Which Parasite Medicine Do You Use?

[libya 115]

I feel that the time has come again to rid my body of the worms and snakes that are living in my stomach and intestines. I do it about every six months, since coming to Thailand.

It can be quite shocking if you care to analyse the results the morning after taking the tablets.

I recall seeing brightly coloured parasitic worms in my morning ablutions.

So: the question is which tablet here in Thailand do you recommend? I cannot find the empty package from last time; and I hear that some tablets are stronger than others.

[Crushdepth]

Any idea where you are picking up your passengers? I've been here for 5 years and never had a problem - and I had an 'analysis' a couple of months ago as part of an annual health check. What are you eating??

[H2oDunc]

I've found a regular consumption every day of several chang keeps all the nasty bugs and what not out of the system, I dont think they like it. Works for me. never had a bad gut or anything since I discovered it. Also works with mozies as well. All the Heineken drinkers I drink with get eaten alive when we are out and about but the chang seems to keep em at bay. The new wonder drug!!!!

Cheers Dunc

[libya 115]

I eat a lot of Thai take-aways, plus I eat at roadside vendors, like many people here in Thailand.

I understand that Pork and Beef are the worst for parasitic infection.

Even though you might be 100% fit: it is almost certain that after eating 'out' in Thailand for six months or more, that you will have some kind of intestinal parasite(s).

Ask any Thai, about the six-monthly 'tablet' procedure.......

[libya 115]

I've found a regular consumption every day of several chang keeps all the nasty bugs and what not out of the system, I dont think they like it. Works for me. never had a bad gut or anything since I discovered it. Also works with mozies as well. All the Heineken drinkers I drink with get eaten alive when we are out and about but the chang seems to keep em at bay. The new wonder drug!!!!

Cheers Dunc

It would not surprise me: Chang is pure chemicals, however I think the reason I am rarely bitten by mozzies is onions and garlic in my diet.

I believe that mozzies don't like the secretions after eating these foodstuffs.

Alcohol in the stomach (and during eating) can indeed disinfect the stomach from some harmful bacteria, however parasites are hardy and do infest, often asymptomatically.

[Tammi]

I use Albendazole aka Zentel. Take 2 tablets daily for 1 or 3 days. Read the leaflet.

[Tammi]

Also, you will find that labs usually find nothing in stool specimens and doctors usually recommend to go ahead and take worm medicine if stool is not looking as it should and you obviously do not have typhoid or some such.

[leisurely]

I've never done it, do you think it is recommended for a family with no symptoms?

[Heng]

Ask any Thai, about the six-monthly 'tablet' procedure.......

Been Thai for 31 years, and in Thailand for the last 8. No worms or pills needed to date, and yes I dine roadside and everywhere else. I don't eat any raw type foods though (except for sashimi) such as 'nam,' or 'jim joom.'

Recommend you skip the pills and just do a yearly full physical exam (which should include a stool analysis).

[h90]

Ask any Thai, about the six-monthly 'tablet' procedure.......

Been Thai for 31 years, and in Thailand for the last 8. No worms or pills needed to date, and yes I dine roadside and everywhere else. I don't eat any raw type foods though (except for sashimi) such as 'nam,' or 'jim joom.'

Recommend you skip the pills and just do a yearly full physical exam (which should include a stool analysis).

my wife and her sister (already all their life Thais) never did that or heared about that...

[Vespa]

Ask any Thai, about the six-monthly 'tablet' procedure.......

Been Thai for 31 years, and in Thailand for the last 8. No worms or pills needed to date, and yes I dine roadside and everywhere else. I don't eat any raw type foods though (except for sashimi) such as 'nam,' or 'jim joom.'

Recommend you skip the pills and just do a yearly full physical exam (which should include a stool analysis).

my wife and her sister (already all their life Thais) never did that or heared about that...

Reality is that we all have live bacteria in our bodies at any given time.

Living in Thailand may and does cause those u eat the local food to have more of them i.e. much less pesticides used in the growing of veggies , antibiotics in the meat .

And the idea Uncle Fester has of a flush is a good idea as often it is only when we get sick do we realize we ingested a bad one.

Edited September 7, 2006 by Vespa

[h5n1]

if you really have worms, you need a stool test.

i have eaten in some of the worst stalls from pakistan to north korea, south to papua. id lived in cambodia in early 90s when no one had ANY clue what sanitation was -

never had worms. DO NOT start gobbling this and that and do not take a chemists advice. stoll test is VERY cheap - an dthen you know what meds to take 100%

[libya 115]

if you really have worms, you need a stool test.

i have eaten in some of the worst stalls from pakistan to north korea, south to papua. id lived in cambodia in early 90s when no one had ANY clue what sanitation was -

never had worms. DO NOT start gobbling this and that and do not take a chemists advice. stoll test is VERY cheap - an dthen you know what meds to take 100%

There seems to be quite a few people out there who don't believe that they have parasitic worm infection. Remember often there are NO symptoms.

