Strong indigestion/GERD medicine in Thailand?

[Batty]

Hi there. My wife has been struggling with some kind of indigestion issue for a good while along with burping quite a bit, its pretty bad actually and the range of foods she can eat now is really limited. She is on omeprazole but it barely makes any difference, if any. Is there anything stronger available in Thailand over the counter, in pill form?

 

She has had an endoscopy and various other tests at my insistence, no ulcers found or any other nasties. Four trips to the doctor over several months now. They did a biopsy of her stomach (apparently) and found some kind of bacteria that is known for causing bad indigestion, they said the bacteria likely came from street food. I dont know, thats what they claim anyway. I always have my doubts when it comes to doctors here. They gave her a bunch of antibiotics to take for a few weeks which made no difference.

 

Until we can figure it out, just wondered if there are some stronger pills to take to at least reduce the symptoms? Does anyone know? I could google it of course but the range of pills available here is probably limited so I figured I would ask around on here first.

 

Thanks :)

[xylophone]

Did she test positive for Helicobacter pylori (H. pylori)??

 

It can be difficult to shift, even with a combination of antibiotics and proton pump inhibitors (like omeprazole) amongst others, and sometimes it takes a couple of efforts to get rid of it.

[marin]

I had a bad stomach for the first time in my life recently. Diagnosed as 'sour stomach'. After the first meds did not work well a young doctor gave me Esomeprazole (Esomeprazole) Sold as Axiago here and imported by Astra Zeneca. 350 baht for a pack of 15, once in the morning and it worked. Now on day 7 stopped with no symptoms at all. 

[2009]

Anyone know of any good stomach doctors? 

[BritManToo]

First time in my life I have no indigestion/discomfort.

https://www.lazada.co.th/products/i2499065615-s8831241291.html

One tablet every evening, or one when you feel a bit iffy.

Works a treat!

[scubascuba3]

When i had gastritis I found daily 40mg of Omeprazole much more effective than 20mg so try upping the dose if using 20mg

[BE88]

Can take capsule activated Charcoal that you find in pharmacies for free sale only when her are in pain, then take two turmeric capsules after each meal as BritManToo has already indicated and do not eat in the evening to allow digestion to work well before going to sleep.

There are no miracle drugs but this can help a lot.

[JackGats]

Good old Peptobismol helps.

 

Omeprazol and Pantoprazol are against hyperacidity (ulcer).

[dj230]

Does she take birth control? 

 

I have no clue why a few girls I talked to in Thailand all have GERD, turned out it was their birth control, once they stopped taking it the GERD went away. 

[sqwakvfr]

I had H. Pylori over a decade ago.  It was really bad and I had 2 endoscopies in 2 years. I was on several PPI’s(Proton Pump Inhibitors).  Omemprazole is one of the them.  I went to a GI specialist in Chiang Mai several years ago and he prescribed Dexilant(30 or 60 MG) and it was very effective.  But Dexilant is very expensive(6000 Baht for a 4 week supply).  Long term use of any PPI is not recommended.  

 

I would recommend two other options:

 

1) Aloe Vera Juice

2) Pro-Biotic drinks.  I drink small bottle of Yakult everyday. Yakut or even Beta-Gen is widely available at most grocery stores in Thailand. 

 

I also do not eat big meals.  I eat about 60% to 70% of what a “Norma;l” person eats at each meal.  Additionally I mostly eat low acid foods,.

 

I had really bad symptoms for over 2 years and it will not be easy.  I still have some occasional symptoms(bloating, acid tastes in my month and sometimes excessive saliva) but is now mostly manageable.  

 

 

[spidermike007]

Be very careful. A little known fact is that GERD, other stomach ailments, and complications arising from GERD, are one of the top killers in Thailand, of people under 40. Especially women. My wife has it too. The doctors have said fermented foods, raw meats and fish, beer, processed foods, sweets, sodas, and many other things cause it, and it can kill.

 

Most conditions affected by GERD are triggered by unhealthy habits which can simply be altered to avoid the mentioned symptoms and other consequences.

