Diarrhea Since Over Two Weeks - Won't Go Away

[Thanh-BKK]

Hi.

Since over two weeks i am suffering from diarrhea. It started after i emptied a cup of lemonade from an Auntie Anne's at Tesco On Nut, and the last bit in the cup (from the ice that had melted) tasted somewhat dodgy so i suspect unclean ice.

However i have since been to a doctor twice and got medicine (four different ones of which one is an antibiotic) however the antibiotic only lasted for three days each time - of which second and third day i was symptom-free (in fact didn't need to go to toilet at all) however as soon as i stopped the antibiotic it came right back.

Last Saturday i been to the hospital and got blood and stool tested (i will get the test results later on today when i have to go there a second time) and was given a different antibiotic which doesn't have any effect at all.

This is worst during the night, i just can't sleep as i have to run to the toilet every about two hours to release what comes like water and stinks horribly. During the day however i have very little problems and, apart from the diarrhea, no other symptoms (no vomiting or stomach ache, i can actually eat normal like always).

In those two weeks i have lost almost 8 kilos of weight and due to the lack of sleep i feel sleepy all day long.

I am 34 year old, male, don't drink alcohol and don't smoke. I eat mainly Thai food but also western (on weekends).

What could this be? I've had food poisoning before but that never lasted longer than 2-3 days.

Best regards.....

Thanh

[FBN]

The onset of food poisoning is usually from within about 4-8 h and does not last more than 24 or 36h.

This is most probably and infection by anything from Amoeba to Giardia or Cryptosporidium.

These all need specific treatment (usually Flagyl or Fasigen) and not any other conventional antibiotic.

If the original antibiotic helped, could have been one of these but you may need to take either higher doses or over a longer period of time.

Blood tests would not be helpful and stool tests are usually not diagnostic as it may take repeated samples to finally make the diagnosis.

Would be useful to know which antibiotic was given so far as well as the results of the tests.

[Thanh-BKK]

Hi.

Of the first antibiotic i don't know the name, i got it from a small clinic near my place along with three other medicines of which one is sure Paracetamol. The antibiotic itself was capsules (green-black) but quite small. I had to take two each three times per day, however i got only enough to last for 8 doses (16 capsules) each time.

The one i got from the hospital is round, white tablets, i have the package at home so i can write the name later on (now i'm at the office) however those (i have to take one tablet each in the morning and in the evening) don't show any effect whatsoever.

The time frame is about right for it initially being food poisoning, i took that dodgy water around 6 pm and the first time i woke up that night and had to "run" was around 1 am.

Maybe i should add that from time to time the "discharge" goes along with very large amounts of gas, if that is a sign for something..? Also at night it happens pretty regularly in two-hour-intervals (1 am, 3 am, 5 am) while during the day there is usually not much, maybe twice during the whole day (but i sit most of the time). Today it is worse, it keeps it's two-hour intervals all day even though i did not eat anything at all today.

Best regards.....

Thanh

[FBN]

Thanh,

Difficult to guess what those antibiotices were with that info.

The link attached below is to an article about "Travellers Diarrhoe" and contains a very useful table on the number of disease that can cause your symptoms, ways of transmission and also incubation periods.

http://www.traveldoctor.co.uk/diarrhoea.htm

Useful background info that will be good to have at hand when you go for a follow-up.

Best!

[monekyface]

Campylobacter is your issue!!! It is rampant here. I have been through the spectrum of antibiotics, up to an including Cipro, but nothing works like Zithromax. And you can get the generic (azithromycin) here as well. Zithromax destroys the proteins on which campylobacter feeds, unlike other antibiotics that provide only short-term relief because campylobacter has developed a resistance to them.

http://www.reuters.com/article/healthNews/...R40646020070214

It seems that if you do the single-dose (check with your pharmicist as I don't remember the precise dosage- two big capsules- maybe 1000mg?) it will give you a headache at least it does with me. I just keep some tylenol handy.

[Thanh-BKK]

Hi.

Seems you were right with that. At the hospital the doctor told me that neither stool nor blood yielded any knowledge of what i got, but matter of fact i'm literally shitting my guts out. Next they suggested an endoscopic check, however at 20,000 Baht i can't afford that the next few years.

