Treatment For Stomach Cramps

[Mobi]

I have been experiencing stomach cramps with some diarrhoea for several days, so I went to see a doc yesterday, and he prescribed me 3 drugs.

The first is Tinidazole 500 Mg which I have to take one per day. I Googled this drug and discovered that it is a an antibiotic for bacterial infections and the standard dosage is 2 grams per day for 3 days. Yet the Doc only prescribed a quarter of this dosage.

My second drug is Ciprofloxacin 500 Mg. My trusty Google tells me this does a similar job to Tinidazole and the dosage is 1 gram a day, which was what I was prescribed.

The third drug is a tiny pill called Benera (also notated as Belladonna) which is supposedly an antispasmodic, but I can't find it on Google. I'm supposed to take this after meals. If the antibiotic kills the infection, why do I need an antispasmodic?

Why didn't the doctor just prescribe 1 antibiotic? From past experience they always do this - sometimes prescribing even more than two. Surely I would be better off just taking the full dosage of Tinidazole, rather than taking two different drugs?

And what's with the Belladonna? I thought it was poisonous!!

And 24 hours later I still have stomach cramps

[londonthai]

different antibiotics are used for different bacteria - maybe that's why you have 2 of them.

the tiny ammount of the poisonous Belladonna would stop from feeling pain and would prevent stomach wall muscles from cramping.

if the antibiotics don't work than you might have not a bacterial infection but a virus. Often muscle cramps are effect of stress. Did anything happen to you just before the onset of stomach pain?

[Mobi]

different antibiotics are used for different bacteria - maybe that's why you have 2 of them.

the tiny ammount of the poisonous Belladonna would stop from feeling pain and would prevent stomach wall muscles from cramping.

if the antibiotics don't work than you might have not a bacterial infection but a virus. Often muscle cramps are effect of stress. Did anything happen to you just before the onset of stomach pain?

Thanks for that.

It could well be stress, as yes, something has just happened and I do feel very stressed. This also explains my unstable systolic blood pressure.

I'll keep taking the pills and see what happens - but so far I've still got the cramps.

[londonthai]

as your problem is probably not solved yet you will be stressed for sometimes and you might have some stomach discomfort - go for some massage treatments as often as you can, do sports, work less.

spicy food will aggravate your problems - so take easy on chili

[Sheryl]

What he did was to treat for 2 possible causes rather than identify the cause...or wait to see if it resolved on its own. Would not be the Western way, but not uncommon in Thailand. Going by the book, what should be done is (1) if it has been less than 48 hours and there is no blood or mucus in the stool, rehdration only. Most episodes like this are self-limiting and due to either virus or food poisoning. (2) If persists or if blood or mucus, test the stool to identify the cause and treat accordingly.

Thai doctors tend to assume that patients want immediate relief rather than a more time consuming diagnostic approrach, and also that patients equate many drugs with better treatment. I'm not convinced this is true even of thai patients and certainly isn't of westerners, but there you have it.

Tinidazole treats protozoal infections (giardia) and amoeba, amoebic dose is higher than protozoa dose. Also has some action against some bacteria. Cipro treats other bacteria. in other words, pus totgether it is a shot-gun approrach to cover a wide range of possible causes. One ofthe disadvantages of this is that it can contribute to drug resistance, also can unnecessarily further uopset the GI tract since helpful as well as harmful bugs wuill get killed off.

In any case since you have already started on these 2 drugs I'd suggest continuing them as an incompklete course is even more likely to create problems for you. Forget the belladonna, a hot water botle or heating pad to the abdomin will give some relief. The cramps are due to the rapid intestinal movement and irritation which is causing the diarrhea and should stop when the diarrhea does.

If I've got it righjt this is now day 3 of the medication for you. If the diarrhea hasn't greatly improved by tomorrow morning see another doctor and insist ion a stool test.

I'm assuming you don't have a fever. If you have high fever then see another doctor today.

good luck!

[Mobi]

Thanks Sheryl,

I'm feeling much better today. Still a bit of diarrhoea this morning but the stomach cramps seem to have gone at long last.

Hopefully that's an end to it, and yes you have confirmed what I suspected about the doctors' prescribing practices.

I have known Thai doctors prescribe up to 6 medications for a simple medical complaint.

My ex wife used to call this practice prescribing a 'team' on the basis that at least one of them would score.

Edited October 19, 2007 by Mobi

[wpcoe]

... also can unnecessarily further uopset the GI tract since helpful as well as harmful bugs wuill get killed off.

Sheryl, since you mentioned that helpful bugs will get killed off, I assume you are including the probiotics?

I'm reluctant to go on antibiotics as often as my Thai doctors seem to want to prescribe them. I had a series of ear infections and each time was given systemic antibiotics (a different one each time) to the point where I was on antibiotics four times in three months. My main concern was building up resistance to antibiotics, but secondarily to depleting the probiotics that belong in one's digestive system.

My doctor did not know what I meant when I referred to "probiotics" and had to actually go on the internet and use Google to find out what they were! After he understood my concern, he agreed to give me a prescription for acidophilus (so that it would be covered by insurance, rather than out of my own pocket when I went to Fascino pharmacy like I did before.)

I don't want to prescribe "treatment," but would it be reasonable to advise Mobi to take some probiotic cocktails (there are some capsules that contain more probiotics than just acidophilus) to restore the "healthy bacteria" in his system?

[londonthai]

yogurt (rather the natural one and not sweetened), sour milk should be a part of the healthy diet - but even more so when taking antibiotic tablets

[Sheryl]

... also can unnecessarily further uopset the GI tract since helpful as well as harmful bugs wuill get killed off.

Sheryl, since you mentioned that helpful bugs will get killed off, I assume you are including the probiotics?

I don't want to prescribe "treatment," but would it be reasonable to advise Mobi to take some probiotic cocktails (there are some capsules that contain more probiotics than just acidophilus) to restore the "healthy bacteria" in his system?

Definitely anyone who has been on antibiotics would do well to eat live yogurt . As for taking probiotics, I've heard conflicting things about the actual contents of various preparations (e.g. whether or not they are in fact still live, which is what they need to be), probably varies with the brand. Can't hurt and may help. Personally I just eat a lot of yogurt.