Severe Food Poisoning In Thailand

[deepsea149]

I have been to Thailand 5-6 times in the past several years, and sometimes during those visits I would get a mild case of food/stomach sickness. However, last year I was visiting a resort in Northern Thailand and I got a very SEVERE case of food poisoning (the last thing I ate at the resort was bacon, eggs, bread). It was so bad that I was hospitalized and the bacteria moved to my heart, causing heart attack-like symptoms. I was freaking out; the sickest I have ever been.

My question to the expats living in Thailand is how do you guys prevent this, or what do you take when/if you guys get food poisoning?

I would really like to know what type of medicine to have on hand should it happen again when I visit this August.

Deepsea149

[damo]

Get sick, go see a doc.

I got e-coli poisoning from a vegetarian dish, who woul've thought! There is little you can do to prevent food poisoning apart from simply not eating or drinking.

Just don't put off seeing a doc, when I got e-coli poisoning I thought it was just gastro. I let it run for a few days and just got worse and worse until I went to the doc. Later on back in Oz I mentioned it to my doctor and he said quite bluntly that I would have been hospitalised if I was in Oz at the time.

[BigJohnnyBKK]

I used to get Bangkok belly once or twice a year, but it usually passed after a day or two, and now for several years I haven't had anything but a little grumbling for a couple of hours. IMO your resistance builds up over time and it is best to facilitate this by avoiding the too-sterile practices in the west, better to stress your immune/digestive system by pushing your limits on a regular basis, not just when you travel to less-developed locations.

However I did have one instance where it lasted for days; I went to BNH's specialist gastro/tropical diseases unit and they fixed me right up, once they identified the pathogen and prescribed the right medicine I was right as rain within 18 hours.

Note the source can be viral, bacterial or even fungi, and the accurate diagnosis for the specific pathogen by a specialist is required - do **not** accept a hand-waving generalist just giving you an off-the-shelf antibiotic as would happen with most doctors/hospitals here.

I don't think there's any way to prevent these events via medicine. Some people refuse to eat street food, only patronize expensive aircon restaurants etc but IMO this is counter-productive, and what's the point of travel if you're going to do everything the same as back home.

But common sense obviously applies - patronize places with high turnover, don't eat shellfish sitting out all day without any ice around, etc. . .

[Soutpeel]

There is no way to prevent this, but I always carry charcoal and antiboitics with me.

The charcoal/antiboitic thing will told to me by a pharamcist friend of mine and its stood me in good stead after 25 years of working all over the world...In all those years only ended up in hospital once when the trot's didnt clear....strangly enough it was Thailand and ended up in BPH on a drip.

[meatboy]

in just about 30years i have been lucky just had the runs a few times but nothing more than 2days,as soutpeel says i always got a stock of ca-r-bon charcoal activated charcoal capsules 15bht.for 10.

[Soutpeel]

in just about 30years i have been lucky just had the runs a few times but nothing more than 2days,as soutpeel says i always got a stock of ca-r-bon charcoal activated charcoal capsules 15bht.for 10.

I think you will find in most cases its actually not food poisioning per se...just some Bangkok belly....and a few charcoal tablets sorts you out pretty quickly...I think the key is if going on for more than 4-5 days time to go the hospital or doctor. The other thing I was told by my pharmacist friend was stay away from Immodium

[deepsea149]

I used to get Bangkok belly once or twice a year, but it usually passed after a day or two, and now for several years I haven't had anything but a little grumbling for a couple of hours. IMO your resistance builds up over time and it is best to facilitate this by avoiding the too-sterile practices in the west, better to stress your immune/digestive system by pushing your limits on a regular basis, not just when you travel to less-developed locations.

However I did have one instance where it lasted for days; I went to BNH's specialist gastro/tropical diseases unit and they fixed me right up, once they identified the pathogen and prescribed the right medicine I was right as rain within 18 hours.

Note the source can be viral, bacterial or even fungi, and the accurate diagnosis for the specific pathogen by a specialist is required - do **not** accept a hand-waving generalist just giving you an off-the-shelf antibiotic as would happen with most doctors/hospitals here.

