Stool test for diarrhea in Bangkok - where?

[milioooooons]

Hello,

I'm in my mid 30's - have had a bad case of Diarrhea now for about 3-4 days. Started Doxycycline as this is the only antibiotic I know for sure I don't get any adverse reactions to and has helped me with this before but has not been helping this time.

Now contemplating getting a stool test. What can this do for me? Can they apart from showing whether it's actually bacterial also tell what kind of bacteria and thus what kind of antibiotic I should use? Do I need to go to one of the big hospitals for this or can I do this at any small thai clinic? I'm living by on nut.

I have not been vomiting and the am taking ORS so not feeling like I'm about to die but reckon I should get this under control as soon as possible.

Very thankful for any answers...

[Sheryl]

The fact that you have already started an antibiotic will make it more difficult to detect bacteria on stool culture. Your other problem will be in getting a Thai doctor to order a stool culture. As it takes 48 hours or so to get results, usually reserved for very severe or prolonged diarrhea.

Parasites like giardia and amoeba, on the other hand, can be detected in a very quick test and not affected by the med you have taken. However, false negative results are possible.

If I were you I would probably proceed as follows:

1. Take activated charcoal. Ca-R-Bon brand is available in most 7-11s, and continue the ORS, and give it another day at least. Very possible the charcoal will do the trick.

2. If it does not, and if the diarrhea is accompanied by a lot of gas and you have no contraindicatiosn to the drug, empirically treat for giardia with t inidazole 2GM single does, take with food and don't drink. Equal to 4 tabs).

3. If that fails, see a good GI specialist. This one at Samitivej (Suk Soi 49) is excellent: https://www.samitivejhospitals.com/en/doctors/rungsun-rerknimitr/

Be sure to tell you what meds you have already taken

[milioooooons]

The fact that you have already started an antibiotic will make it more difficult to detect bacteria on stool culture. Your other problem will be in getting a Thai doctor to order a stool culture. As it takes 48 hours or so to get results, usually reserved for very severe or prolonged diarrhea.

Parasites like giardia and amoeba, on the other hand, can be detected in a very quick test and not affected by the med you have taken. However, false negative results are possible.

If I were you I would probably proceed as follows:

1. Take activated charcoal. Ca-R-Bon brand is available in most 7-11s, and continue the ORS, and give it another day at least. Very possible the charcoal will do the trick.

2. If it does not, and if the diarrhea is accompanied by a lot of gas and you have no contraindicatiosn to the drug, empirically treat for giardia with t inidazole 2GM single does, take with food and don't drink. Equal to 4 tabs).

3. If that fails, see a good GI specialist. This one at Samitivej (Suk Soi 49) is excellent: https://www.samitivejhospitals.com/en/doctors/rungsun-rerknimitr/

Be sure to tell you what meds you have already taken

Thank you very much Sheryl. I did start taking the ca-r-bon charcoal late last night. How many capsules would you recommend a day? Not a lot of gas, just very watery dark green stools - color wise I understood this could be the effect of the doxycycline? Little to no stomach pain.

[h90]

The fact that you have already started an antibiotic will make it more difficult to detect bacteria on stool culture. Your other problem will be in getting a Thai doctor to order a stool culture. As it takes 48 hours or so to get results, usually reserved for very severe or prolonged diarrhea.

Parasites like giardia and amoeba, on the other hand, can be detected in a very quick test and not affected by the med you have taken. However, false negative results are possible.

If I were you I would probably proceed as follows:

1. Take activated charcoal. Ca-R-Bon brand is available in most 7-11s, and continue the ORS, and give it another day at least. Very possible the charcoal will do the trick.

2. If it does not, and if the diarrhea is accompanied by a lot of gas and you have no contraindicatiosn to the drug, empirically treat for giardia with t inidazole 2GM single does, take with food and don't drink. Equal to 4 tabs).

3. If that fails, see a good GI specialist. This one at Samitivej (Suk Soi 49) is excellent: https://www.samitivejhospitals.com/en/doctors/rungsun-rerknimitr/

Be sure to tell you what meds you have already taken

Thank you very much Sheryl. I did start taking the ca-r-bon charcoal late last night. How many capsules would you recommend a day? Not a lot of gas, just very watery dark green stools - color wise I understood this could be the effect of the doxycycline? Little to no stomach pain.