It is the normal and safe thing to do, to take medication every six months in Thailand:

There are three main types of parasite:

Diphyllobothriasis or fish tapeworm infection (intestine), Taeniasis Saginata or beef tapeworm infection (intestine), Cysticercosis (Cy) or pork tapeworm all come from animals that have eaten the eggs of these worms.

Echinococcosis (Ec) or hydatid diseases are caused by variety of worms infecting animals that ingest the eggs, such as rodents, dogs, sheep, cattle, and humans. They can invade and grow in many organs, such as liver, bone, heart, and brain.

Hymenolepiasis Nana and Diminuta larval stage occurs inside insects and fleas (rats and mice) and if these insects are eaten, as in uncooked cereals, they can grow in the intestine and cause problems.

Are you sure that your stool samples are being closely examined in Thailand?

A Stool should be collected and sent to a laboratory for the presence of eggs, cysts, or larvae (Ova and parasites).

Every Thai, I know understands about 'worm tablets'; although many are too scared to take medication, because of the shock of seeing so many brightly coloured emissions the following morning.

Anyway, shall take mine: 'Alben' Albendazole 400mg tonight

and post results tomorrow??

[Goldenbead]

I worm the whole family once every four months or so. When one or more kids start to complain of an itchy bum I know it is time.

This is normal as far as I am concerned. When we were growing up, my parents did the same. Doesn't hurt.

[h90]

first of all bacteria and worms are different things.

Would say a bacteria and a worm is far more different than a worm and a human....

Second you need the bacteria actually the split the food for you, protect your skin, mouth and the all the other openings you have against other harmfull bacteria.

So you need them and should protect them.

With different food they don't vary in amount (maybe also) they vary in what they can do, they specialise on the food you eat.

Ask any Thai, about the six-monthly 'tablet' procedure.......

Been Thai for 31 years, and in Thailand for the last 8. No worms or pills needed to date, and yes I dine roadside and everywhere else. I don't eat any raw type foods though (except for sashimi) such as 'nam,' or 'jim joom.'

Recommend you skip the pills and just do a yearly full physical exam (which should include a stool analysis).

my wife and her sister (already all their life Thais) never did that or heared about that...

Reality is that we all have live bacteria in our bodies at any given time.

Living in Thailand may and does cause those u eat the local food to have more of them i.e. much less pesticides used in the growing of veggies , antibiotics in the meat .

And the idea Uncle Fester has of a flush is a good idea as often it is only when we get sick do we realize we ingested a bad one.

[kat]

if you really have worms, you need a stool test.

i have eaten in some of the worst stalls from pakistan to north korea, south to papua. id lived in cambodia in early 90s when no one had ANY clue what sanitation was -

never had worms. DO NOT start gobbling this and that and do not take a chemists advice. stoll test is VERY cheap - an dthen you know what meds to take 100%

There seems to be quite a few people out there who don't believe that they have parasitic worm infection. Remember often there are NO symptoms.

It is the normal and safe thing to do, to take medication every six months in Thailand:

There are three main types of parasite:

Diphyllobothriasis or fish tapeworm infection (intestine), Taeniasis Saginata or beef tapeworm infection (intestine), Cysticercosis (Cy) or pork tapeworm all come from animals that have eaten the eggs of these worms.

Echinococcosis (Ec) or hydatid diseases are caused by variety of worms infecting animals that ingest the eggs, such as rodents, dogs, sheep, cattle, and humans. They can invade and grow in many organs, such as liver, bone, heart, and brain.

Hymenolepiasis Nana and Diminuta larval stage occurs inside insects and fleas (rats and mice) and if these insects are eaten, as in uncooked cereals, they can grow in the intestine and cause problems.

Are you sure that your stool samples are being closely examined in Thailand?

A Stool should be collected and sent to a laboratory for the presence of eggs, cysts, or larvae (Ova and parasites).

Every Thai, I know understands about 'worm tablets'; although many are too scared to take medication, because of the shock of seeing so many brightly coloured emissions the following morning.

Anyway, shall take mine: 'Alben' Albendazole 400mg tonight

and post results tomorrow??

Ok, libya, what are the results? I think I'm going to follow your lead. As we've discussed in the past, I've had stomach problems here. I don't trust that they were fully resolved, although I am asymptomatic now. If there are worms in my stomach, I'd like to leave them here before I return home.

where do you get Alben, at any pharmacy?

[Crushdepth]

Well, just as a side track I know a guy who has been working on parasites transmitted by eating fish in Vietnam (the project is called FIBOZOPA, you can google for it if you really want).