Avoid smoking and alcohol drinks

Avoid tea, coffee, soda and juice

Avoid strong tasting foods: too sour, too spicy, too fat

Keep your weight in control

You should have your dinner at least 3 hours before bedtime and do not eat too much

Eat less but more often

Do not wear too tight clothing

Exercise regularly

 

https://www.vejthani.com/2019/02/gerd/

 

Chronic reflux, or gastroesophageal reflux disease (GERD), can affect quality of life and lead to long-term complications, including a higher risk for esophageal cancer in some cases.

 

https://www.mhealth.org/blog/2014/november-2014/five-things-you-should-know-about-acid-reflux

[MrJ2U]

1 hour ago, xylophone said:

Did she test positive for Helicobacter pylori (H. pylori)??

 

It can be difficult to shift, even with a combination of antibiotics and proton pump inhibitors (like omeprazole) amongst others, and sometimes it takes a couple of efforts to get rid of it.

How do you get that?

 

Uncooked or dirty food?

[xylophone]

55 minutes ago, MrJ2U said:

How do you get that?

 

Uncooked or dirty food?

The exact way H. pylori infects someone is still unknown. H. pylori bacteria may be passed from person to person through direct contact with saliva, vomit or fecal matter. H. pylori may also be spread through contaminated food or water.

 

https://www.mayoclinic.org/diseases-conditions/h-pylori/symptoms-causes 

[Sheryl]

From what you describe she has H. Pylori infection causing gastritis. The multiple antibiotics she was given was to eradicate the H. pylori but first round of treatment does not always work and she needs to be re-tested. It is important to eradicate the H. pylori as not only does it cause gastritis (and even sometimes ulcers) but iot is a risk factor for subsequent gastric cancer.

 

She does nto necessarily need another gastroscopy, they can do a urea breath test to see if the H. Pylori is elimibated or nto.

 

Once the H. Pylori is eradicated it takes up to a few months for the gastric mucosa to recover - that is normal. One cannot expect to feel better immediately as the lining of the stomach takers time to heal. How long ago did she complete the multiple antibiotic course?

 

In the interim in terms of short term relief, if it is gastric pain that bothers here (as opposed to the belching) omeprazole can be increased to twice a day (2 * 20 mg) if necessary (and if she is nto already on 40mg a day). She can also add Gaviscon, in either tablet or liquid form, available pretty much all pharmacies.

 

And this herbal remedy often helps with gas: 

https://shopee.co.th/Handy-Herb-Airess-แฮนดี้เฮิร์บ-แอเรส-ช่วยขับลม-บรรเทาอาการท้องอืด-ท้องเฟ้อ-(2-แคปซูล-ซอง-24-ซอง-กล่อง)-i.213722682.7935409600

 

If the problems continue more than 1-2 months after tests show the H. pylori is fully eradicated then may have to consider other possibilities such as food intolerance. Dairy would be the first suspect, people can become lactose intolerant later in life.

 

 

 

 

[how241]

2 hours ago, JackGats said:

Good old Peptobismol helps.

'TUMS'  is great and works very fast against acid.  The problem is that for some reason, TUMS  is not sold in Thailand even though it is just calcium carbonate. You can buy this as a vitamin and crush up the tablet BUT  this will be very expensive. 

[meatboy]

i have suffered all that has been discribed above for over 46yrs.the doctor put me on ZOTON lansoprozole which changed my life.2009 i moved to thailand and went on omeprozole 20mg,twice a day,this past 4yrs.its down to 1 tab.a day plus a peppermint oil capsule at 6pm.[putin hara] now its completly OK.

now this she must do.

do not wear any tight clothing around the waist or belts.

avoid bending

elevate her bed on a house brick.and sleep with at least with 2pillows.

do not eat after 5PM. and avoid all spicy food.

it did take the hospital 4yrs to tell me i have A HIATUS HERNIA 

if she has to eat during the day,i suggest fruit.small amounts.