If the problem is big, you need lots of charcoal and it works better if you only drink lots of water but no food or other things. With heavy diarrhea it really cleans me out.

[MichaelJohn]

Bangkok Nursing Hospital Sathorn/Convent Road have a GI dept who do blood and stool tests; results very quick.

I've tried Samitivej and much prefer BNH.

My personal opinion, I'm not a doctor just someone who suffers from this problem, would be to stop all intake except copious amounts of water for 24 hours. If still no better then go to the doctor.

Having drugs recommended by a doctor, specific for diarrhea or intestines, would be far more sensible than picking an antibiotic you know? Antibiotics will kill the good bugs in your gut, as well as the bad ones and then you're more likely to have repeat and/or continuing problems.

From Boots you can buy Bioflor which is Saccharomyces Boulardii; excellent for helping diarrhea and boosting your good bugs (probiotics); Google it :-)

Hope you feel better soon.

[Sheryl]

Dark green or black stools is to be expected from the charcoal.

Can take 2-4 caps at a time up to a maximum of 16 in a day.

Suggestion for probiotics is good especially as you are taking an antibiotic. Bioflor or even just yogurt (real yogurt, not the sweetened junk- Lalida brand or other plain unsweetened).

[milioooooons]

Thank you very much for all your answers and suggestions. I'll not be afraid to go heavy on the charcoal pills then. The reason I reached for doxycycline was simply that it was very effective the last time I had something like this down here but I realize it's not ideal to blindly eat antibiotics. Next time, which I certainly hope will not be in the close future (this has been utterly debilitating), I'll go for the charcoal as a first measure.

[h90]

Dark green or black stools is to be expected from the charcoal.

Can take 2-4 caps at a time up to a maximum of 16 in a day.

Suggestion for probiotics is good especially as you are taking an antibiotic. Bioflor or even just yogurt (real yogurt, not the sweetened junk- Lalida brand or other plain unsweetened).

I think charcoal can't be overdosed easily as long as you have diarrhea and it is used for a limited time only.

[Denim]

Another standard treatment is to starve it out. Eat absolutely nothing for a few days and only drink water that is warm and has been boiled. Rest up and avoid being too active or sweating too much. When you start eating again after about three days go slowly and start off with bland food in small amounts. Unbuttered toast , or a little fruit that is not too acidy then maybe a light boiled egg salad to start off with. If the problem does not return slowly start increasing your food intake. The charcol treatment already mentioned is also good.

[BKKdreaming]

interesting that I have never seen anyone taking charcoal pills in the USA ,

I am sure they work, just wondering why they are not used everywhere

[ldnguy]

Your other problem will be in getting a Thai doctor to order a stool culture.

I don't see why this should be a problem. It's a fairly common test and you're paying, so they have no reason not to order it for you. I can't think of any reason they wouldn't do it for you.

[Torrens54]

Sorry but do you mean a, STHUL as in excrement?

[h90]

interesting that I have never seen anyone taking charcoal pills in the USA ,

I am sure they work, just wondering why they are not used everywhere

No profit in it. charcoal is just medical grade charcoal. You could even eat your homemade charcoal for free......

[h90]

Another standard treatment is to starve it out. Eat absolutely nothing for a few days and only drink water that is warm and has been boiled. Rest up and avoid being too active or sweating too much. When you start eating again after about three days go slowly and start off with bland food in small amounts. Unbuttered toast , or a little fruit that is not too acidy then maybe a light boiled egg salad to start off with. If the problem does not return slowly start increasing your food intake. The charcol treatment already mentioned is also good.

That works well and best together with the charcoal, but you must be very carefully on that. Your body doesn't get Vitamins and Minerals so I would at least eat a Multivitamin pill and drink an electrolyte powder dissolved in water sometimes.

Bottled water doesn't need to be boiled and you can drink it cool as well.

I (for my body) would not start with a salad, would not do me good.

