At What Point Do You Go To The Doctor For A Stomach Upset Here In The Land Of Risky Food And Water?

[phetaroi]

Over the years I've had TD a couple of times in Thailand...twice really bad. Although, the two worst cases of food poisoning I ever had (once e-coli) was actually in the States!

I'm having my first bout since moving here. Nothing seemingly that bad.

How do you who live here handle it? At what point do you go to the doctor or ride it out or take an antibiotic?

[PeaceBlondie]

I wait till the 2nd or 3rd runny movement. Then I take two 2-mg tablets of Immodium, and one after each BM. If that doesn't stop the runs, I'd see a doctor for testing. Usually don't have to.

[Crossy]

Here in India, where the food and water is infinitely more risky than Thailand a case of Delhi-Belly (or in my case Bangalore-Bowel) is a regular occurrence

Like PB I give it a day or so to go away on its own (drink lots of water to avoid dehydration) then trot off down to the pharmacy for the antibiotic of the day and some Immodium to dry things up.

I don't like to take the Immodium immediately (unless flying), I'd rather keep things moving and hopefully flush out the bad bugs without resorting to antibiotics.

[PhilHarries]

A colleague of mine got very ill from taking immodium and had to be medivacced out of central VN. If you are experiencing the runs it's because there's something bad inside and the body wants it out. Therefore best approach is leave it for a day or two before seeking medical advice. There are alternatives to immodium which are better for the body.

As Crossy says the key is drink water to avoid dehydration, the one time I had a bout of dysentry they admitted me to the Bangkok Pattaya and all they did was rehydrate me via IV drip and electrolyte drinks. Fortunately it was on medical insurance so the costs didn't bother me.

[Samuian]

A colleague of mine got very ill from taking immodium and had to be medivacced out of central VN. If you are experiencing the runs it's because there's something bad inside and the body wants it out. Therefore best approach is leave it for a day or two before seeking medical advice. There are alternatives to immodium which are better for the body.

As Crossy says the key is drink water to avoid dehydration, the one time I had a bout of dysentry they admitted me to the Bangkok Pattaya and all they did was rehydrate me via IV drip and electrolyte drinks. Fortunately it was on medical insurance so the costs didn't bother me.

yes, im-modium, just stops the bowel movement!

in the 70ties in Afghanistan there was wide use of tiny portions of opium and black tea ..

...add electrolytes to the water, black unsweetened tea....

if hit while on the road or long distance travel I use Bactrim only in severe cases!

unless there is blood in the stool, vomiting and heavy cramps,

give it a day or three.

[harrry]

I usually go fairly quickly now if one day doesnt stop it and imodium doesnt work quickly. I found that going too slowly can make it very very hard to go out to the doctor here especially in a wheelchair

[siggie2]

Never had a bad bout of food poisining in Thailand,but most other countries,inc Spain,portugal,usa,canada,greece,turkey i have always got a bad tummy.Never take antibiotics,the worst thing for your body continuous.Get your immune system fighting it,with plenty of water and soft bog paper lol.Must be lucky with no illnesses in Thailand except for a bad flu bug a couple of weeks ago but i did visit uk and was on 2 planes so might have caught it there

[Cuban]

Unless you are passing blood (either red or dark brown/black) give it at least 2/3 days before seeing a doctor. You will be fine not eating for two days, as others say drink clean water - not excessive amounts. If you are not taking any other food add a little sugar and salt to the water. If you feel like eating something but can't face real food your body can survive on only yogurt and rice (brown is best) for a long time.

Diarrhea loves to spread itself around, it's a feature of the watery splash - beware of spreading via hand contamination etc.

As for stopping your body from ridding itself of the bugs - only if you need to travel, otherwise let your body deal with it.

[deejah]

there is some pretty strong and cheap medicine

you get 4 large pills in a yellow paper pack for 10 or 15 baht

DISENTO

if all else fails i use those

try one and later if needed 2

that almost always clears things up in a day or two

still havn't needed a doc for the stomach yet (knock knock)

after many years and many a bad stomach

good and strong medicine

not aware of any dangers

has 5 different medicines in it

i swear by the stuff and think everyone should know about it

i really hope this helps someone

[Soutpeel]

Here is the advice I recieved from a friend of mine who is a pharmacist many years ago...

1. Start off with charcoal tablets - 2 every 4 hours, if a minor dose of "something"...should be clear within 12 hours..

2. If above dont work carry on with charcoal tablets and take an antibiotic for two days, and continue with antibiotic for 5 days

3. If above dont work/see improvement and you are into your 4th or 5th day.....go to hospital

Obviously with above drink as much water as you can get down your neck

Also recommended that you never take immodium...