I don't think there's any way to prevent these events via medicine. Some people refuse to eat street food, only patronize expensive aircon restaurants etc but IMO this is counter-productive, and what's the point of travel if you're going to do everything the same as back home.

But common sense obviously applies - patronize places with high turnover, don't eat shellfish sitting out all day without any ice around, etc. . .

Thanks for the detailed reply. Yeah, it is ironic that during the entire time I was in Thailand I had been eating from street vendors. However, I didn't get sick until I stayed at a 4 star resort and had an English breakfast! Too funny.

[deepsea149]

Okay, it appears as if I use common sense (I usually do), have a stock of charcoal tablets on stand-by, and have the insurance card ready to use, I will have done my due diligence. Fair enough. Thanks for the advice all.

[WebBangkok]

Ive been here 3 and a half years and got food poisoning twice.

Both times from KFC.

But on holidy about 5 years ago, I had the runs for about 4 days eating oysters, man it was hard drinking and needing to go to the toilet every 30 mins.

But yeah, I have had a few friends here who have gotten it bad.

If I eat at a street cart, I make sure its fried. I just dont trust there soups and the water thats in it.

[meatboy]

as big johnny bkk.says common sense,and being aware of what you are eating,2 instances which we experianced,one which made the wife very ill,eating a thai sausage bought at one of the main bus stations in bkk.and the other being served meat which was still frozen in the middle that was in one of the fast food resturants in a shopping mall so never mind where you eat just be on your guard.

[JusMe]

Only time in Thailand was about fifteen years ago up in Nong Khai, although I had been travelling for about 36 hours and was exhausted, which might have contributed to the problem.

Had a nasty case after eating at a restaurant in Sydney, and another after pulling a can of creamed corn from the back of my refrigerator - smelled okay, until I started to produce nasties!

Not about Thailand - just about being careful of what you eat and accepting that there is a risk in being alive.

[mommysboy]

Hopefully what you had was one of those once in a lifetime events.

Being in Thailand, occasionally helps you to fully understand the phrase sick to the stomach.

Less serious stuff you'll be able to ride out. Personally I'm not shy in taking the antibiotics given me, and rehydration is essential as quickly as possible.

Funnily enough I had a similar experience eating western food and have had lesser upsets on Thai food.

[dddave]

I made the mistake of ordering a Club Sandwich on the BKK-UDON train some years ago...couldn't go more than ten steps from a basin or toilet for three days. Finally spent a night at a hospital in Udon and got cleaned up. I haven't eaten a pre-made packaged meal since.

[Sheryl]

People vary greatly in their sensititivety.

In about 25 years in Thailand, I have never once had serious food poisoning. Maybe 3 or 4 episodes of sudden diarrhea after eating the wrong thing, but no more than a few times in all these years, and those were over in a flash.

And it's not from being super fastidious about what I eat. Especially in the first years here, when I was living way out in the boondocks near the Cambodian border, I ate just about everything inclusing some pretty questionable market stalls. For that matter I have travelled extensively in India and Nepal, eaten and likewise never a problem.

But that's me. Most people are more susceptible and some people are exceptionally so.

[bina]

my mother has an iron stomach so the only thing that ever helped her was a trip in cairo........

funny enough also, thai country hubby has sensitive stomach even if we just eat a falafel from a street corner place; i on the other hand, share food with my dogs, would feed seed to parrots off my tongue, and kissed my bucks and nannies on their cute little snouts (goats for those that wonder) , not to mention drinking straight from their teats (vaccinated does).... and never suffer...

bina

i think that part of the 'runs' syndrome is actually from dehydration after the first 'runs' set in; because dehydration itself also causes vomiting and diahrea to kick in.... a bad circle

[tutsiwarrior]

ye haveta distinguish between food poisoning and gastritis..I've had gastritis in the Middle East as well as my wife and others that I know...gastritis symptoms are that you can't keep anything down, not even water but food poisoning is a lot more violent...

in either case you have to be careful with dehydration as it is deadly...my wife was in hospital for 3 days in Abu Dhabi on a drip...I managed after 3 days some years later in Bahrain but was ready to check into a hospital the next day to get re-hydrated...

if you are losing fluids for whatever reason...vomiting and diarrhea...then think about dehydration and then take the necessary measures...a few days in hospital on a drip can save yer life...it's almost like the onset of type 2 diabetes: ye feel ok but then the doctor looks and sez: 'you have severe ketoacidosis and if you don't get into hospital now you shall die...'

