Abdominal pain

[Badrabbit]

I've had continuous pain for 2 yrs, 1st year I took Tramadol to control the pain(at least 6 50mg tablets over 24 hrs) they eventually stopped working, I've been to every Hospital on Phuket, CT Scans, Ultra sound, X Ray's, blood tests, Urine tests etc Hospitals say "can't find anything" local Dr says its Ameba Infection, his tablets do not work.

Can I take 1 50mg Tramadol per day without any long term side effects, no one seems able to help me, International Hospital is 7k per night(30k deposit) you can imagine how much a week would cost with many tests trying to find the problem, I'm at my wits end, I sit in my house with my head in my hands scrunched up trying to bear the pain this is day and night.

I took 1 50mg Tramadol 2 days ago and it worked after about 1 hour, I had 24 hrs of pain relief, I'm scared to take them everyday so can someone tell me if I can take 1 per day to make my life worth living.

[proton]

If nothing found how does the Dr know it's an Ameba infection?

[Badrabbit]

1 minute ago, proton said:

If nothing found how does the Dr know it's an Ameba infection?

This was a local Clinic Dr, said" many farang get this" his tablets did work initially but now do nothing.

[Gaccha]

Describe the pain. Is it dull and nauseating? Is it sharp and agonising? Is it easy to locate (could you point to it?). Is the pain isolated in one location? Do you also feel the pain in other parts of your body (your shoulder, arms etc)? 

 

Is the pain in your stomach area or in your intestinal area?

 

Have you had a doctor have a look inside (stuck a camera in there)? 

[Chicksaw]

This is weird that your pain is so bad yet doctors can find no cause. Obviously, there is one.

 

I have little faith in Thai hospitals. The doctors are well-groomed and nurses pretty. But beyond that medical skills are questionable. (I have taught uni here and know what rote learning can turn even smart people into.)

 

I would go to India. It will be cheaper even including airfare. The hospital environments are not as spotless as here. But the doctors know their stuff. A poster here had high praise for this place https://www.sonoscanhealthcare.com/

 

Chennai and Kolkata are both good medical destinations. And they cater to medical tourists.

 

Good luck. Hope you find a way.

 

[Badrabbit]

1 minute ago, Gaccha said:

Describe the pain. Is it dull and nauseating? Is it sharp and agonising? Is it easy to locate (could you point to it?). Is the pain isolated in one location? Do you also feel the pain in other parts of your body (your shoulder, arms etc)? 

 

Is the pain in your stomach area or in your intestinal area?

 

Have you had a doctor have a look inside (stuck a camera in there)? 

Dull intestinal pain of varying degrees, I know where the pain is, I've had Endoscopy, pain is not nauseating.

I just want to control the pain as mist days I just want to sleep and not wake up.

 

[dddave]

I take Ultracet (Tramadol 33mg, plus acetaminophen) 4 or 5 times a week for knee pain.  My own internet research revealed that up to 100mg/day of tramadol is generally  considered safe and non-addictive however it's effectiveness can lessen over time.

Don't take my word for it.  Do your own research and consult a doctor or registered pharmacist. 

 

I do think it would be worth it for you to take a week in Bangkok, consulting with an internist and getting a diagnosis and treatment plan for your pain.

Edited May 21, 2023 by dddave

[Gaccha]

2 minutes ago, Badrabbit said:

Dull intestinal pain

Time for a colonoscopy. 

 

In the meantime, one reasonable strategy is to assume lactose intolerance, another is to consider the factor of mental stress. I'd suggest immediately increasing high fibre, cutting out all dairy products, and minimising stress in your everyday life. 

[Lacessit]

Have you had your appendix removed? If not, you may have a grumbling appendix. Usually RHS of lower abdomen. It's a long shot, doctors should be able to diagnose it.

The tramadol is not working any more as you are habituated.

The other possibility is giardia or cryptosporidia infection.

I suggest PM Sheryl for advice on where to go, it sounds like the doctors in your area are not competent.

[scubascuba3]

18 minutes ago, Badrabbit said:

Dull intestinal pain of varying degrees, I know where the pain is, I've had Endoscopy, pain is not nauseating.

I just want to control the pain as mist days I just want to sleep and not wake up.

 

i like the India idea above, seriously consider that, not expensive by the sounds of it incl colonoscopy 

[Yellowtail]

The best doctors in India don't stay in India

[scubascuba3]

2 minutes ago, Yellowtail said:

The best doctors in India don't stay in India

Possibly but they start there and there's a massive population, come on we are all sceptical about doctors here

Edited May 21, 2023 by scubascuba3

[steven100]

You mentioned you had an abdominal Ultra sound done ..... 

because I thinking it could be an abdominal aortic aneurysm or AAA.

How are they diagnosed?

