Cases of Constipation and Hemorrhoids in Thailand?

[gejohesch]

The title may intrigue or amuse, but I'm serious. My wife, a Thai woman from Isan, very often complains of constipation and occasionally of hemorrhoids. Now, everyone in the world has come across those problems before, I'm sure, but what I notice is that besides my wife, it's nearly everyone in her family who complains of them. I have come to suspect it's their food that does that to them. My wife appreciates the western food I sometimes make (I'm a decent cook), but only nibbles up a bit of it and goes back to food she makes herself, Thai-Isan food of course, even when we are outside Thailand. Myself, I have nearly never had these problems.

 

What do the "experts" think of it, and what would they advise?

[Celsius]

The crap she eats will eventually give her colon cancer. In any other normal country the symptoms would be a tell tale sign to stop doing what harms you. But not in Thailand. My wife's friend had some cleaning staff who did not poo almost 1 month. They also thought it was normal and never told anyone about it. They died in the hospital.

[gejohesch]

7 minutes ago, Celsius said:

The crap she eats will eventually give her colon cancer. In any other normal country the symptoms would be a tell tale sign to stop doing what harms you. But not in Thailand. My wife's friend had some cleaning staff who did not poo almost 1 month. They also thought it was normal and never told anyone about it. They died in the hospital.

Thanks for this quick reply!

But what is it in their food (Thai and/or Isan food) that causes these problems? Would you know?

 

I keep telling my wife to eat of the cereals I prepare myself in the morning. Sometimes she does, most of the time she reverts to Thai-Isan food.

 

NB 1: the cereals I prepare myself with rolled oats (no sugar added), mixed with whatever nuts and dried fruits I can find. When I can, I include dried prunes (known to be a good laxative). I believe that's excellent food in the morning, and with that in the belly I can easily go until the afternoon!

 

NB 2: I hear of several people in her village having cancer...

[blaze master]

29 minutes ago, gejohesch said:

Thanks for this quick reply!

But what is it in their food (Thai and/or Isan food) that causes these problems? Would you know?

 

I keep telling my wife to eat of the cereals I prepare myself in the morning. Sometimes she does, most of the time she reverts to Thai-Isan food.

 

NB 1: the cereals I prepare myself with rolled oats (no sugar added), mixed with whatever nuts and dried fruits I can find. When I can, I include dried prunes (known to be a good laxative). I believe that's excellent food in the morning, and with that in the belly I can easily go until the afternoon!

 

NB 2: I hear of several people in her village having cancer...

 

Fermented fish sauce.

 

[gejohesch]

10 hours ago, blaze master said:

 

Fermented fish sauce.

 

Yes? What's the story then about fermented fish sauce?

 

Do you mean nam pla (น้ำปลา) or pla ra (ปลาร้า)? I personally think that the first one is healthy. I don't know about the second one but cannot stand its smell and taste, I find it disgusting.

[howerde]

The Thai rural food is appalling, zero hygiene (hepatitis b and that can be passed on to children) , who knows where it came from or what is in it, the food is just left in the heat all day, sticky rice has a high GI index, diabetes is an issue.  liver cancer particulary among issan people is one of the highest in the world this is caused by liver flukes in uncooked fish the flukes then enter the liver , there are constant appeals to people to cook food, this  falls on deaf ears, poor education on healthy diets clean food. clean utensils is ignored.having been there, but to be fair i would not eat street food anywhere in Thailand

The other thing i noticed is how these people alternate between  constipation and diarrhea they think this is normal  

[gejohesch]

1 hour ago, howerde said:

The Thai rural food is appalling, zero hygiene (hepatitis b and that can be passed on to children) , who knows where it came from or what is in it, the food is just left in the heat all day, sticky rice has a high GI index, diabetes is an issue.  liver cancer particulary among issan people is one of the highest in the world this is caused by liver flukes in uncooked fish the flukes then enter the liver , there are constant appeals to people to cook food, this  falls on deaf ears, poor education on healthy diets clean food. clean utensils is ignored.having been there, but to be fair i would not eat street food anywhere in Thailand

The other thing i noticed is how these people alternate between  constipation and diarrhea they think this is normal  

Well, I tend to agree with the general statement, concerning hygiene and poor education in particular. Thanks for explaining about the flukes, I was vaguely aware of the problem.