I believed him, fortunately...

Edited June 19, 2012 by tutsiwarrior

[tropo]

I got e-coli poisoning from a vegetarian dish, who woul've thought!

I would've thought it very likely if your vegetarian food contains uncooked vegetables. The water they wash them in (if they do) could easily contaminate the veges.

[tropo]

IMO your resistance builds up over time and it is best to facilitate this by avoiding the too-sterile practices in the west, better to stress your immune/digestive system by pushing your limits on a regular basis, not just when you travel to less-developed locations.

I don't know about this theory we often see proposed on here.

Thais, who always test the boundaries are still often getting very sick from food pathogens. Same over in the Philippines.

I think it's a much better idea to eat clean food and use hygienic methods for preparation and only eat where the vendors practice hygienic food preparation.

Better to eat healthy to boost your immune system than eat dirty food.

[dingdang]

I got e-coli poisoning from a vegetarian dish, who woul've thought!

I would've thought it very likely if your vegetarian food contains uncooked vegetables. The water they wash them in (if they do) could easily contaminate the veges.

the bacteria also settles in some vegetables itself while growing... e.g. sprouts, but others are known for this, too...

everything has to be well cooked, if you want to be on the safe side...

in europe, the pattern of infections (with complications) became quickly obvious:

- women...

- who preferred very healthy food, eating a lot of raw vegetables...

Edited June 20, 2012 by dingdang

[BigJohnnyBKK]

IMO your resistance builds up over time and it is best to facilitate this by avoiding the too-sterile practices in the west, better to stress your immune/digestive system by pushing your limits on a regular basis, not just when you travel to less-developed locations.

I don't know about this theory we often see proposed on here.

Thais, who always test the boundaries are still often getting very sick from food pathogens. Same over in the Philippines.

I think it's a much better idea to eat clean food and use hygienic methods for preparation and only eat where the vendors practice hygienic food preparation.

Better to eat healthy to boost your immune system than eat dirty food.

Relevant link

[tropo]

Relevant link

That's an interesting article, I can't deny, but what practical benefit does it offer. Most of us have been living highly sanitized from birth and in different countries and climates. Thais were born consuming these bacteria and grew up with them.

What would you suggest we do? Just go and eat on dirty street carts every night and ride waves of food poisoning and diarrhea in the hope that after a period of time we'll develop immunity?

[mommysboy]

I used to get Bangkok belly once or twice a year, but it usually passed after a day or two, and now for several years I haven't had anything but a little grumbling for a couple of hours. IMO your resistance builds up over time and it is best to facilitate this by avoiding the too-sterile practices in the west, better to stress your immune/digestive system by pushing your limits on a regular basis, not just when you travel to less-developed locations.

However I did have one instance where it lasted for days; I went to BNH's specialist gastro/tropical diseases unit and they fixed me right up, once they identified the pathogen and prescribed the right medicine I was right as rain within 18 hours.

Note the source can be viral, bacterial or even fungi, and the accurate diagnosis for the specific pathogen by a specialist is required - do **not** accept a hand-waving generalist just giving you an off-the-shelf antibiotic as would happen with most doctors/hospitals here.

I don't think there's any way to prevent these events via medicine. Some people refuse to eat street food, only patronize expensive aircon restaurants etc but IMO this is counter-productive, and what's the point of travel if you're going to do everything the same as back home.

But common sense obviously applies - patronize places with high turnover, don't eat shellfish sitting out all day without any ice around, etc. . .

