Food Poisoning

[Yooyung]

Hello all,

Yesterday I woke up and had some of the worst bouts of diarrhea in a long time. I estimate that between 7:00 am and 3:00pm I went to the toilet about 25 times! I went to the doctor and, of course he told me I had food poisoning.

The thing that I dont understand is the medicine he has given me. I had no fever or vomiting.

He has given me:

Ciprobay 250mg 2 times twice a day

Flagyl 200 mg 2 tablets 3 times a day

Motilium 10mg 3 times a day... and some tablets to chew for flatulence

Is this overkill? I am feeling like shit and I think its prob the meds after looking into them on the net. Thats 2 types of antibiotic. I am certainly no expert but I thought that antibiotics would not be necessary, afterall I had no fever so my body wasnt fighting anything ( just a thought, though I really dont know)

I have met some dodgey docs in Thailand ( and good ones) over the last 8 years and am sure they get a cut in the meds they give out.

Should I just not bother to continue? My runny tummy has gotten better. What do you think?

[jrbkk64]

You could consider it overkill. However they would have to do a stool test and some others and it takes 3-4 days for a result. Without medicine you will probably suffer longer. Antibiotics and specifically Cipro kill bacteria like salmonella (needs 7-14 days of cipro twice a day). Untreated you can pass them on to others through food and contact and over the longer term they could cause al sorts of issues. There are many other bacteria associated with food poisoning and many of them need antibiotics.

If you really want to know you should get stool tested at least.

[wpcoe]

I'm not a doctor, nor do I play one on television, but I have had three rounds of food poisoning/dysentery. After the first one, that I simply waited it out -- beginning with explosive diahrrea at 15-20 minute intervals -- by drinking lots of water and sports drinks (Gatorade type beverages), eating fruit and yoghurt, I returned to Thailand (I was in Japan when things started) and saw a doctor at Bumrungrad. He said that dysentery can be either bacteria, worms or protozoa.

Only bacterial dysentery would be treated with antibiotics. The cause can only be determined via testing. Did your doctor do any testing, or just prescribe antibiotics in the 1-in-3 "chance" that it was bacterial in nature?

My doctor said two of the worst things to eat while suffering dysentery are fruit and yoghurt (of course...) He reminded me -- I knew this and was drinking a sports drink -- that in addition to remaining hydrated, is to keep mineral/salts up. He said a quick and easy method was to drink Coca Cola with salt added. Thought it sounds gross, it's not so bad -- I did it with my subsequent dysentery bouts. You can also buy inexpensive packets from any pharmacy here in Thailand to add to a glass of water.

Also, he said to not take Immodium or other anti-diarrhea medications unless needed to be able to transport to another location for treatment. Apparently what those anti-diarrhea meds do is essentially paralyze the digestive tract to prevent the expulsion (diarrhea). By preventing the expulsion you may be increasing the toxicity of your system.

[wpcoe]

jrkk644 posted as I was composing my epic novel above. I thought test results could be quicker, in that an observation of a stool sample under a microscope would confirm/deny the existence of protozoa or worms? To confirm the bacteria, might take a few days, but in the absence of protozoa or worms, those treatments could be eliminated? (Please note, these are questions -- and assumptions of mine -- and I'm asking for feedback on them.)

[edited to correct jrbkk644's name.]

Edited January 26, 2010 by wpcoe

[JimmyTheMook]

The vomiting and diarrhea are your bodies natural defences trying to eliminate the poison, the cipro sounds correct.

Also follow the BRAT diet

Bread

Rice (sticky rice works good)

Apples (peeled)

Tea (weak tea - no milk)

[TheWalkingMan]

...

Also, he said to not take Immodium or other anti-diarrhea medications unless needed to be able to transport to another location for treatment. Apparently what those anti-diarrhea meds do is essentially paralyze the digestive tract to prevent the expulsion (diarrhea). By preventing the expulsion you may be increasing the toxicity of your system.

Agreed! I took some Immodium once... It slowed down my plumbing to a stand still. Not a pleasant feeling.

TheWalkingMan

[PhilHarries]

jrkk644 posted as I was composing my epic novel above. I thought test results could be quicker, in that an observation of a stool sample under a microscope would confirm/deny the existence of protozoa or worms? To confirm the bacteria, might take a few days, but in the absence of protozoa or worms, those treatments could be eliminated? (Please note, these are questions -- and assumptions of mine -- and I'm asking for feedback on them.)

[edited to correct jrbkk644's name.]

I agree will all you said in your first reply. I was admitted to the Bangkok Pattaya with dysentry and I provided them with a stool sample (not a thing for the faint hearted to attempt) and the results were back in hours. They kept me in for two nights and all they did was feed me antibiotics, connect me to a saline drip and fill me with electrolyte drink. I could have rehydrated myself just as well at home but wasn't too bothered as the health insurance covered it.

[Yooyung]

Hello again.

Thanks all for the quick replies.

No, I had no stool sample taken. I felt like shit last night, had a hard time sleeping and was very moody. I reckon its the meds. I still have a bit of diarrhea ( but not watery like beofore) but I have read that flagyl can also cause it! I'm sitting here now wondering if its really worth popping any of this crap! I know its not good to start antibiotics and stop but I only started them on Monday afternoon.

Cheers.

[chiang mai]

I think the doctors prescriptions are broadly correct and are what I would take, but one important item was left out, drink lots of fluids because it's very easy to dehydrate out here and that can be far more dangerous than the stomach bug, flat coke or plain tea work well.

[Sheryl]

Thjis is typical Thai medicine "shotgun" approach -- tretaing you for all possibilities without knowing if you have any of them.

