Since there are a couple of members on this forum with a medical background I thought I'd post here to see if I can get help.

For the past couple of weeks I've been suffering with diarrhea. It started with cramps in the abdominal area followed by excess gas and a bloated feeling. This left me doubled up in pain and unable to sleep several nights. A few days later the bloating created so much pressure and resulted in diarrhea. After several trips to the toilet the pressure was relieved and I was able to sleep again.

After several days with the same symptoms I decided to visit the pharmacy, they gave me tablets for abdominal cramps, electrolyte solutions, nausea tablets and Imodium to stop the diarrhea. The symptoms didn't improve but worsened, I think the Imodium blocked me up which resulted in massive buildup of gas and pressure in the intestines, finally being relieved after going to the toilet. A week later I decided to visit Paolo Hospital, and was admitted the same day.

They connected me up to an IV drip, fed me several drugs and administered several antibiotic solutions, one in which I was allergic to so they had to give me another drug to counter act that. They did a stool; urine and blood test, all were fine. The next day, I was feeling a little better, and my wallet 9,000 baht lighter, they decided to let me go home with a bunch of tablets to take.

The symptoms continued with bloated feelings followed by bouts of diarrhea and sleepless nights. I decided to get a second opinion and visited a local clinic. They said that I had a minor infection of the upper bowel and gave me 5 bags of colourful tablets to take.

2 days later the symptoms persisted so I decided to visit AEK Udon for yet another opinion. The doctor didn't think the condition was serious but insisted on another stool sample which showed a slightly higher white blood cell count indicating a minor infection. He prescribed a couple of tablets and told me to revisit in the problems persisted.

It's now two days since visiting AEK, I seem to feel ok through the day, but after a meal in the evening I usually get a bloating feeling, it feels like there's a block in the system and my stomach balloons leaving me with an unpleasant pain. Finally I'll need to go to the toilet and have diarrhea 5 or 6 times, it feels like I'm opening the valve of a pressure cooker and then I start to feel better again.

The diarrhea is a little foamy and has a very unpleasant smell. As I right this I can hear the acids in my stomach gurgling and moving around and lot's of gas building up. My abdomen is usually quite hard because of the gas build up in the intestine/upper bowel area.

Does anyone have any ideas what this could be?

Thanks in anticipation.

Tried to call you - but your phone must be off...

Initially - before I can give you ideas - give me a list of ALL medications that you are / have been taking.

Second - what is your diet like with this condition?

Just to venture a minor guess at this point - the symptoms seem to be pointing to salmonella - a significant food poisoning bacteria. Salmonella is difficult to diagnose and could only be diagnosed in a lab more sophisticated than what is available here in Udon. Typically, it is necessary to test for the salmonella bacteria.

But - before you get to that point - give me the other information. The symptoms that you describe could also be linked to medication you might be taking on a regular basis - say, for high blood pressure.

Thanks for your response Doc.

I have been prescribed the following medications:

Omeprazole 20g (Twice a day)
Librax tablet (for abdominal pain)
Ofloxacin 100mg (antibiotic)
Motillium 10mg (nausea)
Infloran (diarrhea)
Simethicone 80mg (Antiflatulence)
and 2 other drugs without a name on the bag.

I'm not on any other medications for any other conditions; I'm otherwise healthy except for asthma.

I had no fever when in hospital and my blood pressure was normal.

I'm not eating anything spicy food at the moment, just the usual couple of rounds of toast in the morning, rice soup at lunch and something light at dinner. And I'm drinking plenty of water.

I have been taking the usual electrolyte drinks too.

Thanks, Lee

The next typical diagnosis step would be for one of the following: sigmoidascope, lower and upper GI. These tests would determine whether or not there is a bowel obstruction. An alternative could be a sonogram - but the results of that might not be conclusive.