[Sheryl]

Disagree with #2 above and other posters who recommend antibiotics.

Indiscriminate antibiotic use can greatly aggravate problems, among other things will kill off normal gut flora.

Over the years we've seen quite a few threads of people with chronic and intractable intenstinal problems stemming from or aggravated by shotgun treatment with antibiotics.

Basic management of acute diarrhea is to let it run its course and concentrate on maintaing adequate hydration. If unable to keep adequately hydrated (for example, if vomiting or high fever) then go to hospital.

Charcoal won't hurt. Immodium = avoid unless absolutely necessary e.g. if you have to travel somewhere.

Most cases will clear up on their own in a few days. If it is persistent then can either see a doctor or, if you like and the signs seem consistent with it, first treat presumptively for giardia (flagyl or tinidazole) and then if no impreovement see a doctor.

Eating yogurt (preferrably non-sweetned) or taking probiotics also very helpful.

[mauiguy90]

When I first moved here, I had a bad case of "tong sia"(10 days). After several days of suffering, I took some meds my girlfriend got from a pharmacist that she uses. I felt a little better, but it continued for another 5 or so days so I went to a clinic. When I showed the doctor the meds I had, he laughed and gave me Norflaxacin. One pill later, I was all better. I don't get sick that often but when I do, I take Norflaxacin. It works--very fast. No suffering required!!!

I'm all for natural methods of dealing with health problems but I don't like spending endless hours in the bathroom. Next time I'm ill, I will remember to have a healthy serving of natural yogurt to restore the healthy bacteria after I'm all better.

Edited December 18, 2009 by mauiguy90

[PeaceBlondie]

I spoke too soon. Got diarrhea a day later. Cleared w/in 1.5 days. Did not take Immodium.

[ricklev]

Norflaxacin - Single dose on 2nd day and then see doctor on third-fourth day if not cleared up.

That's the most current medical thinking, as best as I can tell and it has always worked for me.

[Benjie]

Wow, reading up about Norfloxacin - I'm really surprised people are taking this for a dicky belly.

"Norfloxacin is associated with a number of serious and life threatening adverse reactions as well as spontaneous tendon ruptures and irreversible peripheral neuropathy. Such reactions may manifest long after therapy had been completed and in severe cases may result in life long disabilities. Hepatoxicity resulting in fatalities has also been reported with the use of norfloxacin."

quote from wiki.

[xylophone]

I too was surprised at the use of Norfloxacin, as there are other, lesss drastic, antibiotics which can be used.

However having said that, the advice given above in general is the best -- -- stay away from immodium if possible (unless travelling), plenty of fluids with an electrolyte drink, and monitor the situation. If it does not improve within two days, then a visit to the doctor/hospital where they will probably take a stool sample, and administer the appropriate medication.

About four years ago I was struck down with a bad dose of the "runs", and immediately I took the water, I would be on the toilet again, and this went on perhaps 10 or 12 times throughout the night, and by that time I had started taking Immodium, but the condition was so severe everything was going straight through me. I managed to get a taxi to the local hospital, where I just about passed out in reception, and woke up about half an hour later with intravenous drips and all sorts (luckily I had health insurance).

I was in hospital on intravenous fluids and antibiotics for over four days, and despite all of the tests they did, they could not isolate the exact cause. However I did gradually improve and left hospital a lot lighter and very frail. I have not had anything as bad since.

On the subject of antibiotics, my son (a doctor) recommends d'oxycycline, a cheap and broad spectrum antibiotic which has been around for years, and it can be used as a prophylactic measure when travelling to places where "travellers diarrhoea" is quite common, and it is well tolerated provided it is taken after food, but watch out for excessive exposure to sunlight.

[ricklev]

http://news.health.com/2008/07/08/fda-blac...pic=Norfloxacin

Yes, you are right, maybe Norflocacin isn't such a good idea. It's hard to assess the risk so I shouldn't be suggesting it.

Too bad, I've had food poisoning five or six times in the last 20 years or so and a single dose has completely cured it within a few hours and with minimal antibiotic side effects.

I first tried it after reading this study: http://aac.asm.org/cgi/reprint/30/5/671.pdf But that was almost 20 years ago.

[wjmark]

Here in India, where the food and water is infinitely more risky than Thailand a case of Delhi-Belly (or in my case Bangalore-Bowel) is a regular occurrence

Like PB I give it a day or so to go away on its own (drink lots of water to avoid dehydration) then trot off down to the pharmacy for the antibiotic of the day and some Immodium to dry things up.

I don't like to take the Immodium immediately (unless flying), I'd rather keep things moving and hopefully flush out the bad bugs without resorting to antibiotics.

