says, once it has settled down, change over to Omeprazole.

[DannyCarlton]

On 8/22/2019 at 4:22 PM, Sheryl said:

Colonoscopy has nothing to do with it, but if you are due for a routine one anyway it saves time and money to do both at same time.

Why on earth would you have a routine colonoscopy? Sending a stool sample to the lab is enough to check for initial signs of bowel cancer or any other serious bowel condition (if you don't have any symptoms).

 

Putting 22 feet of camera up your backside isn't fun and has it's risks.

[LosLobo]

1 hour ago, DannyCarlton said:

Why on earth would you have a routine colonoscopy? Sending a stool sample to the lab is enough to check for initial signs of bowel cancer or any other serious bowel condition (if you don't have any symptoms).

 

Putting 22 feet of camera up your backside isn't fun and has it's risks.

Routine colonoscopies for colon cancer screening are common for people with high risk hereditary factors.

 

Faecal occult blood testing (FOBT) may not show the presence of polyps which may be the precursor of cancer.

 

 

[DannyCarlton]

7 hours ago, LosLobo said:

Routine colonoscopies for colon cancer screening are common for people with high risk hereditary factors.

 

Faecal occult blood testing (FOBT) may not show the presence of polyps which may be the precursor of cancer.

 

 

I'm in a high risk group. I'm sent a pack to my home every year to enable me to take a stool sample and return it to the lab. Not normal practice in the UK to have annual colonoscopys. It's a risky procedure which can bring about a puncture of the bowl/colon.

[Sheryl]

I'm in a high risk group. I'm sent a pack to my home every year to enable me to take a stool sample and return it to the lab. Not normal practice in the UK to have annual colonoscopys. It's a risky procedure which can bring about a puncture of the bowl/colon.

What you describe is not simple test for occult blood (I hope). It is a test in which a tiny video cameta is swallowed


This is very, very expensive in Thailand (about twice the cost of colonoscopy), available in just a few hospitals and has several disadvantages:

1. If polyps or other abnormal growths found they still requirecolonoscoy to remove/biopsy.

2. Studies have shown it is not as accurate as direct colonoscopy especially in regard to detection of pre-cancerous polyps.

Colonoscopy remains standard procedure for colorectal cancer screening in the US, both for high risk individuals and routine screening for people over age 50 and the US government (which us hardly known for generodity in provision of free medical serbices) pays gor it in full for people aged 65 and above.

It also remains NHS standard in the UK for people aged 55 and above though NHS supports just a one time colonoscopy followed by home testing for occult blood unless initial colonoscopy found abnormality or home test found occult blood.

This NHS protocol is based on a cost benefit analysis and some countries' health services have made different decisions.

There is no question that testing for fecal blood is less accurate than colonoscopy especial when it comes to detection of precancerous polyps. However if done every single year using high intensity test (not just standard stool test for blood) and only on people who had normal findings on an initial colonoscopy (which is the UK NHS model) it comes close.

It is important to undetstand that the vonventionsl stool tests offered by Thai hospitals is not the same as the home test done in auK and other westetn countries.






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[DannyCarlton]

27 minutes ago, Sheryl said:

What you describe is not simple test for occult blood (I hope). It is a test in which a tiny video cameta is swallowed

It is a test for occult blood. I had a colonoscopy, immediaely followed by a gastroscopy several years ago. Both normal. I opted to have them performed without anesthesia, sedation or any pain relief. Not pleasant.

 

This is all normal in the UK. It's not because of a cost benefit analysis that the NHS goes down this route, more a risk analysis.

[Sheryl]

Risk benefit analyses of colonoscopy for cancer screening have consistently come out in favor of colonoscopy. The risks are very, very small if performed by a competent doctor.

 

The current UK NHS protocol is definitely influenced by cost considerations not concerns about risk of colonoscopy. However there have been studies suggesting the cost benefit analysis is flawed, see t

https://assets.publishing.service.gov.uk › uploads › attachment_data › file

 

The UK has a lower rate of survival for colon cancer than many other developed countries and this is directly related to the fact that colon cancer there tends to be diagnosed at a later stage and that in turn is arguably due to the current screening practices as well as to poor uptake/compliance with it (only about half of al NHS patients send in their  home tests).

 

 

[onera1961]

1 hour ago, Sheryl said:

Colonoscopy remains standard procedure for colorectal cancer screening in the US, both for high risk individuals and routine screening for people over age 50 and the US government (which us hardly known for generodity in provision of free medical serbices) pays gor it in full for people aged 65 and above.

I am not in high risk but my insurance (United Health) keeps bothering me to do a colonoscopy since I turned 50. Insurance would pay for it 100% and it does not depend on your deductible. At last I got it done when I was 57 (now 59) and every thing was OK. Now they will pay again after five years. I think Medicare also pays every five year only.  

[Sheryl]

Every 10 actually. (More often if any abnormal findings).

 

And no deducible under Medicare.

[ThaiBob]

As the OP, some posters implied I was planning a colonoscopy because of GERD, They are not related and the endoscopy/colonoscopy costs were mentioned as a question if the price was reasonable for a private hospital (answer; it is). I see the doc on September 27 and if discomfort from GERD persists I will have an endoscopy but the Prevacid seems to be working. I have travel plans but after I return later in the year I will have a colonoscopy. I believe in the old saying an ounce of prevention is worth a pound of cure. 

[LosLobo]

‘Why don’t I need a colonoscopy?’

https://www1.racgp.org.au/ajgp/2018/june/need-a-colonoscopy

A novel approach to communicating risks and benefits of colorectal cancer screening by the 
Australian Journal of General Practice published by the Royal Australian College of General Practitioners

 

Evidently Australia and New Zealand together have the highest incidence of colorectal cancer worldwide.

 

This is an interesting up to date study showing, how the risk of colorectal cancer is exponential with increased hereditary risk factors, and how the associated risks of colonoscopy (perforation, haemorrhage and, rarely, death) versus the need for colonoscopy screening in the average and moderate hereditary risk groups.

 

Expected frequency tree for population at moderately increased risk of colorectal cancer

[scubascuba3]

It sounds like if at average risk an iFOBT is better than a colonoscopy.

Can you get a faecal occult blood testing (FOBT) or immunochemical faecal occult blood testing (iFOBT) in Thailand?

[zorrow424]

Guy used to post here of India  Calcutta   2 hours away  colonoscopy 5to 800 baht,endoscopy 1200

  Colonoscopy ,no pain,no nerve endings,  polyp sighted  claw comes out,grab the polyp bit like elastic,pulling,splash of blood on lens,that's it,absolutely no pain,no drugs administered

[allencraig]

On 8/24/2019 at 1:14 PM, spornb said:

Chulalongkorn has separate colonoscopy clinic costs including lab and pathology with two shot anaesthetic approx bht 10500

I have the bill

You are totally out no pain

They also have brocure

spornb, how were you even able to find out they HAD a digestive clinic that could do a colonoscopy? I have been scouring their website (translating all the pages) and can't figure out anything other than "just show anytime after 5:30am and get in the queue" or something like that. (Their cardiology clinic is a completely different ballgame though.)