You could try keeping the stomach empty for a day - to see if that would help. Then try something very light for the next couple of days. Toast that is dry is a good start - as repulsive as it may be - well at least for us Yanks. A protein drink could be beneficial for keeping up your strength, providing that it does not have any dairy products. If there is no improvement with that regimine, then you can opt for the diagnostic tests. None of the drugs that you are taking would create any problems.

If you want to gamble a bit - then you could try to find a drug known as chloramphenicol which is more or less the drug of choice for salmonella poisoning in developing countries, which I would classify Thailand as. The best source for that would be at the pharmacy on the second floor of the Complex next to the gold store. They would know if there is something better on the market.

If you had regular food poisoning, it would, in all probability be cleared up by now. To be on the safe side, think back to what you ate in the few days prior to demonstrating the symptoms. If it was something in your refridgerator, then I would replace it as a precaution - especially if you have still been partaking of those products since the symptoms appeared. A new water supply would also be recommended, particularly if you are drinking the water from a 5 gallon bottle. If you are using a water filtration system in your house - that could be the source of the problem.

HI LEE

SOUNDS LIKE YOU HAVE A TOUCH OF MY CONDITION WHICH i AM RECEIVING HELP FOR THE LAST SIX YEARS> dONT WANT TO WORRY YOU BUT IT SOUNDS LIKE PANCREATITIS. I WAS IN 3 HOSPITALS IN UDON WITH THIS AT XMAS BEFORE I ARRIVED AND ADDMITTED TO PAULO. UNFORTUNATELEY THEY HAVE NOT GOT A CLUE IN PAULO AND ALL THE DRUGS I REQUESTED WERE OFF THE MENU. I LUCKLY FOUND OUT THAT 1 OF THE IV,S THEY WERE FEEDING ME WAS A "CANCER" DRUG BELONG TO ANOTHER PATIENT".

FROM THAT MOMENT I TOOK CHARGE AND REQUESTED LOSEC ON DRIP AND DF118 FOR PAIN AND WAS OUT IN 2 MORE DAYS. IT TOOK THEM A WHILE TO AQUIRE THESE DRUGS FROM OTHER HOSPITALS BUT I HAVE BEEN LAID UP WITH THIS BEFORE AND I KNOW THE DRUGS REQUIRED.
ASK THE PHARMACIST AT THE CHOONSERI 2ND FLOOR BESIDE THE GOLD SHOPS FOR THESE 2O MG OF LOSEC TABS THEY WILL STOP THE BLOATING AND RELIEVE THE ACID. AS FOR THE PAIN ASK HIM FOR PETADINE TABS OR THE EQUVILENT.

HOPE IT WORKS FOR YOU.

P.S. SORRY FOR THE SPELLING AND THE CAPS , JUST NOTICED KNOW AND I HAVE TO GO TO WORK , I AM VERY LATE .
CHEERS

Doc wrote:If you had regular food poisoning, it would, in all probability be cleared up by now. To be on the safe side, think back to what you ate in the few days prior to demonstrating the symptoms. If it was something in your refridgerator, then I would replace it as a precaution - especially if you have still been partaking of those products since the symptoms appeared. A new water supply would also be recommended, particularly if you are drinking the water from a 5 gallon bottle. If you are using a water filtration system in your house - that could be the source of the problem.

I remember buying a frozen vegetarian meal a couple of weeks back from Big C, keeping it in the fridge and eating it the next day. After that I had these symptoms, but I didn't think this was a problem because it was just a vegetable dish.

I drink bottled mineral water so I can cross that off the list. I guess I could could have picked something up from anywhere i.e. dirty ice, dirty food at a restaurant etc.

I'll take your advise and stay of the food for a day and see how I feel.

Your help is much appreciated.

P.S. I'll be seeing you about that Bupa Insurance very soon!

Lee, if you decide to go down the Losec path (after consulation with a medical practicioner) give me a call. I can supply a months supply of Acimax (generic Losec, active ingredient Omeprazole) at a very good price. I use it for reflux.