Since AAAs don’t usually cause symptoms, healthcare providers often diagnose unruptured AAAs when they’re performing exams or tests for other health conditions. The following imaging exams may reveal an AAA:

Abdominal ultrasound: An ultrasound is a quick, painless test that uses sound waves to create real-time images of the inside of your belly. Your healthcare provider may be able to see an aneurysm on an abdominal ultrasound.

 

But you really need to go see a gastroenterologist. Gastroenterologists are medical doctors who specialize in evaluating, diagnosing, and treating conditions within or involving the gastrointestinal (GI) tract and digestive system.

[Yellowtail]

Just now, scubascuba3 said:

Possibly but they start there and there's a massive population, come on we are all sceptical about doctors here

While I'm skeptical of doctors everywhere, the doctors I have had in Thailand have generally been great. 

[Celsius]

You said you had endoscopt, but colonoscopy should be better suited, no?

 

Edit...already mentioned 

Edited May 21, 2023 by Celsius

[Upnotover]

3 minutes ago, Celsius said:

You said you had endoscopt, but colonoscopy should be better suited, no?

Colonoscopy is endoscopy.  Top down endoscopy is a gastroscopy.

[Plern]

Could be gut infection, tapeworm? Have you isolated the possibility of food? Med allergy? Is something dirty / infectious in the home without you realizing? Eating regularly in an unclean restaurant that appears clean?

 

I've had giardiasis many times, it's nasty but not painful.

 

Thai doctors are horrible at this sort of thing imo. Took ME two years to get wife on proper cholesterol medicine. Battled doctor ignorance every step of the way.

[FritsSikkink]

14 minutes ago, scubascuba3 said:

come on we are all sceptical about doctors here

Nope, fixed everything up to now.

[proton]

30 minutes ago, dddave said:

I take Ultracet (Tramadol 33mg, plus acetaminophen) 4 or 5 times a week for knee pain.  My own internet research revealed that up to 100mg/day of tramadol is generally  considered safe and non-addictive however it's effectiveness can lessen over time.

Don't take my word for it.  Do your own research and consult a doctor or registered pharmacist. 

 

I do think it would be worth it for you to take a week in Bangkok, consulting with an internist and getting a diagnosis and treatment plan for your pain.

Ultracet is 37.5mg tramadol and 325mg paracetamol, got a box in front of me

Edited May 21, 2023 by proton

[Tom H]

Gastroscopy. Acid issue.

You must try more for the right diagnosis.

 

Morbus xy?

 

Once the diagnosis is correct, treatment can start.

 

Fact.

 

 

[Dan O]

You could have IBS. Go to a good gastro\enterologist and stop guessing. No one on the forum can tell you as it could be a number of things. Shoot Sheryl a message and see what her advice is. 

[moogradod]

2 hours ago, Dan O said:

You could have IBS. Go to a good gastro\enterologist and stop guessing. No one on the forum can tell you as it could be a number of things. Shoot Sheryl a message and see what her advice is. 

I did not know what IBS is, so I googled it. And it is very much probable that I have exactly that. I do Colonoscopies regularily at a renown hospital in Pattaya, but my Gastroenterologist does not really help apart from taking away polyps if they find some (which is normal for me) and recommendations of a ridiculous diet which is impossible for me to adhere to. I would starve.

 

The procedure itself was really painful the last time - it should not be. But a very easy to manage (no anesthesist necessary, a nurse with some experience is enough - have done it in Switzerland) Propofol Infusion would take away any pain completely. Exept the pain in the wallet. They demand a fortune for that, a multiple of the colonoscopy itself.

 

So I would be happy to see some recommendations for an alternative hospital / specialist. If we all PM Sheryl she would maybe not be so happy. I guess many have that kind of ailment.

Edited May 21, 2023 by moogradod

[Sheryl]

It is entirely possible that the tramadol itself is the cause of your problem now, whatever it may have originally been. (Narcotic Bowel Syndrome).

 

While you now state that you have been in pain "continuous pain for 2 yrs", we have had multiple communications in which you reported the pain had (temporarily as it turned out) ceased. So it has not been continual for 2 years.

 

Best advice I can give is to gather all records, test results (inlcuding DVD of any scans or endoscopies) and see this doctor in Bangkok.

 

https://www.bumrungrad.com/en/doctors/Parit-Mekaroonkamol?gclid=CjwKCAjwgqejBhBAEiwAuWHioOoGFC_mCEFIRFoRm11vfE-ocuOtOnZxEVMcXWGCp6d-nAGgKxg42BoCVusQAvD_BwE

 

He has successfully diagnosed many people when other doctors could not.

 

By "see", I mean a consultation., There is no reason at all to think inpatient hospitalization would be required.  And it sounds like you have already had pretty extensive testing. What you need is a more skilled diagnostician.

 

 

[Shop mak]

3 hours ago, steven100 said:

I thinking it could be an abdominal aortic aneurysm or AAA.