To cut a long story short, the project analyzed a lot of shit. They found that parasites from fish are actually not that much of a problem (so long as it is cooked). There is a problem with both raw freshwater fish and also freshwater snails (liver fluke, can cause liver cancer). However, parasites from eating unhygenically produced vegetables were rampant. They treat people who are found to be infected, but they pick them up again pretty quickly.

I don't think this is a problem in Thailand though. Anyway, if concerned, take your worm tablets and be happy. Me, I don't eat raw meat (well, apart from sushi from marine sources).

[dekka007]

To cut a long story short, the project analyzed a lot of shit.

Thats ok I dont eat that much

Filthy job tho unlucky.

Edited September 11, 2006 by dekka007

[sabaijai]

I recently (last year) had my first physical in 19 years. The stool test was analysed by a Lao parasitologist whom my Australian doctor said was one of the best in SE Asia, in terms of finding GI parasites 'no one else' seems to be able to find.

Although I had no symptoms I expected they would find something as during the last 19 years I've travelled widely in Laos, Myanmar, Malaysia and Thailand, as well as shorter intervals in Nepal, India and Sri Lanka, and eaten all manner of street food (except raw meats, though these I've indulged in at restaurants).

The results were negative for all known parasites. I was surprised and so was the doctor. She explained that I may have been exposed numerous times to parasites but that for whatever reason they didn't 'stick' in my system. She said that she sees many foreign patients who test positive after only six months in SE Asia, and others who have been here much longer and nothing shows up. What I take from this is that some individuals are more parasite-prone than others. Who knows ...

[Gary A]

I think that being your own doctor is far more dangerous than the worms.

[bina]

sabaijai, u may have hit on somehting there;

in animals, we see an increase in worms/parasites among animals that are under stress (including pregnancy etc)... therefore, we always worm before breeding, before shipping, and also if the animal is sort of 'down' (i.e. symptoms of 'going to be ill soon')... the vets explained that many times, stress reduces the immune system as well as affecting the flora/fauna of intestines etc in many animals therefore not being able to 'hold down' the balance of worms et al.... that are there (most animals are not totally worm free, even if passed all stool etc checks, the idea is to keep the number down to a minimum as to avoid health problems), blood tests for the heart worms etc...

so maybe some people are just more worm prone, or their bodies deal less well with them (not talking about flukes et al in livers, jst intestinal stuff)... btw, flukes and things can be gotten from rivers/ponds too

[Sheryl]

To test stool for parasites it is necessary to have 3 different fresh specimens checked -- and even then the detection rate is only 50%.

Which is why many people simply treat pre-emptively without bothering with the test.

Albendazole is a very safe drug & it is a single dosage. Only caution is should not be taken in pregnancy. Effective against the most common worms.

Where stool test is warranted is where there is a suspicion of amoeba or flukes, since treatment fior those involves more toxic drugs.

[cruciate]

There are many, many kinds of parasites. In most situation, when we said "parasite", we usually refer to intestinal parasite. But there are many parasites that do not live in the intestine, there are tissue parasite, blood parasite, liver parasite and so on.

Albendazole works against common (not all) intestinal parasites such as Ascaris, hook worm, Strongyloid, Enterobias, etc. But it is less effective or even useless in other kinds of parasites. The best way to diagnose intestinal parasite is to have the stool exam. Although the sensitivity of stool exam is not so good, it is generally recommended. Since it will give the definite diagnosis. In some case, serologic diagnosis is useful. In general, regular self treatment with antiparasite medication is not recommended.

Apart from intestinal parasite, the diagnosis for parasitic infestation is quite complicated. Consultation with physician is strongly recommended. Some symptoms may suggest tissue parasite infestation such as creeping eruption or migratory swelling. Some symptoms may be caused by parasites such as hemoptysis (bloody sputum), jaundice, etc. However there are many other possiblilities. The diagnosis requires full history taking, physical examination and some lab test.

You can visit the Thai Travel Clinic, Mahidol University, for consultation, lab test and treatment. It is the part of Hospital for Tropical Diseases, located near Victory monument.

[tropo]

To test stool for parasites it is necessary to have 3 different fresh specimens checked -- and even then the detection rate is only 50%.

Which is why many people simply treat pre-emptively without bothering with the test.

Albendazole is a very safe drug & it is a single dosage. Only caution is should not be taken in pregnancy. Effective against the most common worms.

Where stool test is warranted is where there is a suspicion of amoeba or flukes, since treatment fior those involves more toxic drugs.

I thought it best to revive this old thread rather than start a new one as it has some useful information.

I'm surprised that considering the proliferation of intestestinal parasites in Thailand that few threads have been started on this topic. There are more threads about intestinal parasites in pets.