Flagyl is for protozoa (ameba or gardia) and these can be identified right away in a stool sample. Plus it's nasty stuff to take. Makes many people very nauseous.

Cipro would be indicated only for bacterial food posoning and even then most cases will recover without it. You mention feeling wierd and being moody, that's the cipro, it can have neurological side effects is some people (inlcuding headache, insomnia and mood swings).

If it were me and given no fever I wouldn't take anything, just concentrate of staying hydrated and let nature do the rest.

Regardless of what you decide to do re the meds, be sure to drink a LOT of fluids, enough to keep your urine light in color. Oral rehydration sachets, sports drinks or green coconut water also advised as these will help replace the electrolytes you lost with all that diarrhea.

[syd barrett]

Most people get the odd case of diarrhea in the tropics.

Unless there is blood and mucus present in the diarrhea (*) or you have a fever with agonizing stomach cramps then let it take its course.

Rehydrate with STONG-K mineral sachets and stay close to the toilet.

Beware of local drinking water, boil it first.

Diarrhea in farang is Thai Doctors bread and butter.

Self treat unless it is serious (see above) (*) or lasts for 72 hours or more.

[phetaroi]

The only caution I would like to mention is for those of us who already have an intestinal condition of some type. Then food poisoning can be far more serious because it can further damage natural processes in the intestinal tract.

For most of my life I have suffered from some degree of IBS. Always manageable, although along with it was a moderate case of dairy intolerance (I could eat cheese, for example, but regular milk was a no-no). A couple of months ago here I had a bad case of food poisoning. Now I am suffering from what is called "post-infectious IBS", where the conditions worsen...which could clear up over time, or not. Suddenly I am very daily intolerant.

My only point here is that one should consider their general intestinal "health" when deciding how to react to food poisoning.

[Yooyung]

Thanks all,

I have decided to go it without the meds and just keep up the electrolytes. I still have a bit of diarrhea but then again I was an idiot last night and ate some kfc that my sister in law brought over. That really didnt sit well. Thing is I am feeling fine within myself, still no fever and no pain, just a bit of a queasy feeling. It has been a while since this whole thing came on though and thats the only thing thats bothering me. I started Sat, eased off and came back Mon. Is the fact that its been that long a problem? Certainly its over 72 hours and obviously I havent been eating much since saturday.

Anyway thanks for all the feedbck. It gives me a little more faith in the forum again. Makes a change from sifting through a load of bickering about trivial things.

Cheers.

[syd barrett]

Thanks all,

I have decided to go it without the meds and just keep up the electrolytes. I still have a bit of diarrhea but then again I was an idiot last night and ate some kfc that my sister in law brought over. That really didnt sit well. Thing is I am feeling fine within myself, still no fever and no pain, just a bit of a queasy feeling. It has been a while since this whole thing came on though and thats the only thing thats bothering me. I started Sat, eased off and came back Mon. Is the fact that its been that long a problem? Certainly its over 72 hours and obviously I havent been eating much since saturday.

Anyway thanks for all the feedbck. It gives me a little more faith in the forum again. Makes a change from sifting through a load of bickering about trivial things.

Cheers.

If it continues for several days, consider a stool-test.

There is a possibility of cryptosporidiosis here in Thailand.

[PhilHarries]

There is a possibility of cryptosporidiosis here in Thailand.

Is that the one from rat's urine? This is why you sould never drink direct from cans, use a straw or pour into a glass.

[syd barrett]

There is a possibility of cryptosporidiosis here in Thailand.

Is that the one from rat's urine? This is why you sould never drink direct from cans, use a straw or pour into a glass.

Good advice, always use a glass to drink beer or else wipe the neck of the bottle with an antiseptic wet-wipe.

Leptospirosis is the rats-urine disease. (Bacterial).

Cryptosporidium is a different (parasite) infection.

[thaipod]

I've found that carbon tablets to absorb the bacteria works well with sipping electrolytes with rest . I only take norfloxin antibiotics if it's serious.

[bellste]

Hello again.

Thanks all for the quick replies.

No, I had no stool sample taken. I felt like shit last night, had a hard time sleeping and was very moody. I reckon its the meds. I still have a bit of diarrhea ( but not watery like beofore) but I have read that flagyl can also cause it! I'm sitting here now wondering if its really worth popping any of this crap! I know its not good to start antibiotics and stop but I only started them on Monday afternoon.

Cheers.

Continue the cure as the doctor have told you, that is my advice. My wife and me, have always done as they have told us, and it has always worked for us.

Edited January 28, 2010 by bellste

[chiang mai]

There is a possibility of cryptosporidiosis here in Thailand.

Is that the one from rat's urine? This is why you sould never drink direct from cans, use a straw or pour into a glass.

No, you're thinking of Letospirosis or Weils disease, nasty.

[Sheryl]

Thanks all,

I have decided to go it without the meds and just keep up the electrolytes. I still have a bit of diarrhea but then again I was an idiot last night and ate some kfc that my sister in law brought over. That really didnt sit well. Thing is I am feeling fine within myself, still no fever and no pain, just a bit of a queasy feeling. It has been a while since this whole thing came on though and thats the only thing thats bothering me. I started Sat, eased off and came back Mon. Is the fact that its been that long a problem? Certainly its over 72 hours and obviously I havent been eating much since saturday.

Anyway thanks for all the feedbck. It gives me a little more faith in the forum again. Makes a change from sifting through a load of bickering about trivial things.

Cheers.

What constitutes "a bit" ? If still multiple bouts each day then would be wise to get a stool test.