Now i've gotten three new medicines (feeling like a lab rat - try this one and come back again to try the next one) and i'll give it till Saturday when my next appointment is due, i will then suggest this Zithromax to the doctor and see what he thinks about this type of bacteria (which, according to some googling, can not even be detected in standard tests, which would be another sign that i might just have that one).

The previous medicine which didn't have any effect at all is "Ofloxin" (Ofloxacin 200 mg).

What i got today is "Duspatin" (Mebeverine 135 mg), "Zentel" (Albendazole 200 mg) and "Flagyl" (Metronidazole 400 mg).

Best regards.....

Thanh

[saintofsilence]

do you have any of these symptons ?

[kyb789]

I had a similar problem. I contracted Salmonila and C-diff. The infection did not go away for 3 months. I've heard that Salmonila can be life-threatening and C-diff does not always go away...some people carry it for life. I was on Cipro and Flagyl for 3 months. No drinking. I finally got better.

The thing about antibiotics is that they do not always kill the parasite, they only prevent the parasite from duplicating. So you must take antibiotics for a long time until the original host dies from its normal life cycle. Good luck.

[Thanh-BKK]

Hello.

Now in the fifth week with this <deleted>, it still won't go away. "Zithromax" is already on the list of drugs that didn't do jack all, and even the "universal remedy" of Ultra-Carbon does nothing but colour the diarrhea black.

In fact after taking the Zithromax (three-day-variant) last week Monday, Tuesday and Wednesday things looked like they'd improve - less frequent runs, and i could sleep the nights through.... however once the additional drug (Duspatin) was used up (Saturday) it pretty much immediately got worse again and since yesterday i am once again shitting my guts out, waking up multiple times at night to run to the toilet (or, even worse and happened yesterday morning, waking up AFTER "it" happened.... so depressing!) and as mentioned Ultra-Carbon, which according to every website i read about it should stop any diarrhea immediately only adds the black colour to it.

I am at my wit's end and so is the doctor at Thainakarin. He keeps pushing for the endoscopic check however i doubt that it will reveal anything and i don't have the money for it anyway. So any idea what else i could try..? I have no stomach pain, no vomiting or other effects, "just" diarrhea but that often enough to literally dry me out. I have eaten nothing but Khao Tom during all of last week and drink nothing but "Sponsor" electrolyte beverage.

Ok i'm off to the hospital for the fifth time.......

Regards.....

Thanh

[TerryLH]

You mentioned being at the office.

Do you have Thai Social Security? If not, why not?

They provide good health benefits. They'd probably pay for the 'test', but only at the hospital you're signed up at, OR, at a hospital that you have been sent to by 'your' soc sec hosp.

Ask the hospital you've been going to if you can make a couple of payments over several months.

If all else fails, try one of the teaching hospitals. Let the med students get 'hands on' with your problem.

Good luck with this.

[WaiWai]

Thanh, look at this post in the thread titled "Bumrungrad". If you could contact the poster to get this doctor's name it may help.

Curt1591

View Member Profile 2009-06-15 09:56:48 Post #7

Member

Group: Members

Posts: 28

Joined: 2009-06-11

Member No.: 84,869

From my experience, over many years, I have found that if I want a problem to be solved, head to Bumrungrad. I have had varying degrees of success using both local and "international" hospitals in Bangkok. But, whenever I've taken my problem to Bumrungrad, I have come away with the cure.

They may seem to run excessive tests, and over prescribe, but being from the States, I am used to this. Besides, if the problem is cured, what the heck!

My latest episode:

I came down with my occasional bout with diarrhoea. After the Gastrol Bismol failed, I took a 5 day dose of Cipro. Everything seemed fine, but then the diarrhoea returned.

I went to a very famous, non-international hospital for diagnosis. The doctor said it was possibly this, that or the other thing. I asked if he wanted a sample. He replied that he has found that patients can't take a decent sample, then prescibed a weaker antibiotic and told me not to eat fruit, veggies, spicy food, milk ,... etc".

This yielded marginal results. But, when I returned to the doctor for a follow up, he pronounced me "cured"!

I did a follow up at Bumrungrad. The doctor discussed the possibilities and trusted me with the awsome task of taking a sample. At that point he said to continue what had already been prescribe and we will wait on the tests.

