Medication Advice Needed For Rampant Diarrhea

[Mobi]

I have had terrible diarrhea since Sunday, just passing volumes of liquid, and today (day 3) it is getting worse.

I also have a mild to moderate fever 99 - 100+.Degrees F. and occasional stomach cramps.

Last Saturday night I ate quite a lot of fresh oysters at a seafood restaurant, and I am assuming that this may be the cause of my problem but can't be absolutely sure.

I have been taking Amoxil 500 mg since Sunday evening, but today my condition seems to be worse than ever.

I also have a large supply of Cifloxin, (Ciproflaxin 500 Mg), but am unsure if I should switch to this or try something completely different.

You may wonder why I don't go to a doctor?

Well I have no faith in any Pattaya based doctors. If I go and see a hospital -based doctor they will charge me a small fortune to carry out every test known to mankind, or the clinic doctors will give me a range of meds in the hope that one might work. For me, neither approach is satisfactory.

Anyway, if there is anyone who can recommend a good med for food poisoning/acute diarrhea, I would be grateful.

[Sheryl]

Mobi

Do not mess about with antibiotics on your own, may well make things worse (this includes the Amoxil)

Take activated charcoal (see current thread for brand names) and drink plenty of fluid, enough to keep your urine clear in color. Coconut juice is especially good as it has the needed electrolytes

If it persists OR if fever increases OR if you are unable to take in enough fluid to keep your urine clear in color, OR if any blood/mucus in the stool

Then :

see a doctor. Samitivej Sri Racha or Queen Sirikit probably being the nearest good options.

Whatever happens stay on top of your BS especially if you aren't able to eat much for a while.

[wpcoe]

If fresh coconut juice is not available, every pharmacist sells packets of electrolyte powder to mix with water. Dehydration and loss of electrolytes are both critical issues with severe, constant diarrhea.

[Jdietz]

All of the above, but I'll personally switch to ORS (Oral Re-hydration Salts) packets dissolved in lukewarm water, in combination with Cipro 500 3x daily for 3 to 5 days.

But in your case as it has been going for a while, I'd certainly advise to go see a doctor...

[Naam]

two capsules of Immodium (available in each and every pharmacy) should settle the case within two hours Mobi. but you still have to replenish lost electrolyte.

[nonthaburial]

I dont wish to be an alarmist, but be very aware. I had the same problem in the early 80's in Manila whilst on vacation, exactly as you describe it and after a week I couldnt keep awake. I realised I was in trouble and somehow managed to make my way home to HK. I can remember my wife calling a Doctor who came to the house and I can recall him saying "The only question I am going to ask you is which hospital do you want to go to". Luckily the British military Hospital was still operating then , and I honestly cannot remember anything else until I woke up 2 weeks latert with drips etc everywhere AND a very yellow complexion and dark urine.

I was also lucky that at that time a visiting tropical Disease Doctor was 'on loan" to the BMH from Harley Street. He openly told me that I was lucky to be alive. I spent nearly 6 weeks in hospital and the only charge I had to pay was for a can of mushroom soup the day I was released.

Thats what Hepititis did to me and the culprit was the same as you are suggesting Oysters

[neverdie]

Mobi,

I don't want to be alarmist either, but when in the middle east I got extremely sick with Salmonella Poisioning, Abdominal cramps, diarrhea, fever like what you describe were all present. I also had vomiting, which after the inital stage just became a feeling of unwellness and headaches, loss of appetite etc.

Apparently and Im no expert on the issue but Oysters can be a sorce for Salmonella and make no mistake about it, it can be quite serious, to give you an idea, I ended up losing nearly 30% of my bodyweight over a number of weeks/months & it was wrongly diagnosed initially.

Take care.

[Mobi]

After I posted this topic I decided to go and see a doctor - there is a a clinic very close by to where I live.

He said that it was definitely the oysters and I had food poisoning. He felt my stomach and said there was "no salt in my stomach" and I was severely dehydrated.

He asked me if I was feeling weak and I told him I couldn't stop sleeping.

This is in spite of the fact that I have already been taking electrolytes with water since Sunday.

He prescribed more electrolytes, told me no food for 24 hours, and changed my main antibiotic to Norfloxacin 400Mg.

Since I have been home I can't stop sleeping and feel weaker than ever.

Maybe the sleep will help.

[Mobi]

two capsules of Immodium (available in each and every pharmacy) should settle the case within two hours Mobi. but you still have to replenish lost electrolyte.