 

I have the feeling that the issue is severely compounded by the lack of regulations or the non-respect of existing regulations. I confess not to know the details, but I don't have the impression that anyone in a position of authority genuinely and sincerely worries about the health of the population, and that it's rather much of a rat race to sell whatever rubbish to make money, money, money!

[howerde]

4 minutes ago, gejohesch said:

Well, I tend to agree with the general statement, concerning hygiene and poor education in particular. Thanks for explaining about the flukes, I was vaguely aware of the problem.

 

I have the feeling that the issue is severely compounded by the lack of regulations or the non-respect of existing regulations. I confess not to know the details, but I don't have the impression that anyone in a position of authority genuinely and sincerely worries about the health of the population, and that it's rather much of a rat race to sell whatever rubbish to make money, money, money!

yes , every thing is flexible when it comes to regulation, as i was told 40 years ago by a Thai. only YOU are responsible for your health, remember in Thailand virtually all officials either pay for the job they are doing or are appointed by a friend, it has nothing to do with competency 

[Harrisfan]

Try Tiger balm

[Lacessit]

IMO the prime cause of constipation in Thailand is rice, particularly the sticky rice variety. Most Thais eat white rice, not brown rice which has fibre. The also eat it with nearly every meal, including breakfast.

 

White rice is pure starch, it has next to no fibre.

 

Bamboo, sweet corn, and fruit such as pineapple, apple, Jackfruit and mango are all good sources of fibre. Drinking plenty of water also helps ward off constipation.

 

Hemorrhoids are caused by various factors, including constipation, excessive straining, and obesity.

[Magictoad]

30 minutes ago, Harrisfan said:

Try Tiger balm

Ouch!

[Magictoad]

Regular fruits in the diet and regular. Forlax mixed with a pint of water daily and when needs be: Hepalac the latter works very quickly and and alternative is glycerin suppositories 

[Magictoad]

6 minutes ago, Magictoad said:

Ouch!

Tiger Balm on the rectal area is NOT recommended 

[3NUMBAS]

Upf in the form of meatballs ,everyone lives on em ,every day ,can’t be good

[3NUMBAS]

Meatballs in meatballs out

[gejohesch]

2 hours ago, 3NUMBAS said:

Upf in the form of meatballs ,everyone lives on em ,every day ,can’t be good

UPF .... yeah, I always wonder about all those additives everywhere, and tons of sugar too. Don't know if it affects constipation and/or hemorrhoids, but I'm sure it cannot be good for the general health!

[RSD1]

On 6/11/2025 at 1:47 AM, gejohesch said:

The title may intrigue or amuse, but I'm serious. My wife, a Thai woman from Isan, very often complains of constipation and occasionally of hemorrhoids. Now, everyone in the world has come across those problems before, I'm sure, but what I notice is that besides my wife, it's nearly everyone in her family who complains of them. I have come to suspect it's their food that does that to them. My wife appreciates the western food I sometimes make (I'm a decent cook), but only nibbles up a bit of it and goes back to food she makes herself, Thai-Isan food of course, even when we are outside Thailand. Myself, I have nearly never had these problems.

 

What do the "experts" think of it, and what would they advise?

Two quick suggestions.
 

If she eats any fresh dairy products at all, try cutting them out entirely for a week and see if that helps improve the situation. People who are very sensitive to constipation, often have problems digesting fresh dairy. So, no milk (not even in coffee or other drinks), no yogurt, and no fresh cheese. Usually aged cheese eaten occasionally is not a problem though.

 

The other thing is that if she adds 5 grams per day of raw psyllium husk to her diet, first thing in the morning, that would probably help to get things moving for her on a regular basis. It's natural and not habit forming. It's just a natural fiber supplement, but normally takes a few days of daily use for it to start having a pronounced effect on the system. You can get it on Lazada.

 

https://www.lazada.co.th/products/psyllium-husk-1-i4347844968-s17326961117.html

 

Also, you want to consume at least two or three glasses of water within 15 minutes of when you take any psyllium husk or powder or there is a risk that it could solidify in your intestines and worsen the situation instead of helping. A lot of people try this fiber supplement, but don't take enough water with it and then don't get the intended results.

 

Also, does she drink at least 2 to 3 L of water daily on a regular basis? 

[gejohesch]

6 hours ago, RSD1 said:

Two quick suggestions.
 

