Testing For Parasites?

[PaulKemp]

Does anyone know anything about getting tested for parasites in Bangkok?
Ideally I would like to have a thorough screening, rather than the quick poop test and all clear.

Where do I go?
What kind of doctor should I see?
And what tests should I ask for/ make sure I am getting?

Thanks in advance!

[Sheryl]

If you mean intestinal parasites, the test is a stool test, but should be done at least 3 separate times. Any hospital or lab can do this.

Even then, there is about a 50% chance of a false negative.

For which reason some people opt to treat empirically for ascaris/hookworm etc. Wouldn't do that for giardia or amoeba, though.

Exactly what parasites are you concerned about? Are you symptomatic?

[PaulKemp]

Ive been looking around to try to find the cause of a few ailments I have had for quite some time and it sounds like I might have intestinal parasites- or so I have read.
My symptoms are consistent to what the all seeing-all knowing eye of the internet would suggest as Hookworm, pinworm, or roundworms.

Is it possible to just treat any/all of these without seeing a doc? I have been to the gastro specialist a few times before, and all I keep getting are the suggestions that food in Thailand is too spicy for foreigners (despite rarely eating spicy food), and to increase my vitamins to combat chronic low iron. Doesnt really improve my confidence.

Thanks for the help!

[infinity11]

It is common to de-worm once or twice a year as the meds are cheap and it is a good idea.

Someone on here said to actually de-worm again 2 weeks after first dose to kill eggs that hatch but i am not sure how prudent, necessary or helpful that is.

[Sheryl]

 

Ive been looking around to try to find the cause of a few ailments I have had for quite some time and it sounds like I might have intestinal parasites- or so I have read.

My symptoms are consistent to what the all seeing-all knowing eye of the internet would suggest as Hookworm, pinworm, or roundworms.

Is it possible to just treat any/all of these without seeing a doc? I have been to the gastro specialist a few times before, and all I keep getting are the suggestions that food in Thailand is too spicy for foreigners (despite rarely eating spicy food), and to increase my vitamins to combat chronic low iron. Doesnt really improve my confidence.

Thanks for the help!

 

Yes, you can treat for all of these with single dose 400mg albendazole, found in all pharmacies, Boots, Watsons etc.

Probiotics may also help, e.g. yogurt but be sure it is unsweetened, can usually find at Villa Market.

[watcharacters]

 

Ive been looking around to try to find the cause of a few ailments I have had for quite some time and it sounds like I might have intestinal parasites- or so I have read.

My symptoms are consistent to what the all seeing-all knowing eye of the internet would suggest as Hookworm, pinworm, or roundworms.

Is it possible to just treat any/all of these without seeing a doc? I have been to the gastro specialist a few times before, and all I keep getting are the suggestions that food in Thailand is too spicy for foreigners (despite rarely eating spicy food), and to increase my vitamins to combat chronic low iron. Doesnt really improve my confidence.

Thanks for the help!

 

Yes, you can treat for all of these with single dose 400mg albendazole, found in all pharmacies, Boots, Watsons etc.

Probiotics may also help, e.g. yogurt but be sure it is unsweetened, can usually find at Villa Market.

.

Good helpful reply Sheryl.

A year or so ago I knew a fellow in Patts who finally told me he'd been suffering from diarrhea for over three months. He was a legendary tight wad and didn't want to pay for a doctor's advice or tests to find out about his condition. He finally learned he did indeed have a parasite. I don't know what the outcome of his situation was.

I only know the street food seems to lend itself to these kind of issues. While "stall food" may be quaint and cultural, I think it's safety may at times be especially suspect for falangs. How do you address that Sheryl?

Do you scarf it down with wanton abandon? I'm sincerely curious as you seem to be aware of these things.

[Sheryl]

Actually street stall food is not necessarily riskier than restaurant food. If it is the type that is prepared right in front of you, it may be safer.

And at least you can see the food preparation procedures since it's out there in the open.

