Gut problem

[gerryBScot]

Over the last 12 months I have been experiencing diarrhoea at periodic intervals, perhaps once a month. I just got up out of my sick bed today after 36 hours of it culminating yesterday morning in some heavy vomiting. I am confident it is not food poisoning as I did most of the cooking at the weekend and it was all fairly straightforward stuff like tomato soup and pasta, we all ate the same and no one else at home is showing any ill effects. After the vomiting things seemed to ease but I have a bit of diarrhoea remaining but it is not explosive. The last time I went to the local doctor they examined my stool and established it wasn't bacteria but that there was a high level of protein in it. To cut a long story short, I am considering a trip into Bangkok to see a specialist and I wonder if someone could recommend a doctor to me? Also are there any tests I could get done locally which might help in diagnosis and elimination? Many thanks for your assistance.

I should add I am not flush so would be looking to go to somewhere like St Louis or Bangkok Christian as opposed BRG etc.

Edited January 12, 2016 by gerryBScot

[NickJ]

Pathogens that cause problems dont just enter the body in contaminated food. Dirty utensils or cutting boards are often the cause. Lots of stuff that causes problems in you may not have any effect on people around you. Stool tests are not always an absolute either. Recent intake of anti biotics leave the gut weakened as well......I would replenish my gut with good bacteria. Bio flor is a good product to try as well.

[Sheryl]

Sounds like inflammatory bowel disease of some kind, based both on reported symoptoins and their duration and the protein in the stool.

It may be necessary to do a colonoscopy.

This type of problem is much more common among Westerners than among Thais, need a doctor trained in the West.

I recommend Prof. RUNGSUN RERKNIMITR. US trained and US board certified.

He is on faculty at Chula and may be possible to see him through their "after hours" clinic (though may be a long wait for appointment, and you'll have to go in person to make the booking).

He is also at Samitivej but that of course is expensive and since you may well need a colonoscopy, worth a wait to see him at Chula. http://www.chulalongkornhospital.go.th/index.php/2015-11-05-06-19-39/2015-11-05-06-20-07 ("clinics after hours". I think it is the 13th floor. You need to register on ground floor first to get a patient number. While the hours start from 4:30, nurse may be there and able to do booking say an hour before that).

He may also be available at this private clinic. I am not certain if it is still operational but if so cost would be in between Samitivej and Chula rates. https://www.medigo.com/en/clinic/thailand/bangkok/digestive-health-clinic-53bd12e8ba522#staff

I don't think there are any tests worth your doing before you see the specialist but I would suggest probiotics and also an elimination diet. Start by stopping all dairy first, except yogurt, give it a month and see if that helps. Sometimes people not previously lactose intolerance become so at a later age.

[gerryBScot]

Sounds like inflammatory bowel disease of some kind, based both on reported symoptoins and their duration and the protein in the stool.

It may be necessary to do a colonoscopy.

This type of problem is much more common among Westerners than among Thais, need a doctor trained in the West.

I recommend Prof. RUNGSUN RERKNIMITR. US trained and US board certified.

He is on faculty at Chula and may be possible to see him through their "after hours" clinic (though may be a long wait for appointment, and you'll have to go in person to make the booking).

He is also at Samitivej but that of course is expensive and since you may well need a colonoscopy, worth a wait to see him at Chula. http://www.chulalongkornhospital.go.th/index.php/2015-11-05-06-19-39/2015-11-05-06-20-07 ("clinics after hours". I think it is the 13th floor. You need to register on ground floor first to get a patient number. While the hours start from 4:30, nurse may be there and able to do booking say an hour before that).

He may also be available at this private clinic. I am not certain if it is still operational but if so cost would be in between Samitivej and Chula rates. https://www.medigo.com/en/clinic/thailand/bangkok/digestive-health-clinic-53bd12e8ba522#staff

I don't think there are any tests worth your doing before you see the specialist but I would suggest probiotics and also an elimination diet. Start by stopping all dairy first, except yogurt, give it a month and see if that helps. Sometimes people not previously lactose intolerance become so at a later age.

Thanks Sheryl brilliant as always.

[MichaelJohn]

Have you considered an allergy?

For example, Lactose intolerance can become more sensitive after 50 and if you eat food with high lactose (milk powder etc) you will have stomach problems diarohera etc

[gerryBScot]

I recommend Prof. RUNGSUN RERKNIMITR. US trained and US board certified.

Sheryl I've been in touch with the hospital and Prof Runsun holds a clinic at Chula on Tuesdays and I am going in to see him next week. Many thanks for the recommendation. I'll let you know how it unravels.

[Sheryl]

Great that you could get an appointment so soon. Was this through the after hours clinic ior are you going through the public channel? Problem with the latter is that it is very rushed, limited time with the doctor and also interns/residents do most of the direct care.

I have Thai friends who receive care at various specialized clinics in government hospitals whom I have actually taken to see the same supervising doctor at a private hospital simply to be able to actually talk with him for more than 3 minutes! (continuing to get the meds and treatment through the public channel of course).

[gerryBScot]

I've not got an appointment just told his clinic is on a Tuesday daytime and I should come in then as a new case. I don't have an appointment as such but was hoping to be seen and no doubt it will be a bit as you describe.

[Sheryl]

If you aren't happy with what you get try seeing him privately through the after hours clinic which is highly affordable. They do their best in the public channel but have to manage hordes of people in very limited time