strongest pain killer?

[dragonfly94]

I get bouts of diverticulitis that are absolute agony. Yesterday I was crawling round the floor for a couple of hours in pain and was even banging my head on the wall. I would have gone to the hospital but could hardly stand and I know it passes off after a while. I need to get some better pain killers for the next time as paracetamol are no use at all, what's the strongest you can buy in Thailand and what can a Dr prescribe?

[Sheryl]

Without a prescription, you can buy:

NSAIDs - not a good idea in diveticulitis due to risk of bleeding

Tramadol, or tramadol + paracetemol. Pretty strong but only pharmacies that meet certain criteria can sell it and they will limit the amount sold at a time.

On prescription from a hospital pharmacy, you can get:

Codeine preparations

Morphine

Fentynl patches

But there is more to pain management of diverticulitis than just analgesics. I trust you are under a doctors care and getting antibiotics and on a special diet. If not, that should be the first step. In some cases hospitalization is necessary. The worsening pain may indicate this,so even if under a doctors care it may be time to go back and let him know how much worse the symptoms have become. It may be necessary to stay in hospital for a while on IVs to rest your bowel and that will also allow for IV morphine for the pain. If there is an abscess, it will need to be drained.

In some patients the antiinflammatory drug mesalamine helps, but this should be used only under medical guidance.

Given how dangerous the complications of diverticulitis can be (including perforation) I would not focus so much on how to mask the pain as on why it has gotten so much worse. It is possible there is a perfromation or abscess, both of which require immediate medical attention.

See a doctor at once.

[dragonfly94]

well I feel more or less OK today with no acute pain so I do not think it will be an abscess or perforation. Next time I think it will have to be a Dr visit though, thanks for the drug info.

[NeverSure]

Have you had lab tests done to see if you have a bug that could be treated with antibiotics?

Years ago I got sick in rural Spain from something I ate. I had all kinds of upsets for a couple of years and nothing showed in lab tests. Then by coincidence my doctor gave me Cipro for something unrelated and the problem was gone almost overnight. Apparently there was something in there that didn't shed for lab tests. I think there are some that burrow like that.

Anyway, good luck with it. No fun at all.

[NeverSure]

BTW I found that the only relief I could get to any extent was from Loperamide (Immodium.) I'd ask a doctor first if it could actually harm you before I used it. It "freezes" the contractions in the stomach and intestine and in layman's terms acts as a muscle relaxer. Of course it's indicated for diarrhea so this is an unusual use for it but it helped me.

Please ask a doctor though because you may have something entirely different from what I had.

[dragonfly94]

I had antibiotics when I was in NZ a couple of years ago for it when it did not wear off they worked, anti spasmodics are good as long as you are not throwing up all the time as well. Uk Dr gave me mebervine which seem good. Next time it's hospital though if it's that bad again. Thanks for the replies.

[dragonfly94]

Anyone know where to buy tramadol in Bangkok? tried near Suk soi 4 but they don't have it. Got some ultracet in Pratunam at 150 baht for 10, but it has a lower amount of tramadol in it

[wpcoe]

I've bought tramadol at the pharmacy counter in the Boots store on Silom right near the Saladaeng BTS station (on the north side of the Silom.) ISTR they had different dosages available. I suspect the same would be true for Boots or Watsons stores through the city.

[Sheryl]

Most large pharmacies will have it. But I really would be worried about the worsened pain and see a doctor. This is a potentially serious condition which can have life threatening complications and you need to stay on top of it.

Prof. Dr. Chucheep iSahakitrungruang s an excellent colorectal specialist. He is at Bangkok Christian Hospital, I forget exactly when but I think Tuesday mornings - call them to confirm. Or can see him at Bumrungrad Tuesdays 3-5 PM https://www.bumrungrad.com/doctors/Chucheep-Sahakitrungruang. Will cost a couple hundred baht less to see him at Bkk Christian (larger savings if endocscopy is indicated) , which is on Silom near the Saladaeng station.