The type of street stall food that sits out for a while is better avoided especially later in the evening (when it has been out longest) and altogether in the very hot season. But that's because of risk of food poisoning, not parasites.

[tropo]

Just a warning about Thai beef. I picked up a tapeworm from eating rare Thai beef a couple of years ago.

You'll have it for at least 3 months before you know you've got one. That's how long it takes for the tapeworm to grow long enough to start releasing proglotidds out of your ass. Those are 1 inch wriggly little things that look a little like maggots. You'll also find dead ones in your underwear that wriggled out while you were sleeping. They're actually egg sacks.

If you like rare beef, the fix is very simple. All you have to do is freeze the meat for at least 12 hours to kill the larvae. The risk with NZ and Australian meat is nil.

I can say one thing for sure - probiotics (kefir) and tapeworms are a very bad combination.

Edited May 13, 2013 by tropo

[infinity11]

Just a warning about Thai beef. I picked up a tapeworm from eating rare Thai beef a couple of years ago.

You'll have it for at least 3 months before you know you've got one. That's how long it takes for the tapeworm to grow long enough to start releasing proglotidds out of your ass. Those are 1 inch wriggly little things that look a little like maggots. You'll also find dead ones in your underwear that wriggled out while you were sleeping. They're actually egg sacks.

If you like rare beef, the fix is very simple. All you have to do is freeze the meat for at least 12 hours to kill the larvae. The risk with NZ and Australian meat is nil.

I can say one thing for sure - probiotics (kefir) and tapeworms are a very bad combination.

As long as there are clear symptoms like you describe then good, it is those things that are hard to diagnose, and false negatives that are the problem.

[Tolley]

Just a warning about Thai beef. I picked up a tapeworm from eating rare Thai beef a couple of years ago.

You'll have it for at least 3 months before you know you've got one. That's how long it takes for the tapeworm to grow long enough to start releasing proglotidds out of your ass. Those are 1 inch wriggly little things that look a little like maggots. You'll also find dead ones in your underwear that wriggled out while you were sleeping. They're actually egg sacks.

If you like rare beef, the fix is very simple. All you have to do is freeze the meat for at least 12 hours to kill the larvae. The risk with NZ and Australian meat is nil.

I can say one thing for sure - probiotics (kefir) and tapeworms are a very bad combination.

I can stil remember the pics you posted. I wont be eating rare beef anytime soon that is for sure.

[tropo]

Just a warning about Thai beef. I picked up a tapeworm from eating rare Thai beef a couple of years ago.

You'll have it for at least 3 months before you know you've got one. That's how long it takes for the tapeworm to grow long enough to start releasing proglotidds out of your ass. Those are 1 inch wriggly little things that look a little like maggots. You'll also find dead ones in your underwear that wriggled out while you were sleeping. They're actually egg sacks.

If you like rare beef, the fix is very simple. All you have to do is freeze the meat for at least 12 hours to kill the larvae. The risk with NZ and Australian meat is nil.

I can say one thing for sure - probiotics (kefir) and tapeworms are a very bad combination.

I can stil remember the pics you posted. I wont be eating rare beef anytime soon that is for sure.

If there's enough interest I'll post them again. I have a video too.

I still eat rare beef, but only beef I've frozen and cooked at home.... or imported beef if I'm eating out.

Edited May 14, 2013 by tropo

[tropo]

As long as there are clear symptoms like you describe then good, it is those things that are hard to diagnose, and false negatives that are the problem.

They are easy to diagnose once "signs" start appearing, but the 3 months before I saw the evidence were not fun. I had no idea why my bowels were so disturbed and my kefir drinking might have made it worse due to the increase of peristalsis.

Edited May 14, 2013 by tropo

[PaulKemp]

Thanks for all the help!

I went out and found some albendazole - but the trouble is that I am having a hard time finding any consistent doses on the internet. The different recommended doses I have seen so far;
400mg x 2 day for three days.
200mg x 2 day for three days.
400mg once.
400mg once a day, for two weeks!

Etc, etc...