It can be difficult to find parasites by a stool examination therefore it's understandable that Thais do like to take parasite medication once or twice a year.

For example, my beef tapeworm has probably been growing since late July yet I've only just discovered it and the first obvious signs were only visible in early November. It takes about 3 months for the tapeworm to reach maturity and for the proglotidds to start releasing themselves into the stool. In other words, by the time you find out you've got a tapeworm it's full grown (5 to 10 m in length).

As has been mentioned already in this thread, tapeworms don't usually produce symptoms and if they do they will be hardly noticeable in most cases.

It is incorrect that Albendazole is a one dose medicine. It is used to kill many different species of intestinal parasites and doses will vary depending on which ones you've got. This makes self medication problematic in that if you don't know what you've got you don't know how much to use. Some parasites will require lengthy (several weeks) use of Albendazole.

In my case with a beef tapeworm I was prescribed 5 daily doses of 400 mg by my doctor and given milk of magnesia to help purge the tapeworm when it is dead. It will be interesting to see how long it is - I've read they can reach 25 in length.

I've eaten rare beef in Australia and NZ and never had one. I suspect rare roast beef from Big C is the culprit.

Edited January 4, 2012 by tropo

[bangkokrick]

It's a coincidence that this thread came up. I was talking to one of my wife's Thai friends the other day and I was shocked to hear her story. She has always been painfully thin since we have known her and she eats like a horse, but could never increase her weight. A while back her stomach began to bulge to the point where she thought she may be pregnant, so she went to the doctor to get checked out. The tests completed, the doctor gave her 'worming tablets' which she duly took and the following day she dropped a 7.0M tape worm. She said it was gross and I felt sick thinking about what she described. This worm must have been living inside her for a long time to get to that size, so no wonder she could never put on weight.

I go with Libya and after hearing my friends story will take the tablets twice a year.

[tropo]

It's a coincidence that this thread came up. I was talking to one of my wife's Thai friends the other day and I was shocked to hear her story. She has always been painfully thin since we have known her and she eats like a horse, but could never increase her weight. A while back her stomach began to bulge to the point where she thought she may be pregnant, so she went to the doctor to get checked out. The tests completed, the doctor gave her 'worming tablets' which she duly took and the following day she dropped a 7.0M tape worm. She said it was gross and I felt sick thinking about what she described. This worm must have been living inside her for a long time to get to that size, so no wonder she could never put on weight.

I go with Libya and after hearing my friends story will take the tablets twice a year.

Interesting story!

I read they can live 25 years. There would be a huge nutrient drain after years of infestation.

In contrast to the popular story that tapeworms increase the appetite, they normally cause a reduction in appetite. My appetite has definitely been down the past sevaral months. On the plus side I've been able to eat a lot of chocolate etc without putting on fat. They love carbohydrates as they don't have a digestive system but absorb digested food from the host's intestine. They have a real sweet tooth.

[GarryP]

I worm my dogs once a year without any outward signs of infection and see no harm in us humans doing the same. In fact reading this thread has made my bum itchy and reminded me that I haven't had Benda or Fugacar in years.

I am curious as to whether these medicines will kill liver flukes.

[tropo]

I worm my dogs once a year without any outward signs of infection and see no harm in us humans doing the same. In fact reading this thread has made my bum itchy and reminded me that I haven't had Benda or Fugacar in years.

I am curious as to whether these medicines will kill liver flukes.

I don't have an itchy bum. I don't believe tapeworms cause that. You can't feel the proglottids wriggling out of the anus.

Better you read the drug information on "wormers" first as they don't all treat every type of parasite and require different doses depending on what you've got. You also should be careful to read the contraindications of a drug before you swallow it. For example, Albendazole is hard on the liver and is not recommended for people with liver disease or even elevated liver enzymes.

Edited January 4, 2012 by tropo

[bangkokrick]

I worm my dogs once a year without any outward signs of infection and see no harm in us humans doing the same. In fact reading this thread has made my bum itchy and reminded me that I haven't had Benda or Fugacar in years.

I am curious as to whether these medicines will kill liver flukes.

I don't have an itchy bum. I don't believe tapeworms cause that. You can't feel the proglottids wriggling out of the anus.

Better you read the drug information on "wormers" first as they don't all treat every type of parasite and require different doses depending on what you've got. You also should be careful to read the contraindications of a drug before you swallow it. For example, Albendazole is hard on the liver and is not recommended for people with liver disease or even elevated liver enzymes.

Tropo, too much information!

[tropo]

Tropo, too much information!

LOL. It's a dirty topic - no way around that.

BTW I'm heading to the gym - maybe I should put on a diaper first....

Edited January 4, 2012 by tropo