John

lee wrote: I guess I could could have picked something up from anywhere i.e. dirty ice, dirty food at a restaurant etc.

I had this trouble once in Bangkok... 'Dirty Ice in my drink' was the suspect, but it cleared up after 2 days of fasting (+ 1 Imodium Plus pill)... so I'd be inclined to think something else is causing this.
I know how you must be feeling Lee... "When the world falls out of your bottom, the bottom falls out of your world na?"

Hope it clears up soon mate

Lee, Listen to Doc, his advise is sound. Under NO circumstances take Imodium, this drug only stops the bodily function for a short time, It can do more damage to the system as the bacteria will multiply.

Having has exactly what you have described twice now!! I feel I can advise you to do the following:

NO Alcohol
No Spicey food
No milk or dairy products.

No Ice in drink
Drink Sprite or seven up (Flat if Possible,leave the cap off for a short while)
Drink electrolyte replacements

Get some Ultrcarbon Tablets (these absorb all the bacteria) (they are basically Charcoal !!) The guy at Charoen Sri Pharmacy is a great guy and I trust him 100%

You might need a light pain killer for the cramps, nothing too heavy.

What I have found that it is usually related to eating seafood of some kind, for that reason I do not eat Oysters or Non sea water prawns.

I hope the above will be of some use to you, the carbon tabs work for me !!

Lee, From a layman's perspective, I'd be inclined to stop taking everything, apart from the anti-biotics. There maybe one or more things that either don't work for you, don't agree with you, or that are antagonising things. And I certainly concur do NOT take Imodium.

Lee One thing to keep in mind is the possibility of Giardia the fix for it is a drug called flaygl. I am not recomending that you take this just keep it in mind. I had the same symtoms when I was in Tibet and it completly knackered me. I was on the same heap of meds you are on and a Doctor I met the doc was on holiday thought I was unresponsive so he thought it was Giardia I was back in the game in a few day. Again I am not qualified to give you medical advice but dont be afraid to get some test because I think they can see some of these things in a scope.
Good Luck to you

Starve it,stay off the imodium,lots of fluids and eletrolytes.
I concur with docs advice except I would not gamble on meds without the G.I.checkout! If my body or instincts say possible blockage,I would definitely insists on diagnstic tests to rule out a blockage!I would rather be wrong and pay the costs than just rely on a doctors or anyones educated guess!Good luck!

Thanks for the helpful replies everyone. I'm staying off the food for the moment and drinking plenty of water and electrolytes. I'm also drinking that Brands chicken drink for a little protien.

I'll see how I feel in the morning, if no change I'll look into getting some of those Ultrcarbon Tablets.

Thanks, Lee

lee wrote: I'm also drinking that Brands chicken drink

Thanks, Lee

ewwww mate that `brands chicken drink` tastes soooo badddd

its good for you but ewwwww yuck!!!!

Sorry Lee - but the ultracarbon tabs will only serve to mask the problem for a short term - especially if you have samonella or, E-coli. Carbon will kill basic bacterias - not the complex syntax bacterias that can be found.

One thing that you didn't tell everyone is that you have had this condition for about 10 days - plus that you had been drinking Soy Milk. This puts things in a whole different perspective. Soy Milk puts good bacteria in the stomach - but it is not effective at killing the bad bacteria. The end result is that the bad bacteria prevails which can cause the bloating, then the gas and the foamy crap. Also, stay away from the rice soup. Even though rice is easily digestible, it can breed bacteria and enhance it very quickly.

I know that you try to eat healthy - and have had no problems in the past. The vegetarian thing does raise the possibility of an E-coli bacteria. That is a hard one to get rid of - just as salmonella is. Neither one of those bacterias will show up in a microscope as they need to be cultured for at least 24 hours in a controlled environment. The labs here in Udon are not able to do that. In the microscope, they are looking primarily for parasites - bacteria does not always show up in the microscope.

Call me later this morning and let me know how you are feeling. That should give everyone a better baromoter on how things are going.