If she eats any fresh dairy products at all, try cutting them out entirely for a week and see if that helps improve the situation. People who are very sensitive to constipation, often have problems digesting fresh dairy. So, no milk (not even in coffee or other drinks), no yogurt, and no fresh cheese. Usually aged cheese eaten occasionally is not a problem though.

 

The other thing is that if she adds 5 grams per day of raw psyllium husk to her diet, first thing in the morning, that would probably help to get things moving for her on a regular basis. It's natural and not habit forming. It's just a natural fiber supplement, but normally takes a few days of daily use for it to start having a pronounced effect on the system. You can get it on Lazada.

 

https://www.lazada.co.th/products/psyllium-husk-1-i4347844968-s17326961117.html

 

Also, you want to consume at least two or three glasses of water within 15 minutes of when you take any psyllium husk or powder or there is a risk that it could solidify in your intestines and worsen the situation instead of helping. A lot of people try this fiber supplement, but don't take enough water with it and then don't get the intended results.

 

Also, does she drink at least 2 to 3 L of water daily on a regular basis? 

Thanks, good advice.

One thing is, she probably does not drink enough water. But same with me (always been a challenge to drink more than a few glasses in the day), and that's not caused me any pbm (so far).

[proton]

On 6/11/2025 at 5:32 PM, Magictoad said:

Regular fruits in the diet and regular. Forlax mixed with a pint of water daily and when needs be: Hepalac the latter works very quickly and and alternative is glycerin suppositories 

 

where do you get the suppositories from here? Boots don't sell them only in the UK. Latulose is not that good, soon get a tolerance to it.

[RSD1]

14 hours ago, gejohesch said:

Thanks, good advice.

One thing is, she probably does not drink enough water. But same with me (always been a challenge to drink more than a few glasses in the day), and that's not caused me any pbm (so far).

 

Not enough water in a day will certainly exasserbate the problem. That is such an easy thing fix. I easily drink 3-4 liters a day, but I am quite active. WIthout water the bowels often don't get the urge to move. So it can be critical for some people. 

 

Also, another thing she can try is senna seeds. It it made into various products for anti-constipation. I used to use one called Agilolax, which is a German-made product. Used it for years, but then found out long term use is not healthy for the kidneys. So I stopped. Also, too much of it can cause stomach spasms and discomfort.

 

But if someone is really plugged up there is a product called Senokot, which is sold in Thailand (link below). Not expensive and comes in strips of 20 small tablets. If you take 2-3 in a day then the next day you should have the urge to go. What I don't like about it is the urge can be really strong and cause you to push a bit too hard during a BM because it causes mild stomach spasms. If she already has hemorrhoids then pushing is something she wants to avoid. But she can try just taking one tablet as an experiment and see what happens the next day.

 

https://senokot.com/

https://medthai.com/เซนโนไซด์/

[RSD1]

14 hours ago, proton said:

 

where do you get the suppositories from here? Boots don't sell them only in the UK. Latulose is not that good, soon get a tolerance to it.

 

What kind of suppositories? Steroid based to reduce inflammation from hemorrhoids?

 

You can get the ones on the following links in just about any Thai pharmacy. The brand is Doproct. About 80 Baht a box for 10:

 

http://www.pharmbma.com/drug-list/b/40-benzocaine-hydrocortisone-zinc-suppository

https://www.yaatoyou.com/product/1132186

[RSD1]

14 hours ago, gejohesch said:

Thanks, good advice.

One thing is, she probably does not drink enough water. But same with me (always been a challenge to drink more than a few glasses in the day), and that's not caused me any pbm (so far).

 

As a follow up to my previous response, just bear in mind any of these supplements that have any kind of laxative effect (including senokot), whether they are natural forms or chemical forms like Forlax (though this does not include natural fiber supplements like psyllium), can cause the bowels to become "lazy" over time. Which is something you don't want. These things can be helpful as short-term aids, but shouldn't be used long term or in place of making dietary changes to fix the problem longer term. Lazy bowels means after a while they may not want to move on their own without the use of laxative supplements. So this should be something to watch out for.

[fredwiggy]

What Lacessit said is as close as it gets. My girlfriend, ex wife and others I know all complain about constipation, and they all eat fruits. Too much of the white rice, which doesn't have the fiber brown does, binds you up, and many also don't drink enough water here, especially seeing it's a place where it's usually always hot and they're outside a lot. It's been my problem also, not drinking enough water. You have to remind yourself or carry a bottle around with you because you tend to not drink unless thirsty.