Well, I guess I was good enough to wrangle up two different "foreign" bacteria. But, what impress me was that, after finding the little bugs, they cultured them and tested their reaction to different antibiotics. The doctor made his prescription based on this.

But there's more.

After a couple days of taking the pills, I came down with some really heavy diarrhoea. We called the pharmacy, they contacted the doctor, he stopped one of the meds and the problem cleared.

Now we were stuck with had become expensive, useless meds.

NOT!

The pharmacy, following the doctors report, refunded the price of the unused medication, minus 10% because they have to destroy it. Try to find this in the States!

I've always been pleased with Bumrungrad. But, as stated before, doctors are individuals, and your mileage may vary!

This post has been edited by Curt1591: 2009-06-15 09:58:55

P.S. Link to the thread: http://www.thaivisa.com/forum/Bumrungrad-t272826.html

Edited June 22, 2009 by WaiWai

[Soutpeel]

Ultra-Carbon does nothing but colour the diarrhea black.

Without trying to state the obvious, there is something more wrong here than just "Food posioning"....

Sounds like you have antibiotic resistant form of "something" (this is what happens when Dr's start prescribing antibiotics willy-nilly)

Ultra-carbon will not cure you of something like this, granted for an occassional bout of the trots, Ultra-carbon will fix you up in about 3-4 hours, from experience with a lot of food posioning... ... usually a combination of Ultra-carbon and an antibiotic is in order..

If your own doctor can't solve the issue, you need to seek a 2nd opinion....5 weeks is a h*ll of long time to have the sh*ts, will not be doing your body any good....endoscopic check....Ha...what is that going to prove ??

As somebody else has pointed out, its normally requires mutliple blood test/stool samples to get to the bottom of something...

Also note...once cured, if you keep getting stool samples, they will keep coming up positive for months after...Contracted a dose of Salmonela, went the hospital, on the meds for two weeks as requested, went back for another stool test and it came up positive again....Dr said I wasnt cured and wanted to put me on more medication, even though had no symtoms and he wouldnt sign my medical fitness certificate to work offshore....very annoying....

Did a bit of research in Lancet and it appears that being given high does of antibiotics to cure this can cause your test to come up positive for Salmonela for upto 3 months after being cured, so armed with the Lancet article, back to the hospital and showed the Dr ..."Oh" was the answer..."never knew that".... ....given a clean bill of health about 10 minutes later....

[FBN]

Thanh,

You are now probably beyond whatever may have caused this in the first place. All the antibiotics have change your intestinal flora so much that it becomes really difficult at this stage.

What usually happens now is one of the following:

Tropical Sprue

Pseudomembranous colitis (C. dificile as one poster mentioned above)

Candida or fungal diarrhoea

Irritable bowel syndrome. The intestines may become so irritated by the strange bacteria/fungi now colonising it after the antibiotics, it is simply irritable and takes time and a proper diet combined with taking some "probiotics" and lactobacillus to try and get the normal balance of bacteria back.

Suggest you google each of the above and see if you come across any familiar symptoms.

It may be worthwhile to stop all medication for a few days or so and see what happens. (Colofac is an antispasmodic that works on the larger intestine and is sometimes used in IBS)

Good Luck!

[Thanh-BKK]

Hi.

Well today i have seen a different doctor (but in the same hospital) and got different medicine and advice again..... Now i've got "Ciprofloxacin" and "Imodium", the latter only to be taken if i get diarrhea too often.

According to this doctor i should not have eaten normal food on Saturday (as i did, expecting it to be over with because i felt ok that day...) and instead should have stuck to Khao Tom. Now he told me i should not eat anything but Khao Tom or Joke or similar soft-soupy foods without any fat for at least another four weeks.....

@Terry

I don't have a health insurance for the same reason i don't get the endoscope check... i simply can't afford it. I have gotten several offers, each between 25,000 to 50,000 Baht, to be paid in one "go". If i had that much money lying around i would have a few less worries. Also at this hospital a partial payment is no option - all at once or no check.