[Batty]

On 2/23/2022 at 2:17 PM, xylophone said:

Did she test positive for Helicobacter pylori (H. pylori)??

 

It can be difficult to shift, even with a combination of antibiotics and proton pump inhibitors (like omeprazole) amongst others, and sometimes it takes a couple of efforts to get rid of it.

Sorry for the late reply, and thanks so much for your reply. Yes, she tested positive a few weeks back at the hospital and you are right - its been murder! A ton of antibiotics and research, natural remedies and stuff. We have thrown the kitchen sink at it.

 

Thanks again.

[Batty]

On 2/23/2022 at 2:25 PM, marin said:

I had a bad stomach for the first time in my life recently. Diagnosed as 'sour stomach'. After the first meds did not work well a young doctor gave me Esomeprazole (Esomeprazole) Sold as Axiago here and imported by Astra Zeneca. 350 baht for a pack of 15, once in the morning and it worked. Now on day 7 stopped with no symptoms at all. 

Thanks for the reply. Yes she takes omeprazole, the generic version sold over counter, pretty cheap.

[Batty]

On 2/23/2022 at 2:40 PM, BritManToo said:

First time in my life I have no indigestion/discomfort.

https://www.lazada.co.th/products/i2499065615-s8831241291.html

One tablet every evening, or one when you feel a bit iffy.

Works a treat!

Yes we have that already, thanks for the advice though.

[Batty]

On 2/23/2022 at 3:56 PM, sqwakvfr said:

I had H. Pylori over a decade ago.  It was really bad and I had 2 endoscopies in 2 years. I was on several PPI’s(Proton Pump Inhibitors).  Omemprazole is one of the them.  I went to a GI specialist in Chiang Mai several years ago and he prescribed Dexilant(30 or 60 MG) and it was very effective.  But Dexilant is very expensive(6000 Baht for a 4 week supply).  Long term use of any PPI is not recommended.  

 

I would recommend two other options:

 

1) Aloe Vera Juice

2) Pro-Biotic drinks.  I drink small bottle of Yakult everyday. Yakut or even Beta-Gen is widely available at most grocery stores in Thailand. 

 

I also do not eat big meals.  I eat about 60% to 70% of what a “Norma;l” person eats at each meal.  Additionally I mostly eat low acid foods,.

 

I had really bad symptoms for over 2 years and it will not be easy.  I still have some occasional symptoms(bloating, acid tastes in my month and sometimes excessive saliva) but is now mostly manageable.  

 

 

Thanks for the reply - sorry for taking so long to come back on this.

 

She just finished two rounds of triple therapy (two antibiotics, PPI). She did a two week run, didnt help. Took two weeks off then did another two week run which she has just completed. Didnt help.

 

She is going to wait a couple weeks, get her strength back and go back to doctors. I hate to play doctor myself as obviously I am not one, but if tried to give her the same triple therapy again I have told her to politely decline and walk away. I have spent hours, days reaearching this and then next stage as far as I can tell should be quadruple therapy. We can buy everything needed from pharmacy and try it for 14 days.

 

We have some pretty good quality pro-biotics, mastic gum, manuka honey, stomach enzymes, vits B and D, magnesium, oregano oil, flazseed tea, figs soaked in olive oil.... The plan is to use these alternative treatments over the next few weeks before starting quad therapy. It will hopefully restore her gut health a little, boost energy (the antibiotics have ruined her) and fight the pylori before jumping back on the nasty meds.

 

What a swine of an illness this thing is. It ruins peoples lives, I had no idea. 

 

Glad you are feeling better.

[Batty]

On 2/23/2022 at 4:03 PM, spidermike007 said:

Be very careful. A little known fact is that GERD, other stomach ailments, and complications arising from GERD, are one of the top killers in Thailand, of people under 40. Especially women. My wife has it too. The doctors have said fermented foods, raw meats and fish, beer, processed foods, sweets, sodas, and many other things cause it, and it can kill.

 

Most conditions affected by GERD are triggered by unhealthy habits which can simply be altered to avoid the mentioned symptoms and other consequences.

