Giardias

[GG65]

Hi there all,

Just a query ... Have been in Chiang Mai for few mths after two years teaching in Sth China..have been feeling like slow death since. i have lost 6 kgs in a few mths and had every blood test, urine test and a stool test to find not much. I have read that giardiasis can be difficult to find sometimes as the cysts are only shed intermittently...anyway enough about my stool...is there a hospital specific to tropical type diseases here as I have already done Sri Pat..and Loi Kroh...otherwise I have Tindazole tabs in hand..I weigh 42 kgs..I am desperate

[Sheryl]

No, there is not a better hospital up where you are, Sri pat is the best, though like anywhere it depends on the individual doctor.. There is of course much more in Bangkok.

You do not mention diarrhea - are you having any? The cause of the weight loss will not be giardia (or any other intestinal infection) if you are not having significant diarrhea.

If you are having diarrhea I would personally go ahead and try a course of tinidazole. Probably at the ameobic rather than giardia dose...that will cause more side effects (mainly nausea) but may as well be sure. If that fails then a trip to Bangkok may be in order.

If you are not having diarrhea (or very little of it) then something altogether else is going on and I need to know more about symptoms and lab results.

[GG65]

It started in China many mths ago...have had many symptoms...but to dat...diarrhea only about once a week followed by stomach spasm all the way up...had gastroscopy here...last Nov...said had pylori and only mild inflammation...took antibiotics and was retested twice here and Melb...both negative but Gi symptoms continue...will be fine for week or so then wham..another attack..which usually lasts 24 hrs...a lot of pain high up in chest ( right side ) ...everyone has checked heart, chest x rays, bloods, tumour markers ..all okay..recently took albendazole in hope ... that it was an infestation ... I thought weight loss might be thyroid...docs say it is within normal range...nothing in bloods stand out..one doc gave me a multi vitamin and said come back in mth!...meanwhile I am thinner...I read somewhere on Thai visa that there is a tropical med place somewhere in chiang Mai? Anyone know?

[GG65]

Oh and waht is the amoebic dose..was given 4 tabs 500 mg and told take all 4 at once...2gm dose...I am very wary and can't decide whether to take or try and get someone to take multiple stool samples? Had one sample checked ...at Loi Kroh..came bck ok..

[Sheryl]

What you describe, with diarrhea only once a week or so and cramping pain on the right side does not sound to me in the least like giardia or amoeba.

Actually what it sounds most like is gall bladder. Have you had an abdominal ultrasound? Do these attacks seem to follow meals containing fat (fried foods, meat) that you can recall?

Another possibility is liver fluke. Abdominal ultrasound would be indicated for that as well.

There is a Tropical medicine Hospital in Bangkok. None in Chiang Mai. Google "Mahidol University Hosp[ital for Tropical Diseases".

[GaryB1263]

Are you having sulfurous burps? That goes with Giardia.

[GG65]

No...when I have the digestive issues I certainly burp a lot but not sulfurous....after talking to people I am now moving away from giardia to something else!

[ammagic]

Please go to Internal Medicine Specialist Dr Rattiya at Chiangmai Ram. She is excellent

[GG65]

Thanks for all the advice...