Like other posters I'm not sure about pushing limits. You don't necessarily develop immunity, and as you found out the body can't fight some germs on its own. Moreover, some illness comes from toxins and they'll make you sick every time. In fact when you violently puke it's usually because of the poisons the bacteria has produced more than the bug itself.

We can develop antibodies to a wide range of virus though and it's true that we can get tolerance to small amounts of toxins over a given time period, hence some people are able to drink more alcohol, or it takes more of a medicine to have an effect.

We do things that we'd think twice about doing back home. I once had food poisoning eating from a grubby looking fish and chip shop just down the road from my house in Blitey, and would always think twice about eating from a street vendor or kebab shop, here we do it every day.

As another poster pointed out though we each have different experiences.

[meatboy]

one thing that pi--es me off is hotel buffet breakfasts,last year stayed at 2x4star hotels,one in bkk and other khon kaen,all the food at breakfast time was stone cold,fried eggs,fried rice,bacon,baked beans ect.all the food was laid out on top of bain-marie food warmers which were empty,i spoke with the manager answer no do.

[tropo]

Like other posters I'm not sure about pushing limits.

We've heard the theory many times before. That was an interesting article published in the New York Times and made a lot of sense, but.... how does one toughen up one's digestive system in Thailand in a safe and controlled manner?

Is it possible?

[tutsiwarrior]

if a westerner choses to live in a place where the hygiene is not the same as in the west then the necessary immunity shall develop over time...

tourists get sick...so what?

[mommysboy]

Like other posters I'm not sure about pushing limits.

We've heard the theory many times before. That was an interesting article published in the New York Times and made a lot of sense, but.... how does one toughen up one's digestive system in Thailand in a safe and controlled manner?

Is it possible?

Like other posters I'm not sure about pushing limits.

We've heard the theory many times before. That was an interesting article published in the New York Times and made a lot of sense, but.... how does one toughen up one's digestive system in Thailand in a safe and controlled manner?

Is it possible?

A good question.

Yes I think so for general health. When I play in goal I find the rolling about in the dirt cures my immediate problems like sinus blockage and same gardening when you get your hands dirty. I wonder does nature provide a top up in our immune system by simply being close to the ground, or could literally be grounding (earthing) as in electrical currents.

No doubt an already settled stomach/gut also helps. The argument being that an inflammed lining provides an easier target for germs to attack. So I'd say plenty of the right things, bland food, fruit and veg, live yoghurt.

Then 'a peck of dust before you die', which in this instance I take to mean that if you are exposed to a little then your body may gain immunity. Certainly, the toughen up argument is true when very young.

But the problem is that an invading bacteria initially has the upper hand. They also thrive in hot conditions, in fact Thailand is ideal weather all year round 24 hours a day. And although bacteria can't survive in the stomach long term (except H.Pylori), we all know the initial price paid is not nice at all.

And toxins abound these days, you never really get immune to them, they are just agitants full stop.

Hence we really have to watch what we eat.

In the future, I imagine we'll have the opportunity for 'gut flora' implants, ie, taking a sample from someone elses' bowel and putting it in our own, likely from a healthier member of our immediate family but if the worls continues to be a polluted place then it solves only half the issue.

A good question.

No doubt an already settled stomach/gut helps. The argument being that an inflammed lining provides an easier target for germs to attack. So I'd say plenty of the right things, bland food, fruit and veg, live yoghurt.

Then 'a peck of dust before you die', which in this instance I take to mean that if you are exposed to a little then your body may gain immunity. Certainly, the toughen up argument is true when very young.

But the problem is that an invading bacteria initially has the upper hand. They also thrive in hot conditions, in fact Thailand is ideal weather all year round 24 hours a day.

In the future, I imagine we'll have the opportunity for 'gut flora' implants, ie, taking a sample from someone elses' bowel and putting it in our own, likely from a healthier member of our immediate family.