A small amount chicken soup (with lot of water and not too salty) with a little bit white rice inside does well for me for the beginning. Unbuttered toast also. Fruits not. But everyone is different. Normally you know per instinct

[BKKdreaming]

interesting that I have never seen anyone taking charcoal pills in the USA ,

I am sure they work, just wondering why they are not used everywhere

No profit in it. charcoal is just medical grade charcoal. You could even eat your homemade charcoal for free......

yeah but even at $2-$3 a box you could still make a good profit

I guess someone needs to get it going , get on Dr Phil or Oprah ( is she still on ? ) make it a natural miricle cure and then rake in the millions !

[Aussieroaming]

I had similar but black black black, more like black water, but full of acid. Suffice to say I ended up hospitalised and on an atibiotic drip. Keep hydrated, take some salt and I found bland starchy food helped.

Good luck..it does improve

[h90]

I had similar but black black black, more like black water, but full of acid. Suffice to say I ended up hospitalised and on an atibiotic drip. Keep hydrated, take some salt and I found bland starchy food helped.

Good luck..it does improve

I started to bleed......enormous amounts of blood.....I am still surprised that I survived it

[h90]

interesting that I have never seen anyone taking charcoal pills in the USA ,

I am sure they work, just wondering why they are not used everywhere

No profit in it. charcoal is just medical grade charcoal. You could even eat your homemade charcoal for free......

yeah but even at $2-$3 a box you could still make a good profit

I guess someone needs to get it going , get on Dr Phil or Oprah ( is she still on ? ) make it a natural miricle cure and then rake in the millions !

no not a good profit because really everyone can produce it. (even yourself)

Of course organic charcoal with homeopathic nano silver particle for $30 a box would be per better (for profit), or 40$ and you support the Alex Jones show with your purchase .

[wpcoe]

I have seen charcoal tablets (capsules) in US drug stores.

[mommysboy]

Stomach upsets are normal in Thailand. They tend to last a few days and then subside. Just make sure anything you eat for the next few days is bland and well cooked. Consider canned food in the future. And boil all your veg. well. Only eat whole fruit like bananas and apples. Don't eat pre cut fruit sold off stalls. Shellfish is another likely source of infection.

I don't think doxycycline is indicated for stomach upsets, but is unlikely to cause any side effects. Good for treating acne and UTI.

Try to relax. Anxiety can make matters worse.

Go to doctor after 7 days or so if no better.

[mommysboy]

Another standard treatment is to starve it out. Eat absolutely nothing for a few days and only drink water that is warm and has been boiled. Rest up and avoid being too active or sweating too much. When you start eating again after about three days go slowly and start off with bland food in small amounts. Unbuttered toast , or a little fruit that is not too acidy then maybe a light boiled egg salad to start off with. If the problem does not return slowly start increasing your food intake. The charcol treatment already mentioned is also good.

Very unwise to fast for so long. 12-24 hours is usually quite sufficient.

[chubby]

...........so you have no theory, OP, how you contracted this problem? street food , shellfish , etc ?

[lopburi3]

As I recall charcoal based medicine was a standard treatment in the 60's but believe there were adverse findings (at least for the drug of choice) and it was removed from the market. Do not recall what the reason was as only an occasional consumer. Currently the below warning may have something to do with it (it also absorbs other medications as well as the bad guys).

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

Do not take charcoal with any other medicine. Take your dose of charcoal at least 2 hours before or 1 hour after a dose of any other medicine. Charcoal binds to other drugs and can make them less effective, which could become dangerous.

[milioooooons]

Even though I do feel better and ate almost normally yesterday I still have very loose stools, not as bad or frequent as a few days ago but I do eat charcoal now regularly which I did not do then.

I am now considering either waiting for a few days more or taking Tinidazole. Would the single 2g dose to be recommended then?

As to what may have caused it I am very unsure. Have only been back here for a couple of weeks after two months in Europe. I normally am quite cautious of what I eat, and I'm a pescetarian so I don't eat any meat or poultry. I usually take ice with my beverages though and do eat out or order food quite a lot.