Agree,  that was my first thought as well. Typical symptom early on would also be severe back pain.

OP: any back pain?

 

Another possible indication of AAA would also be if OP can feel his pulse, outside the stomach?

 

But if pain was severe 2 years ago, AAA could had bursted by now - IF you actually have AAA and not something else. That make AAA less likely, imo.

 

OP: you take way too much tramadol, 300 MG is dangerous level. You're beyond side effect, long time already.

Ask your doctor if he can prescribe Morphine MST, lasts for 12 hours. Eventually top up with only 1 Tramadol 50 mg per day.

 

You must reduce the intake of tramadol, not surprised if it doesn't work already, you taken way too much. And you might create more medical problems, and what I think can be addiction to Tramadol more than a month or two use (From experience).

 

Don't self-medicate, take only what is prescribed by hospital.

 

CT scan was with contrast or not? This would clearly show if you have AAA.

 

I would go to the best private hospital, and start with a CT with contrast, if negative follow other test the hospital suggest. 

 

But get your use of Tramadol under safe level.

 

[Rimmer]

Troll post has been removed

[connda]

One 50mg Tramadol tablet a day - from my own experience - isn't an amount that is going to cause you any serious problem when you decide to stop.  You can buy Ultracet with is 37.5 mg Tramadol and the rest paracetamol in order to step you down in dosage.  Use that for a week, then cut the Ultracet tabs in half for a week, and you should be able to simply stop.

However, I understand your frustration about not being able to find the root cause of the problem.  Things it could be?  H. Pylori infection if they have ruled out structural issues.  I'm surprised they haven't check that.  There are invasive and non-invasive ways to check.  If you doctor does an upper GI scope they would usually take a sample for biopsy and H. Pylori culture.  H. Pylori can cause the symptoms your describing. 

Hopefully Sheryl can recommend a good gastroenterologist to see.

4 hours ago, Badrabbit said:

This was a local Clinic Dr, said" many farang get this" his tablets did work initially but now do nothing.

He's probably talking about Giardia which can cause stomach pain and diarrhea. But "many farangs get this."  Nonsense, unless you drink pond water or contaminated sources.  If you're drinking bottled water you shouldn't have a case of Giardia, and ethnicity has nothing to do with the susceptibility of infection. 

You really need to talk to a good GI specialist

[connda]

4 hours ago, Chicksaw said:

This is weird that your pain is so bad yet doctors can find no cause. Obviously, there is one.

 

I have little faith in Thai hospitals. The doctors are well-groomed and nurses pretty. But beyond that medical skills are questionable. (I have taught uni here and know what rote learning can turn even smart people into.)

 

I would go to India. It will be cheaper even including airfare. The hospital environments are not as spotless as here. But the doctors know their stuff. A poster here had high praise for this place https://www.sonoscanhealthcare.com/

 

Chennai and Kolkata are both good medical destinations. And they cater to medical tourists.

 

Good luck. Hope you find a way.

 

For those posting "laughing emoticons."  That's pretty callous and disrespectful. I wouldn't call this a laughing matter, nor the care you can receive in India.  It is a option.  There is nothing funny about that, especially considering the OP's issues.

[connda]

1 hour ago, Sheryl said:

It is entirely possible that the tramadol itself is the cause of your problem now, whatever it may have originally been. (Narcotic Bowel Syndrome).

I hadn't heard of that one before, but with opioids that would make sense.  They slow the peristalsis and can cause constipation.  Interesting.  Hummm.  ????  Learn something new every day.

https://pubmed.ncbi.nlm.nih.gov/17916540/

 

[steven100]

OP ...   go and see a specialist ....   FGS/

[Mickeymaus]

1 hour ago, moogradod said:

I did not know what IBS is, so I googled it. And it is very much probable that I have exactly that. I do Colonoscopies regularily at a renown hospital in Pattaya, but my Gastroenterologist does not really help apart from taking away polyps if they find some (which is normal for me) and recommendations of a ridiculous diet which is impossible for me to adhere to. I would starve.

 

The procedure itself was really painful the last time - it should not be. But a very easy to manage (no anesthesist necessary, a nurse with some experience is enough - have done it in Switzerland) Propofol Infusion would take away any pain completely. Exept the pain in the wallet. They demand a fortune for that, a multiple of the colonoscopy itself.

 

So I would be happy to see some recommendations for an alternative hospital / specialist. If we all PM Sheryl she would maybe not be so happy. I guess many have that kind of ailment.

Where to you get a colonoscopy in Pattaya and how much does it cost?

Sometimes I have abdominal pain too. So far we assume that it is a muscle problem. Sometimes I can hardly get up from a chair. But when I stand it's gone. Pills didn't change anything. Swimming helped a lot. But there is an uncertainty. It didn't disappear completely. But the pain is very mild now since I go swimming almost every day.