Thanks Nam. I was taking them along with the antibiotic as I had a stock from a previous bout with the runs. Didn't work I'm afraid.

[Dakhar]

I use TINIDAZOL for minor stomach bacteria issues.... but your oyster issue sounds more severe

good luck... oysters of all shapes and sizes have proven time and time again to be dangerous in my life

[Sheryl]

No immodium, Mobi, unless it is for the purpose of being able to travel to a proper hospital.

Otherwise inadvisable, in food poisoning it is best to let the body rid itself of the toxins

What concerns me about your case is your reported sleepiness/weakness. Is your urine dark? (dehydration) Have you checked your blood sugar? easy for diabetes to get out of control with an infection, in either direction.

Given your many other medical problems, need to be more careful than the average person. If you are not better soon I thibk a short stay in a hospital to get properly rehydrated, BS stabilized etc might be in order.

BTW hepatitis has a fairly long incubation period, not possible for it to account for these symptoms, and tinidiazole is for giardia and ameoba. Which this does not in any way sound like.

Salmonella, toxic forms of E. coli both consistent with the short incubation, susopected food cause.

[EyesWideOpen]

Food poisioning runs the gamut to feeling a bit unwell, to killing you, and everything inbetween.

I agree with the poster above, do not take immodium. A common product that I always travel with is called Disento. It is available at every pharmacy in Thailand. It is an antibacterial product that is apparently specifically for stomach issues. If that does not work for me, I then move on to the " atomic blast" treatment.This consists of a double dose at the same time of 500mg ciprofloxacin. This is well known traveler secret. I use that if I am in the middle of nowhere, and I think I am not going to last much longer. However, since you live in Pattaya, I would reccommend you go to the Bangkok Pattaya hospital. If you have been throwing up and not holding water for more than a few days, you are slowly moving into the danger zone..........

[MikeyIdea]

No Immodium, it turns off the stomach and does the OPPOSITE of what you want the body to (be able to) do, flush the bacteria out. Immodium is one of the worst things you can take, unless it is to be able to travel to a hospital, as Sheryl wrote. Amoxy is a broad spectrum penicillin that is basically useless against bacterial stomach infections, no doctor should (or probably also would) prescribe that for your condition. I hope that you did that on your own. I find it hard to believe that a Thai doctor, whom I more often than not find know their stuff, would have given you that. Electrolytes are important and should be taken, easy to get dehydrated in Thailand, dangerous too. Sheryl's got it right, check urine and your eyes (don't know how to explain this, if they start to look like they have moved into your head a bit, off to a doctor)

Ciproflox is a very potent broad spectrum penicillin which is good for infections in the stomach area, it shouldn't really be used without doctors recommendation you know. It is one of the very few penicillins that work against the Black Death and other really nasty bacterials so it's not candy. Take it for too long and you will get diarrhea, if you didn't have it before (as it kills the bacteria flora in your stomach as well as what it is taken to kill...) Not much left to give if Ciproflox doesn't work (meaning - don't use it unless you have to, when that doesn't work any longer, pray you don't get something really nasty!)

3 days and you should go to a doctor, that's a good rule that you can't go wrong with. Thailand is one of the places where I wouldn't wait 3 days if I have food poisoning...

Go to the hospital one time too often, much better then one time too little

Good Luck

Edited March 10, 2010 by MikeyIdea

[toptuan]

And, when you're able to keep something on your stomach, don't forget the BRAT diet:

B = bananas

R = rice

A = applesauce

T = tea

Been where you are (several times). You have my FULL sympathy!

[toptuan]

Mobi

Do not mess about with antibiotics on your own, may well make things worse (this includes the Amoxil)

Take activated charcoal (see current thread for brand names) and drink plenty of fluid, enough to keep your urine clear in color. Coconut juice is especially good as it has the needed electrolytes

If it persists OR if fever increases OR if you are unable to take in enough fluid to keep your urine clear in color, OR if any blood/mucus in the stool

Then :

see a doctor. Samitivej Sri Racha or Queen Sirikit probably being the nearest good options.

Whatever happens stay on top of your BS especially if you aren't able to eat much for a while.

I would like to publicly thank Sheryl for her consistently valuable medical/health advice over the five years I've been connected with ThaiVisa. Always quick to the rescue, and always on-target. If she's not already a nurse or an M.D. then I bestow her an honorary degree right now. (My qualifications? Uh...business & teaching).

Thanks, Sheryl!