[Sheryl]

400 once single does is the usual treatment unless specific types of parasites have been proven present

[tropo]

400 once single does is the usual treatment unless specific types of parasites have been proven present

I've used Albendazole on a number of occasions, including killing a tapeworm.

There's a huge range of doses for different parasites, so I would not be very confident on 400 mg taken once.

Some parasites require a dose of 400 mg for 5 - 21 days and longer. Even 400 mg twice a day for some.

Here's list of dosages for various parasites:

http://www.drugs.com/mtm/albendazole.html

Edited May 15, 2013 by tropo

[PaulKemp]

Nice, thanks. Any idea how long it will take before my visitors start to make "appearances?" Im excited!

[tropo]

Nice, thanks. Any idea how long it will take before my visitors start to make "appearances?" Im excited!

Sarcasm aside, many parasites cannot be seen, so relying on sight will not be very helpful.

As Sheryl said in a post above, even after 3 thorough stool lab examinations there's still only a 50% detection rate.

[infinity11]

I believe most people in most parts of the world have some kind of intestinal parasites, and also most likely they are benign.

[infinity11]

Just a warning about Thai beef. I picked up a tapeworm from eating rare Thai beef a couple of years ago.

You'll have it for at least 3 months before you know you've got one. That's how long it takes for the tapeworm to grow long enough to start releasing proglotidds out of your ass. Those are 1 inch wriggly little things that look a little like maggots. You'll also find dead ones in your underwear that wriggled out while you were sleeping. They're actually egg sacks.

If you like rare beef, the fix is very simple. All you have to do is freeze the meat for at least 12 hours to kill the larvae. The risk with NZ and Australian meat is nil.

I can say one thing for sure - probiotics (kefir) and tapeworms are a very bad combination.

I can stil remember the pics you posted. I wont be eating rare beef anytime soon that is for sure.

If there's enough interest I'll post them again. I have a video too.

I still eat rare beef, but only beef I've frozen and cooked at home.... or imported beef if I'm eating out.

Sure i would like to see your evidence.

Would you not have been better off using medicine specifically for tape worms ? Only one single dose with a laxative included to kill it and purge it.

I think the one you used was not made for tapeworms but good if it worked.

Edited May 16, 2013 by infinity11

[Sheryl]

Indeed albendazole alone is unlikley to eradicate tapeworm infestation.

Praziquantal or niclosamide are the usual drugs of choice. (Referring just tio taopeworms..albendazole is find for roundworms and the

like)

[tropo]

Indeed albendazole alone is unlikley to eradicate tapeworm infestation.

Praziquantal or niclosamide are the usual drugs of choice. (Referring just tio taopeworms..albendazole is find for roundworms and the

like)

I can assure you that Albendazole alone did the trick. 3 doses of 400 mg for 3 consecutive nights. It was not self medication but prescribed by the doctor at the Pattaya Memorial Hospital.

[tropo]

Just a warning about Thai beef. I picked up a tapeworm from eating rare Thai beef a couple of years ago.

You'll have it for at least 3 months before you know you've got one. That's how long it takes for the tapeworm to grow long enough to start releasing proglotidds out of your ass. Those are 1 inch wriggly little things that look a little like maggots. You'll also find dead ones in your underwear that wriggled out while you were sleeping. They're actually egg sacks.

If you like rare beef, the fix is very simple. All you have to do is freeze the meat for at least 12 hours to kill the larvae. The risk with NZ and Australian meat is nil.

I can say one thing for sure - probiotics (kefir) and tapeworms are a very bad combination.

I can stil remember the pics you posted. I wont be eating rare beef anytime soon that is for sure.

If there's enough interest I'll post them again. I have a video too.

I still eat rare beef, but only beef I've frozen and cooked at home.... or imported beef if I'm eating out.

Sure i would like to see your evidence.

Would you not have been better off using medicine specifically for tape worms ? Only one single dose with a laxative included to kill it and purge it.

I think the one you used was not made for tapeworms but good if it worked.

I took medicine exactly as prescribed by my doctor at Pattaya Memorial Hospital.