@WaiWai

Bumrungrad is rather far from where i live, it would be a total nightmare to get there. Plus from what i have heard it is also on the expensive side, even more so than Thainakarin which is already costing an arm and a leg. But i can get to Thainakarin in 5 minutes if there is urgency.... while Bumrungrad would be more like 1 1/2 hours.

@Soutpeel

I get all these antibiotics indeed as kind of a test - which one will work? Because they DID a stool test (just one though) and could not find ANYTHING. All the while it's burning holes in my pocket and does not seem to have any effect on whatever bug there is in my guts.

@FBN

Zithromax was the last antibiotic i took, last week. Thursday, Friday and Saturday i didn't take any, just that other one which is supposed to prevent an upset stomach, it was to be taken before eating. And indeed the situation did improve, yeah - until yesterday morning when it started all over again. I did take the Lactobacillus stuff (Betagen) but seemed to have no effect either.

Best regards.....

Thanh

[Curt1591]

@WaiWai

Bumrungrad is rather far from where i live, it would be a total nightmare to get there. Plus from what i have heard it is also on the expensive side, even more so than Thainakarin which is already costing an arm and a leg. But i can get to Thainakarin in 5 minutes if there is urgency.... while Bumrungrad would be more like 1 1/2 hours.

Best regards.....

Thanh

My total cost at Bunrungrad, including 1st visit/consultation, lab work, follow up, and prescription, ran around 7,000 baht,... CURE INCLUDED!. Yes, it was more expensivie than the local hospitals, but it worked.

I live in Wongsawang. It was worth the journey.

[PeaceBlondie]

Thanh..even at Bumrungrad and Samitivej, you have to get kind of lucky. Samitivej's double specialist was clueless as to which bacteria was internally devouring my shoulder. In Texas, when I nearly died from diarrhea for a year, the best specialists said "I can't help you." She interviewed me anyway, asking most intimate details of my sex practices. Then she checked my lab tests and discovered that some latest antibiotic had cured me of blood poisoning from pseudomonas cepacidae. Good luck.

[sabaijai]

I believe three days is not long enough for most courses of antibiotics to do the job properly. I've always been told 5 days minimum, 7-10 days better.

Mixing a lot of different antibiotics or taking them one after another can cause irritable bowel syndrome.

[Datsun240Z]

Imodium

[adammike]

I have been having diarrhea on and of for some time, and on my last trip [january] I never felt good and finally got hit with a flu virus.

I never really got well in fact felt like shit for 2 weeks.When i arrived in Bangkok for my last few days the shits started emptied me out.

When I arrived home I was not so bad but not really well,but the diarrhea slowly got worse I lost 15kg thats 2 stone.

I felt like shit so went to the doctor who sent me for blood/faeces[3]/urine tests, nothing showed up in fact everything was great but I

was really not well,the doc said first we will try an anti-biotic he gave me Metronidazole not such a broad spectrum anti-biotic.

In a week I was fine.

I think my problem was having 3 courses of anti-biotics in 2 years, played havoc with my intestinal flora these broad spectrum antis

wipe out the good along with the bad,this allowed the bad stuff to take over

I would think that you really must stop with the meds and get some pro-biotics as another poster said, these will maybe get your intestinal

flora back on track

Google pro-biotica there are some hippy dippy sites but the message is right

good luck.

[Datsun240Z]

Another way, eat alot or rice, rice ,rice and banana

[adammike]

I would recommend lots of fresh vegetables [lay of the spices and coffee ] try and get some yoghurt.

[coconut also can give you the runs],broccoli,garlic,yoghurt I would think you need some roughage

brown rice lay of the processed food.

[Nam Plah]

Zentel" (Albendazole 200 mg) and "Flagyl" (Metronidazole 400 mg).

These are anti-parasitic medicines.

It sounds like a parasitic infection like Ascaris Lumbrcoides (common roundworm) or some other fairly hardy variety.

The worms themselves may be harboring bacteria which they release into your digestive tract with their own waste.

Those antibiotics get the bacteria that are free but not the ones inhabiting the parasites.

Many species of human gastrointestinal parasites are more active at night, shedding their waste and being motive hence your inability to "hold it in" during those nocturnal hours.

The above mentioned medicines should clear up the buggers.

Natural alternatives are raw pumpkin seeds, garlic and chlorophyll, like that in sprouts and raw green veggies.