 

They do eat a lot of vegetables which are good fiber sources but rice every meal is never a good idea. This is also why many gain extra weight when they get older, even if they aren't drinking the sugar sodas or eating western food. Your body needs less carbs when you age.

 

Rice is good when you have diarrhea, but too much gets the you other problem. Others here recommended seeds and psyllium, which are good. As well as limiting dairy. Some have either or the bowel problems every now and then, as being regular isn't the easiest thing to do, especially if you're sedentary. 

[gejohesch]

2 minutes ago, RSD1 said:

 

As a follow up to my previous response, just bear in mind any of these supplements that have any kind of laxative effect (including senokot), whether they are natural forms or chemical forms like Forlax (though this does not include natural fiber supplements like psyllium), can cause the bowels to become "lazy" over time. Which is something you don't want. These things can be helpful short term aids, but shouldn't be used long term or in place of making dietary changes to fix the problem. Lazy bowels means after a while they may not want to move on their own without the use of laxative supplements. So this should be something to watch out for.

Good comments, adding on to a number of previous replies. I would like to make a recap, sthg like a 3 points strategy:

1 - Natural approach :

1a = which aliments to favour to alleviate constipation: a number of good suggestions have been made, eg high fiber food and especially a lot of water.

1b = which aliments to avoid. In the case of Thailand, I can see a big issue with the 3-times a day consumption of white rice, and also the fact that so much food is fried!

2 - Remedial approach:

Several suggestions above - Interesting.

I will take good note and pass on to my wife so she has sthg to ask when next she goes to a pharmacy.

However, it's clear that regular use of medication is sthg to be careful with.

 

Conclusion : I will walk my wife over 1a and 1b (the natural approach), and hope she gets sthg useful out of it (as a number of Thais I have come across, she has a tendency to politely listen and nod her head, or just brush away the discussion outright ..... and do everything her own old way anyway!)

[newbee2022]

Drink a lot, high fiber, fruits, vegetables.

Hemorrhoids might be caused by constipation. When bleeding see a specialist Doctor.

Emptying the bowl is normal between 2 times daily and 2 times a week.

[newbee2022]

On 6/11/2025 at 2:40 AM, blaze master said:

 

Fermented fish sauce.

 

No

[newbee2022]

On 6/11/2025 at 4:54 PM, Harrisfan said:

Try Tiger balm

Where to apply?

[fredwiggy]

On 6/11/2025 at 4:44 PM, gejohesch said:

Well, I tend to agree with the general statement, concerning hygiene and poor education in particular. Thanks for explaining about the flukes, I was vaguely aware of the problem.

 

I have the feeling that the issue is severely compounded by the lack of regulations or the non-respect of existing regulations. I confess not to know the details, but I don't have the impression that anyone in a position of authority genuinely and sincerely worries about the health of the population, and that it's rather much of a rat race to sell whatever rubbish to make money, money, money!

Yes, the uncooked fish many here eat in Somtam causes cancer.  A friend's wife who we knew died from it a few years back.

[newbee2022]

On 6/11/2025 at 5:21 PM, Lacessit said:

IMO the prime cause of constipation in Thailand is rice, particularly the sticky rice variety. Most Thais eat white rice, not brown rice which has fibre. The also eat it with nearly every meal, including breakfast.

 

White rice is pure starch, it has next to no fibre.

 

Bamboo, sweet corn, and fruit such as pineapple, apple, Jackfruit and mango are all good sources of fibre. Drinking plenty of water also helps ward off constipation.

 

Hemorrhoids are caused by various factors, including constipation, excessive straining, and obesity.

That's correct.

[Mike_Hunt]

On 6/10/2025 at 2:47 PM, gejohesch said:

The title may intrigue or amuse, but I'm serious. My wife, a Thai woman from Isan, very often complains of constipation and occasionally of hemorrhoids. Now, everyone in the world has come across those problems before, I'm sure, but what I notice is that besides my wife, it's nearly everyone in her family who complains of them. I have come to suspect it's their food that does that to them. My wife appreciates the western food I sometimes make (I'm a decent cook), but only nibbles up a bit of it and goes back to food she makes herself, Thai-Isan food of course, even when we are outside Thailand. Myself, I have nearly never had these problems.

 

What do the "experts" think of it, and what would they advise?

What exactly is Thai-Isan food?