Last week, my Thai wife, who regularly eats Issan somtam, eat some with a lot of raw crab, shrimp and old fish! (That's the norm it seems..). Anyway, afterwards she suffered stomach cramps and the 'runs' very badly, and went to Bangkok Christian Hospital. They admitted her and put her on Glucose drips etc. An x-ray and ultrasound showed a lot of has throughout her small and large intestine, and she had a raised temperature.

She stayed in the hospital for 5 days, and although the runs and upset stomach stopped, she still experienced, (and continues to experience) a sharge pain in the area of her appendix when she moves.

The hospital discharged her after 5 days, (50,000 baht bill!), and she is now back in Phuket. She is able to eat now, but is still suffering from these sharp pains.

I asked the doctors during her stay if she might have the beginnings of apendicitus, but their view was that since her temperature had returned to normal, and since she could now eat food again - that she did not have the start of apendicitus.

I'm wondering why she still has this localised, sharp pain, (not a stomach ache or general ache). I've heard that apendices can 'rumble' from time to time? The only other thing I thought was that it might be a badly pulled muscle in her abdomen. But I'm no doctor, (not yet!), and she is not keen to go back to the hospital if they cannot provide a definitive diagnosis.

Any suggestions? Does eating somtam cause lasting damage??

Simon

Last week, my Thai wife, who regularly eats Issan somtam, eat some with a lot of raw crab, shrimp and old fish! (That's the norm it seems..). Anyway, afterwards she suffered stomach cramps and the 'runs' very badly, and went to Bangkok Christian Hospital. They admitted her and put her on Glucose drips etc. An x-ray and ultrasound showed a lot of has throughout her small and large intestine, and she had a raised temperature.

She stayed in the hospital for 5 days, and although the runs and upset stomach stopped, she still experienced, (and continues to experience) a sharge pain in the area of her appendix when she moves.

The hospital discharged her after 5 days, (50,000 baht bill!), and she is now back in Phuket. She is able to eat now, but is still suffering from these sharp pains.

I asked the doctors during her stay if she might have the beginnings of apendicitus, but their view was that since her temperature had returned to normal, and since she could now eat food again - that she did not have the start of apendicitus.

I'm wondering why she still has this localised, sharp pain, (not a stomach ache or general ache). I've heard that apendices can 'rumble' from time to time? The only other thing I thought was that it might be a badly pulled muscle in her abdomen. But I'm no doctor, (not yet!), and she is not keen to go back to the hospital if they cannot provide a definitive diagnosis.

Any suggestions? Does eating somtam cause lasting damage??

Simon

She had a fever so she definitely had an infection rather than just the usual food poisoning.

The appendix has mostly lymphoid tissue and can get enlarged in the event of an intestinal infection. The one bug that usually causes this is Yersinia which would definitely be implicated in this meal. Did she receive any antibiotics?

The saying goes: "An appendix never rumbles, it always shouts out loud" but this is not always true. A lower abdominal ultrasound will show enlargement and possible inflammation of the appendix.

The treatment here would be conservative, not surgery unless there are clear signs.

Damage should not be lasting...

Ultrasound showed no appendix enlargement - in fact the doctor said he couldn't even see it! - so maybe just a few days of rest is needed.

Simon

A person can have fever associated with food poisioning, so really the fact that she had or has a fever does not really indicate an apendix issue. My guess is that her colon hurts from spasms. Strictly a guess....