My time in India was always lucky - I eat the street food and everything - no real problems. But I heard a clever idea recently.

A woman who was always having stomach problems in Delhi started carrying anti-bacterial gel with her and washed her hands before every meal - apparently her stomach has been fine since...

Of course, the hand is a more common eating instrument in India than here in Thailand

[Soutpeel]

Disagree with #2 above and other posters who recommend antibiotics.

Indiscriminate antibiotic use can greatly aggravate problems, among other things will kill off normal gut flora.

Over the years we've seen quite a few threads of people with chronic and intractable intenstinal problems stemming from or aggravated by shotgun treatment with antibiotics.

Basic management of acute diarrhea is to let it run its course and concentrate on maintaing adequate hydration. If unable to keep adequately hydrated (for example, if vomiting or high fever) then go to hospital.

Charcoal won't hurt. Immodium = avoid unless absolutely necessary e.g. if you have to travel somewhere.

Most cases will clear up on their own in a few days. If it is persistent then can either see a doctor or, if you like and the signs seem consistent with it, first treat presumptively for giardia (flagyl or tinidazole) and then if no impreovement see a doctor.

Eating yogurt (preferrably non-sweetned) or taking probiotics also very helpful.

Sheryl,

You are of course 100% correct over the use of antiboitics, but think my friend the pharmacist, was giving me specific advise considering at the time I was working in many 3rd countries and suggested I always carry a supply of antibiotics and charcoal tablets as he was working on the assumption that in some of the sh*t holes I was working either had inadequate or non-existant medical treatment/facilities

I have followed this regime for over 20 years and has worked on every occassion, with the exception of one time where I landed up in hospital in Thailand, after a bout of "delhi-belly" that would not clear

[phetaroi]

Well, as the OP, I will just report that I am still not back to normal. Took a 3-day course of Azithromycin. Things improved, but again, not back to normal. Finally went to Bumrungrad yesterday. Very impressed with the doctor. Basically he says: 1. Just relax, you'll be fine, almost certainly nothing truly serious. 2. Azithromycin was excellent med to take, but only for 3 days. 3. Today I get to gift them with a stool sample. :-) After all Christmas is the season for personal gifts. They will look for nay unusual strains of whatever. 4. The longevity of this may well be related to my IBS making it a longer recovery than would be expected.

Meanwhile I will continue to live on chicken, bananas, water, an occasional soda, and a few other very select items.

I will add that on the way to Bumrungrad we got in a horrible traffic jam and at an inopportune moment I had to simply jump out of the taxi and walk the rest of the way. Thank god it was just Big-D and I wasn't having a heart attack!

[wjmark]

Well, as the OP, I will just report that I am still not back to normal. ... snip...

Meanwhile I will continue to live on chicken, bananas, water, an occasional soda, and a few other very select items.

Good luck, of course!

I find that just plain rice, perhaps with a spoonful of natural (live-culture) unsweetened yoghurt and a little bit of banana works really well. Just some salt on top...

Tea (without milk) to drink...

Once you graduate to chicken, I hope it is not fried!!!

And I hate to say it, but lots of people find a glass of Coke works wonders. (Also dissolves steel nails, so go figure...).

[kikoman]

I never eat cold street food ,must be hot. I have not been bothered by stomach problems since moving to the village, all my food is home cooked!

Thais are use to not refrigerating leftover till the next meal , my wife and daughters do that, they have been doing it all their lives and I guess are immune to the bacteria growth. We have a pact they can do that but I will never be served unrefrigerated food, works well.

If I do get the runs ,I go on a liquid diet until it has run it course. Which last at the most 2 or 3 days. No medication ,No doctor visits, yet!

Cheers:

[phetaroi]

I never eat cold street food ,must be hot. I have not been bothered by stomach problems since moving to the village, all my food is home cooked!

Thais are use to not refrigerating leftover till the next meal , my wife and daughters do that, they have been doing it all their lives and I guess are immune to the bacteria growth. We have a pact they can do that but I will never be served unrefrigerated food, works well.

If I do get the runs ,I go on a liquid diet until it has run it course. Which last at the most 2 or 3 days. No medication ,No doctor visits, yet!

LOL...I know the feeling. Solved the problem at this home. If its something only my Thai SO will eat, fine, he can leave it out as long as he wants. If its something I will eat and it is not stored properly, I toss it in the trash. It didn't take very long before most things got stored properly and fairly quickly.

I agree with street food, in fact I rarely eat it anymore, even though I enjoy it. Occasional exceptions, but unless I can watch it being grilled when its along the street, I pass it by.