Avoid smoking and alcohol drinks

Avoid tea, coffee, soda and juice

Avoid strong tasting foods: too sour, too spicy, too fat

Keep your weight in control

You should have your dinner at least 3 hours before bedtime and do not eat too much

Eat less but more often

Do not wear too tight clothing

Exercise regularly

 

https://www.vejthani.com/2019/02/gerd/

 

Chronic reflux, or gastroesophageal reflux disease (GERD), can affect quality of life and lead to long-term complications, including a higher risk for esophageal cancer in some cases.

 

https://www.mhealth.org/blog/2014/november-2014/five-things-you-should-know-about-acid-reflux

Thanks for the info, and sorry for the late reply.

 

Yah we are aware of the dangers and links to cancer, now. Its scary, and it worries me. But in terms of being careful, there really isn't anything we can do. We are throwing the kitchen sink at this, doing everything possible to beat it - other than that, not much we can do apart from hope.

[Batty]

On 2/23/2022 at 5:26 PM, Sheryl said:

From what you describe she has H. Pylori infection causing gastritis. The multiple antibiotics she was given was to eradicate the H. pylori but first round of treatment does not always work and she needs to be re-tested. It is important to eradicate the H. pylori as not only does it cause gastritis (and even sometimes ulcers) but iot is a risk factor for subsequent gastric cancer.

 

She does nto necessarily need another gastroscopy, they can do a urea breath test to see if the H. Pylori is elimibated or nto.

 

Once the H. Pylori is eradicated it takes up to a few months for the gastric mucosa to recover - that is normal. One cannot expect to feel better immediately as the lining of the stomach takers time to heal. How long ago did she complete the multiple antibiotic course?

 

In the interim in terms of short term relief, if it is gastric pain that bothers here (as opposed to the belching) omeprazole can be increased to twice a day (2 * 20 mg) if necessary (and if she is nto already on 40mg a day). She can also add Gaviscon, in either tablet or liquid form, available pretty much all pharmacies.

 

And this herbal remedy often helps with gas: 

https://shopee.co.th/Handy-Herb-Airess-แฮนดี้เฮิร์บ-แอเรส-ช่วยขับลม-บรรเทาอาการท้องอืด-ท้องเฟ้อ-(2-แคปซูล-ซอง-24-ซอง-กล่อง)-i.213722682.7935409600

 

If the problems continue more than 1-2 months after tests show the H. pylori is fully eradicated then may have to consider other possibilities such as food intolerance. Dairy would be the first suspect, people can become lactose intolerant later in life.

 

 

 

 

Sheryll im so sorry for the late reply, and thanks so much for the advice.

 

She took antibiotics for 14 days, then took a few weeks off, then resumed for another 14 days. She has been on triple therapy (amoxy, clarithromycin, amozeaprole) twice she has been on this regime.

 

Im not a doctor, and I dont like playing doctor, but if our current doc tries to stick her back on the same regime again (for the third time) I might ask her to politely decline and walk away. Form everything I have read this last few weeks, when the triple fails (as it usually does) the next course should be quadruple, using different antibiotics available at pharmacies here.

 

We also have a ton of natural stuff sitting here ready to use, starting today. She is going to take a few weeks off the heavy meds (apart from PPI) to recover a bit as she is wiped out. We will fire all the alternative stuff at it for a few weeks before jumping on the quad therapy. We have mastic gum, manuka honey, oregano oil, psyllium husk, figs in olive oil, flaxseed tea and some realy high strength pro biotics. This will all be taken carefully at intervals so they dont clash with each other.

 

Thanks again for the advice

[Batty]

On 2/24/2022 at 6:19 AM, meatboy said:

i have suffered all that has been discribed above for over 46yrs.the doctor put me on ZOTON lansoprozole which changed my life.2009 i moved to thailand and went on omeprozole 20mg,twice a day,this past 4yrs.its down to 1 tab.a day plus a peppermint oil capsule at 6pm.[putin hara] now its completly OK.

now this she must do.

do not wear any tight clothing around the waist or belts.

avoid bending

elevate her bed on a house brick.and sleep with at least with 2pillows.

do not eat after 5PM. and avoid all spicy food.

it did take the hospital 4yrs to tell me i have A HIATUS HERNIA 

if she has to eat during the day,i suggest fruit.small amounts.