I posted the pictures on another thread. Just Google beef tapeworm - you'll find plenty of images identical to my proglottid "friends". These images seem to upset some people so let's keep it clean.

I never saw any evidence of a dead one in my stool and I did look carefully for quite a few days. I suspect my digestive system took care of the dead tapeworm. The doctor did give me some laxatives. I was however concerned I didn't see evidence - but that was 16 months ago and it has not returned.

Anyway, tapeworms are probably the better type of worms to have as they can be easy to detect. It's the little buggers which can't be seen that are the most problematic.

Edited May 16, 2013 by tropo

[PaulKemp]

Great success!
...looks like I have/had pinworms.
Thanks to everyone for the help!

On another note- While we were on the topic, my s/o was telling me about her time in Afirca and how she was diagnosed with Bilharzia when she came back. We were thinking about smoking that one out with Praziquantel, but I am not sure of the dosage?

It looked to me that you have to take 20mg/kg 3x a day for one day.
Does that me, she- at 50kg will have to take 1000mg three times in one day? Seems like a lot...

[Sheryl]

Are you saying she was diagnosed and never treated? How long ago was this?

As if she was treated once, unless symotomatic no reason to assume additional tx needed now.

Praziquantel is the drug of choice for this. The treatment is dependent on the species of schistosome responsible.

Schistosoma mansoni, S. haematobium, S. intercalatum = 40 mg/kg divided into 2 doses X 1 day

S. japonicum, S. mekongi = 60 mg/kg divided into 3 doses X 1 day

Treatment is effective only once the eggs have matured so needs to be 6-8 weeks after last exposure.

A repeat stool and urine test recommended 1-2 months after treatment. If she was already treated, then get this before assuming re-treatment is needed.

[PaulKemp]

She was exposed about a year ago- but didnt take the treatment (not too sure why, but ....).
When we went back to another doctor here, they tested the stool and didnt find anything. Can it just disappear? Is it possible/safe to take praizquantel to treat this one "empirically" as well?

We would both prefer to go that route rather than head back to do another battery of tests and not know for sure if they managed to be accurate or not...

[tropo]

She was exposed about a year ago- but didnt take the treatment (not too sure why, but ....).

When we went back to another doctor here, they tested the stool and didnt find anything. Can it just disappear? Is it possible/safe to take praizquantel to treat this one "empirically" as well?

We would both prefer to go that route rather than head back to do another battery of tests and not know for sure if they managed to be accurate or not...

You said she was diagnosed, but here you say they found nothing?

It's a nasty parasite that lives inside internal organs. I'd really want to know if I had it or not. It's often asymptomatic until it causes a lot of damage. Perhaps at a certain stage it cannot be found in the intestinal tract.

[Sheryl]

only exposed, or actually diagnosed a year ago?

If diagnosed for sure, you can treat presumptively with praziquantal but if she is on any other medications need to check first for possible dane=gerous interactions.

Also be aware that she may be unwell for a day or two after taking praziquantal.

And if she has any known chronic helath problems, shoudl check with a doctor first.

[PaulKemp]

Sorry, let me clarify-
She was diagnosed in Germany and then moved to Thailand, where she decided to get it checked again/treatment (the stool test). They didnt find anything the second time.

[Chao Lao Beach]

Relevant additional links. these Beef tape worms sound horrible.

http://www.thaivisa.com/forum/topic/165985-parasitic-worms/

http://www.thaivisa.com/forum/topic/82168-which-parasite-medicine-do-you-use/

Edited May 19, 2013 by Chao Lao Beach

[Sheryl]

Sorry, let me clarify-

She was diagnosed in Germany and then moved to Thailand, where she decided to get it checked again/treatment (the stool test). They didnt find anything the second time.

With light infections it can be hard to detect and require multiple samples.

There is also a blood serology test that can be done and is more accurate. A specilaist in tropical diseases would know.

Or, you can treat presumptively. As with any medication, read up on contraindications and potential side effects first.