My suspicion this time lies with some supermarket sushi wraps but of course I can't be sure. They are sealed in such a complicated way (for hygenic reasons I reckon) that they're basically impossible to open so would be slightly ironic if the bug or bacteria would be what they so carefully wrapped the layers of plastic around.

[h90]

Even though I do feel better and ate almost normally yesterday I still have very loose stools, not as bad or frequent as a few days ago but I do eat charcoal now regularly which I did not do then.

I am now considering either waiting for a few days more or taking Tinidazole. Would the single 2g dose to be recommended then?

As to what may have caused it I am very unsure. Have only been back here for a couple of weeks after two months in Europe. I normally am quite cautious of what I eat, and I'm a pescetarian so I don't eat any meat or poultry. I usually take ice with my beverages though and do eat out or order food quite a lot.

My suspicion this time lies with some supermarket sushi wraps but of course I can't be sure. They are sealed in such a complicated way (for hygenic reasons I reckon) that they're basically impossible to open so would be slightly ironic if the bug or bacteria would be what they so carefully wrapped the layers of plastic around.

When eating outside it can be almost everything.

Cutting vegetables on the same place as the chicken before is a common problem.

Not washing hands after some business on the toilet and than preparing food.

instead of cleaning glasses just flushing it with filthy water.

rat piss on a can....

1000s of possibilities.

supermarket sushi would rank rather high in my list of possible problems.....don't eat that......hot climate eat fresh cooked hot things.

Very loose is OK, nothing to worry, it can be days to weeks with unusual hard or soft stool till everything is in balance again. If it is getting better fast now, you are over it, just your guts and good bacteria need time to recover.

[Sheryl]

Tinidazole can be taken at any point but only indicated if giarda is suspected, which would be persistant diarrhea usually also with a lot of gas.

If it seems to clear up, no need.

[Maestro]

In an emergency, stuck on an aeroplane waiting over one hour for take-off, I drank several cups of strong black tea, two bags per cup, steeped at least five minutes to extract the tannins, and this stopped the diarrhoea.

[chubby]

with most and any problems the "mechanism of injury" helps in the "differential" and therefore the treatment , 1st line, deductions, eg food poisoning, would be treated differently than giardia of course, a good doctor, can often figure out what to do just from asking the right questions, with stool samples, etc

of course, confirmation helps avoid needless treatment, or making something worse, that may have just ran its course, if left along and allowing yourself to have diarrhea to clear out the toxins, and just managing your electolytes, unless very severe whence, a severe electrolyte imbalance, can actually be fatal ........

[h90]

In an emergency, stuck on an aeroplane waiting over one hour for take-off, I drank several cups of strong black tea, two bags per cup, steeped at least five minutes to extract the tannins, and this stopped the diarrhoea.

if it is really serious the tea just falls out on your bottom side as fast as you put it in on the top side......Beside that if it is serious you would not reach airport without pampers....

Sure tannins help, but only in light cases.....

[milioooooons]

As a heads up to any future sufferers I would just like to share what I am fairly certain caused this, and probably many of the similar episodes I have had during the last year of living here. I have spent much time in south east asia under much more rudimentary and less sanitary conditions before which is why I was surprised as to why I during the last year have been having recurring similar episodes.

After 5-6 days of rather bad diarrhea I now took to eating much charcoal, only drinking bottled water and only eating what would be considered completely safe (canned, dried) foods. My diarrhea subsided shortly thereafter. After a few more days of only cooking my own food and being overly hygienic about everything I returned to drinking the usual water from my water dispenser in the condo I stay at. I was at home for a day, went to the gym, and probably drank a few liters of water that day. Evening comes, and the same stomach problems are back. Thinking about it I remembered how the last time I filled up my bottles from the 1THB machine the water had seemed warmer than usual I poured it all out and took to only drinking bottled water, eating charcoal and nothing else. The diarrhea was gone in less than a day and did not return.

I would say I am 90% sure it was the 1THB water that was the culprit at this time, and very possibly the other episodes I've had as well. I for one will not be drinking water from this machine again. I do live in an upscale big name condo, FWIW.

Just my tale and a word of caution.