I know many on Thai Visa share the same gratitude. It's a comfort knowing we can get some quick and knowledgeable feedback from an apparently very-well qualified expat right here in LOS.

[neverdie]

Salmonella, toxic forms of E. coli both consistent with the short incubation, susopected food cause.

I hope and pray mobi doesnt have Salmonella, made me one very sick little nearlydied.

Good on you Sheryl.........ur better than any doctor and you dont make me scared either

[Mobi]

Feeling so much better today.

I followed all the advice and the diarrhea has actually stopped. I slept for about 18 hours, off and on, took my meds, including loads of electrolytes, and no food.

The fever has gone and today I am eating a little.

Hopefully I am on the mend, but I will keep taking the antibiotics.

Just for the record, in my weakened state, I was confusing Immodium with Motillium which treats nausia, belching stomach etc. I would never take Immodium when I had a severe case of diarrhea, for as Sheryl said, you need to get all that bad stuff out, not hold it in. Sorry for the confusion.

Thanks to all the posters on this thread, especially, of course, our own Angel Sheryl.

Where would we be without her? Personally, I'd probably be dead.

[syd barrett]

Good to hear you are feeling better.

Avoid eating shellfish in future in Thailand.

Food poisoning can be fatal. A lot of people forget this.

P.S. Imodium is only for pervous noos or mild 'Chilli' diarrhea.

Edited March 10, 2010 by syd barrett

[khundon]

Get hold of some Lactil Forte tabs to put some bacteria back into your gut, after the runs.

[britmaveric]

Drink gatorade, keep fluids down at the very least. Not sure its food poisoning - normally you'd have vomiting too.

Edited March 11, 2010 by britmaveric

[syd barrett]

1.3 million cases and 83 Deaths from Food poisoning in Thailand in 2007.

[Rimmer]

Food poisoning on increase in Thailand

Study calls for central food center in Pattaya

Ariyawat Nuamsawat

PATTAYA:-- Food poisoning is on the increase in Thailand as more people flock to cities such as Pattaya to set up food carts and restaurants without sufficient training in proper sanitary procedures, a study from Silpakorn University concludes.

Full story

HERE

-- Pattaya Mail

2010-03-13

[newsfooter][/newsfooter]

[Soutpeel]

Not sure its food poisoning - normally you'd have vomiting too.

Not always, had food poisoning a few times, once landed in hospital on an antibiotic drip and never vomited from any of the "doses",

Think the give away in the OP's case was the fever, suggesting it is food poisoning, a fever was the reason I went the hospital in the abovementioned and after week of Charcoal and over the counter antibiotics not working...

[Jdietz]

Most likely because the charcoal absorbed the antibiotics...

[phetaroi]

1.3 million cases and 83 Deaths from Food poisoning in Thailand in 2007.

And as we know, that's a drop in the real bucket since I assume those are only the cases where people went to a hospital, and not including those who just rode it out or medicated themselves.

[Soutpeel]

Most likely because the charcoal absorbed the antibiotics...

Dont think so.....the charoal/antibiotic combination was suggested to me by a friend who is a pharmacist, many years ago and has saved my "ars*" on many occasions.... ...think the occassion I ended up on a drip was to do with the fact that the OTC antibiotics I was takin were just not strong enough for the "bug" which had inhabited my colon..

also suggested in the same conversation was to stay well away from Immodium..

[Mobi]

Drink gatorade, keep fluids down at the very least. Not sure its food poisoning - normally you'd have vomiting too.

Dr. Brit I assume!!!

I haven't thrown up for any reason since I was a young man.

Some people do, others don't, the most I ever feel is a bit nauseous, and that is through countless bouts of serious, hospitalized food-poisoning bouts trough the years, and God knows how many binges when I was so drunk I couldn't move - but never vomited.

I just have no predisposition to vomit in any circumstances, and you really don't know what you're talking about

[phetaroi]

Drink gatorade, keep fluids down at the very least. Not sure its food poisoning - normally you'd have vomiting too.

Dr. Brit I assume!!!

I haven't thrown up for any reason since I was a young man.

Some people do, others don't, the most I ever feel is a bit nauseous, and that is through countless bouts of serious, hospitalized food-poisoning bouts trough the years, and God knows how many binges when I was so drunk I couldn't move - but never vomited.

I just have no predisposition to vomit in any circumstances, and you really don't know what you're talking about

Similar for me, although I don't drink. I haven't vomited since I was a child. I have often said I have an iron cast stomach and paper machie (sp?) intestines.