Thansk so much for the advice - sorry for the late reply. Glad things worked out and you are feeling better. Advice noted and taken into account :)

[xylophone]

i have suffered all that has been discribed above for over 46yrs.the doctor put me on ZOTON lansoprozole which changed my life.

3 hours ago, Batty said:

Thansk so much for the advice - sorry for the late reply. Glad things worked out and you are feeling better. Advice noted and taken into account

The poster above has a good point Batty, because if I recall correctly, the regimen they they prescribed me the first time round didn't work and that included omeprazole and two antibiotics, clarithromycin and amoxicillin.

 

The clarithromycin caused me quite a bit of stomach discomfort, so the medications were changed to metronidazole and tetracycline, along with lansoprazole, and they seemed to do the trick.

 

The funny thing is that I had been taking omeprazole for quite some time, and when this cleared up, whenever I got a flareup of reflux (extremely rare now) I would pop an omeprazole, which did the trick?

[Sheryl]

4 hours ago, Batty said:

Sheryll im so sorry for the late reply, and thanks so much for the advice.

 

She took antibiotics for 14 days, then took a few weeks off, then resumed for another 14 days. She has been on triple therapy (amoxy, clarithromycin, amozeaprole) twice she has been on this regime.

 

Im not a doctor, and I dont like playing doctor, but if our current doc tries to stick her back on the same regime again (for the third time) I might ask her to politely decline and walk away. Form everything I have read this last few weeks, when the triple fails (as it usually does) the next course should be quadruple, using different antibiotics available at pharmacies here.

 

 

 

on what basis did he have her take the second course - is the doctor re-testing her?

[Batty]

3 hours ago, Sheryl said:

 

on what basis did he have her take the second course - is the doctor re-testing her?

Hi Sheryll. He found Pylori after biopsy through endoscopy, then prescribed the meds. No follow up appointment. She went back to see him 1 week after finishing the meds and said she feels exactly the same, no different. The doc said no need to do another endoscope and apparently they are not able to do a breath test at this hospital (an army hospital). He said he was 100% the pylori was still active and should resume the same meds for another 14 days. 

[Batty]

4 hours ago, xylophone said:

i have suffered all that has been discribed above for over 46yrs.the doctor put me on ZOTON lansoprozole which changed my life.

The poster above has a good point Batty, because if I recall correctly, the regimen they they prescribed me the first time round didn't work and that included omeprazole and two antibiotics, clarithromycin and amoxicillin.

 

The clarithromycin caused me quite a bit of stomach discomfort, so the medications were changed to metronidazole and tetracycline, along with lansoprazole, and they seemed to do the trick.

 

The funny thing is that I had been taking omeprazole for quite some time, and when this cleared up, whenever I got a flareup of reflux (extremely rare now) I would pop an omeprazole, which did the trick?

Hi there. Yah he does, totally (have a point) I agree 100%, I just ran out of ways to reply to everyone uniquely ????

 

Thanks for that - funnily enough I have wrote down on a list right here Metronidazole and Tetracycline to go grab from pharmacy for the next round of treatment - thats only if the current doc prescribes a third round of the same meds. If he does that, I hate to be an idiot google doctor but I am gonna put my foot down, tell the wife to politely decline and we will try the treatment above. I have really read a fair bit about this and in almost all cases, if the first round of antibiotics dont work, the doc should change them up. Twice the doc has used the same meds so if he repeats a third time, we will self-treat with those other antibiotics instead.

 

Again I dont wanna play doctor google too much here but just going with my gut instinct I think she should have a couple weeks taking supplements only. We have a war chest full of natural remedies that have been successful for many people and she needs a couple weeks off the antibiotics, they have truly knocked her around!