[tropo]

if a westerner choses to live in a place where the hygiene is not the same as in the west then the necessary immunity shall develop over time...

tourists get sick...so what?

Why should my immunity develop over time if I take rigid steps not to eat dirty food? Where I live I can live as cleanly as I do back at home. I can manage that quite easily in the Philippines and in Thailand and have done so for over a decade. I have a choice of plenty of clean eating places where I've never experienced even a hint of trouble with the food.

The questions is, what you recommend for a person who lives cleanly? Eat dirty and ride out the sicknesses that are sure to develop without any help from medication? I don't believe that system would be very popular amongst most expats.

[tropo]

A good question.

No doubt an already settled stomach/gut helps. The argument being that an inflammed lining provides an easier target for germs to attack. So I'd say plenty of the right things, bland food, fruit and veg, live yoghurt.

Then 'a peck of dust before you die', which in this instance I take to mean that if you are exposed to a little then your body may gain immunity. Certainly, the toughen up argument is true when very young.

But the problem is that an invading bacteria initially has the upper hand. They also thrive in hot conditions, in fact Thailand is ideal weather all year round 24 hours a day.

In the future, I imagine we'll have the opportunity for 'gut flora' implants, ie, taking a sample from someone elses' bowel and putting it in our own, likely from a healthier member of our immediate family.

I have a theory that from consuming kefir daily my immunity to pathogens has improved. The problem is that I loathe digestive disturbances so much that I avoid street food like the plague. I enjoy feeling good and wouldn't want to experiment. With a few minor adjustments like not drinking the town supply water and a few others it's not difficult to eat hygienically in Pattaya.

[mommysboy]

if a westerner choses to live in a place where the hygiene is not the same as in the west then the necessary immunity shall develop over time...

tourists get sick...so what?

Why should my immunity develop over time if I take rigid steps not to eat dirty food? Where I live I can live as cleanly as I do back at home. I can manage that quite easily in the Philippines and in Thailand and have done so for over a decade. I have a choice of plenty of clean eating places where I've never experienced even a hint of trouble with the food.

The questions is, what you recommend for a person who lives cleanly? Eat dirty and ride out the sicknesses that are sure to develop without any help from medication? I don't believe that system would be very popular amongst most expats.

Immunity probably comes more by your girlfriend/wife than any other way. When babies are born they get a great gulp of muck which becomes the cocktail from which their immunity develops. I'd suggest living with a Thai would probably introduce what you need over a given period of time, through just being intimate and sharing same facilities.

Eating outside: through experience I'd say all the sit down side stalls in busy areas that sell noodle type dishes, fried rice, jok, and the like are quite safe. I don't like to eat from the buffet type stalls where the food is precooked and left exposed for a long time. And I concur with others about these buffet style breakfasts in hotels. I had dreadful food poisoning when I ate at a reasonably nice restaurant, again English style food. I think upwards of 50% of food poisoning comes from sea food and would not eat it outside.

But it also depends what you mean by illness, if you are talking about minor gastric upsets, then really you need to get used to them, par for the course.

Have you ever considered your immune system is too strong?. I am fairly sure this lies behind a lot of problems. Actually fortifying your immunity (if that is possible) could be unwise.

[tutsiwarrior]

if a westerner choses to live in a place where the hygiene is not the same as in the west then the necessary immunity shall develop over time...

tourists get sick...so what?

Why should my immunity develop over time if I take rigid steps not to eat dirty food? Where I live I can live as cleanly as I do back at home. I can manage that quite easily in the Philippines and in Thailand and have done so for over a decade. I have a choice of plenty of clean eating places where I've never experienced even a hint of trouble with the food.

The questions is, what you recommend for a person who lives cleanly? Eat dirty and ride out the sicknesses that are sure to develop without any help from medication? I don't believe that system would be very popular amongst most expats.

if you suggest that 'eating cleanly' will avoid gastric problems in any third world country then you are seriously deluded...as folks have suggested on this thread, many local problems are the result of eating at 'western' restaurants...

living in a bubble and being fed intravenousy is not my idea of fun...