Also give yourself some B12 and multi vitamins (LipoVitan is a good choice) and rink plenty of water to counteract the dehydration associated with chronic diarrhea.

Feel better and good luck.!

[phetaroi]

I don't want to be a pessimist, but I note that no one in the forum has suggested that the cause might not be an infection or parasite, but rather some thing along the lines of cancer or other more common intestinal conditions. Probably not as likely as in the West, but that whole range of conditions need to be ruled out if things continue.

[wpcoe]

Imodium

Immodium merely temporarily masks the symptoms, and does absolutely nothing to cure the source.

This may not be technically correct, but Immodium basically paralyzes the digestive tract to keep feces from being expelled form the body. That's not the permanent relief the OP is looking for.

[Gaccha]

The onset of food poisoning is usually from within about 4-8 h and does not last more than 24 or 36h.

This is most probably and infection by anything from Amoeba to Giardia or Cryptosporidium.

I am sure that's it. [giardiasis]

The give away is your description of belching. In time, you will get nauseous to the smell of the diarrhoea. Also, can you confrim the diarrhoea is of only small amounts and that they come out like farts, not large stools...? Does your belching stink?

I would take quinacrine (this can actually make you go crazy so only take it if your getting desperate). Tell the doctors when you next see them that you have almsot certainly have giardiasis.

In the meantime, wash your hands thoroughly. It is highly infectious and anyone living with you is almost certain to get it.

The parastite is very difficult to detect in stools. It often requires repeated tests. If you leave it, it will cure but then return in about 6 months. So don't leave it.

[Gaccha]

he gave me Metronidazole not such a broad spectrum anti-biotic.

In a week I was fine.

Actually this wil be better than quinacrine that I recommend above. Obviously Adammike had giardiasis.

It will not make you go crazy and is more effective. But I think it will be expensive or unavailable in Thailand. Still look for it.

[Soutpeel]

Imodium

Immodium merely temporarily masks the symptoms, and does absolutely nothing to cure the source.

This may not be technically correct, but Immodium basically paralyzes the digestive tract to keep feces from being expelled form the body. That's not the permanent relief the OP is looking for.

Immodium is the last thing you take, as wpcoe has said, it masks symptoms and actually keeps the problem inside actually prolonging things. A good friend of mine is a pharmacist, and actually suggested one time that immodium may actually cause liver damage....Her recommdation for the trots....start with Ultra-carbon, if this doesnt fix you up in day, then you need an antibiotic for around 7 days, combined with ultracarbon until the trots have stopped, have followed this advice over the years and 9 times out of 10 it worked in may case

[bartender100]

Sounds like you have had a nightmare, i was just congratulating myself on how well i have been feeling this trip,(1 day left).

Without stating the obvious, what about your living conditions , could you water supply be contaminated or fridge, have you had any bites that re playing up? do you have a partner you can trust, there was a thread recently about a guy that's been slowly poisoned by his missus. I am sure you have thought about other reason, but i did not see any mentioned in replies

[adammike]

i was negative for giardia/cryptosp.screen

yersinia

shigella

campylobacter

salmonella

faeces parasieten prep

lues TPHA

trichomonas antigeen

GO urine kweek

urine gonoc DNA

hiv as.[1+2]

urine Chlamydia DNA

hep b,c

[Thanh-BKK]

Hello again.

Something seems to be doing something now. Yeah i know, double unknown.... anyway i took the new antibiotic yesterday as prescribed, 1 each for lunch and dinner (both of which were plain Khao Tom without any add-ons whatsoever) and before going to nbed i took two of those Imodium (doctor said only to take them before going to sleep or when the diarrhea comes too often). I didn't drink anything but plain water or electrolyte replacement stuff that's diddolved in water.

I could sleep that night through.

Today again - no breakfast, lunch and dinner both plain Khao Tom followed by one Ciprofloxacin and no further food later in the evening. Again drinking only plain water or electrolyte stuff.

And - i didn't have diarrhea even ONCE throughout the entire day! No other stool either, for that matter, however i could pee normally again (which when i had much diarrhea almost stopped completely).

So either the diet or the meds or a combination thereof does have some effect. I won't take Imodium now, let's see what happens.

Best regards......

Thanh