[bignbad]

On 2/23/2022 at 6:10 PM, how241 said:

'TUMS'  is great and works very fast against acid.  The problem is that for some reason, TUMS  is not sold in Thailand even though it is just calcium carbonate. You can buy this as a vitamin and crush up the tablet BUT  this will be very expensive. 

https://www.lazada.co.th/products/tums-100-i2913122257-s10669170291.html?exlaz=d_1:mm_150050845_51350205_2010350205::12:12654756915!117524295342!!!pla-294682000766!c!294682000766!10669170291!518586414&gclid=CjwKCAjwopWSBhB6EiwAjxmqDQyPnjJsrYAQ8BwcpHgythx_af3JYl_x8LoS5NEp-LdSlx_7r0txAxoCJhoQAvD_BwE

[how241]

4 minutes ago, bignbad said:

https://www.lazada.co.th/products/tums-100-i2913122257-s10669170291.html?exlaz=d_1:mm_150050845_51350205_2010350205::12:12654756915!117524295342!!!pla-294682000766!c!294682000766!10669170291!518586414&gclid=CjwKCAjwopWSBhB6EiwAjxmqDQyPnjJsrYAQ8BwcpHgythx_af3JYl_x8LoS5NEp-LdSlx_7r0txAxoCJhoQAvD_BwE

Thanks !!!   This might be a new listing as I don't recall ever seeing TUMS on Lazada,  but I haven't checked recently.  Thanks for the link .  

[Denim]

On 2/23/2022 at 2:08 PM, Batty said:

They did a biopsy of her stomach (apparently) and found some kind of bacteria that is known for causing bad indigestion,

Worth getting this diagnosed properly.

 

About 12 years ago I also suffered with similar symptoms to your wife plus my stools were never solid.

 

Back in the UK I saw my GP and a sample was left for analysis. A week later I returned but they had lost the sample and so no wiser. No time for a re test as returning to Thailand.

 

I carried on in such a condition for several months back here at home in Thailand until......

 

One day I started to feel very unwell, ran a high temperature and could not eat anything or even look at food. After several days went to the local hospital where they did a blood test which showed my count was down. They didn't know why but gave me general anti biotics.

 

A week later I seriously thought I was dying and had lost so much weight you could see my rib cage. Nights were terrible , sweating profusely and no sleep.

 

Finally went to the Bangkok Pattaya hospital ( from Bangkok ) since I had friends there who could help my wife in case I died.

 

Here they repeated all the previous rests and a lot more. Finally they diagnosed Amoebic Liver Abscess, which can be fatal if not correctly treated.

 

https://medlineplus.gov/ency/article/000211.htm#:~:text=Amebic liver abscess is caused,the intestines to the liver.

 

Not that common but is caused by fecal contamination of food ( somebody not washing hands at restaurant kitchen ? )

 

You can have this stomach parasite for a long time .... a year or more before it causes problems.

It lives on waste matter in the digestive gut. At this stage not dangerous but if it burrows through the intestinal lining and enters the bloodstream it makes directly for your liver and starts eating that. Unless this is now treated your chances of survival are not good.

 

I was cured with Metronidazole which kills the parasitic bacteria in your bloodstream. However, I was informed that this drug would not kill the bacteria still in my digestive system. Another drug was needed for this which is not on Thailands drug list and is not available here.

 

Luckily , my ex girlfriend in the UK is now a Matron at pvt hospital and got a doctor to write a prescription for the required drug which my mother then sent out to me.

 

A close shave as the doctor at the Bangkok Pattaya hospital told me that I had only made it with a week to spare. The alternative would have been dying.

 

Sorry for the long winded reply and I hope your wifes condition is something less serious. I have only made this reply since many doctors are unfamiliar with this disease and might miss the diagnosis altogether.

 

My doctor in the UK had never heard of it when I subsequently told her and asked if she could keep the info I had downloaded from the internet.

 

Good luck....hope you find out what the problem is.