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Diarrhea For 6 Days While In Thailand? Help!


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Hi. I am vacationing on one of the islands in Thailand. 5 or 6 days ago, I ate some seafood that seemed undercooked but didn't think anything of it at the time. Shortly after eating it I experienced severe abdominal cramping and horrible liquid poop that hurt as it came out. Ever since then I've been having liquid stool, abdominal cramping, severe nausea (but no vomiting), and fatigue that comes and goes. For the first 5 days I had bowel movements 10 - 12 times a day but would urinate only once or twice a day. On the 5th day I felt so awful that I went to a pharmacist for medicine. She prescribed three different medicines for me: Norflox 400mg (to be taken twice a day), Molax 10mg (to be taken three times a day), and Ibuprofen 400mg (to take as needed).

I googled these medicines, of course, and their possible interactions but would like more info... Has anyone else experienced this while in Thailand? What was your diagnosis and treatment? Should I be worried about this? I don't want to go to a hospital if I don't have to. Whenever I have gone to hospitals in the past all they have done is waste my time and charge me a ton of money for doing nothing that a trip to Rite Aid wouldn't have fixed.

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Having suffered similar problems, roughly every 3 months, in my first year here.

I tried several of the anti-biotic on sale for this type of problem. I settled on.

Ciprofloxacin for the Anti-biotic, morning and evening for 3-5 days (ask pharmacy)

Imodium to stop the diarrhea (not more than twice in the duration of the illness)

Electrolytic powders, several packets a day in water to aid re-hydration.

And of course NO ALCOHOL at all for the duration as it negates the effects of the anti-biotic.

You should have asked for help on day two of your illness as you may be suffering severe dehydration now and might actually need to use a hospital to provide re-hydration.

Not sure why they would give you Ibuprofen, if it's to hide severe headaches due to dehydration, that would appear to be very dangerous course of action as the next stage can be seizures.

Please note I am not a doctor, if you die after following any of my advice, not my fault.

Having lived here for several years, I have built up and immunity and no longer use the anti-biotic, and the problem is usually over in a half day.

Edited by TommoPhysicist
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I usually get diarrhea from eating Thai food (I think because of the spices) but it usually only lasts a few hours. I guess thats why I didn't think anything of it until a few days had gone by. And yeah, I have some mild dehydration. So what should I do? Should I continue taking what the pharmacist prescribed or switch to the medicines you said are effective? Also, are you a doctor or nurse?

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Keep taking what the pharmacist suggested (maybe not the Ibuprofen)

The anti-biotic should be having an effect by day 2, if not back to pharmacy or doctor.

Monitor your urine, if it is very dark, you have a problem, if it gets DARKER see a doctor..

Have a glass/bottle of water with you at all times and sip constantly (add electrolytes to the water, from pharmacy, not expensive, not harmful)

Edited by TommoPhysicist
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Diarrhoea is can also be a symptom of dehydration. The first bout of painful camps and the skip-to-the-loo appears to be acute but minor food poisoning, 6 days is worrying and could well be the resultant dehydration.

Ibuprofen can actually cause stomach issues and diarrhoea, I can't think of a reason why the pharmacist would give you that.

One of the forum resident experts (Sheryl) will probably be along soon to assist - her advice is usually highly valuable.

Until then I recommend I nice bottle of red wine... Poor the wine down the sink, throw away the bottle, use the cork !...

Charcoal tablets often help to absorb the junk in your stomach and help you have a proper pooh, also ensure you urine is clear, if not drink more water.

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i had bad case of diarrhea lasted for couple of weeks turned out to be an intestinal parasite.

You should stop eating solids foods drink plenty water and rehydration meds. when diarrhea stops should eat very bland and easy to digest foods to start with and in small amounts

i would see a doctor if it keeps up it can be very dangerous

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i had bad case of diarrhea lasted for couple of weeks turned out to be an intestinal parasite.

You should stop eating solids foods drink plenty water and rehydration meds. when diarrhea stops should eat very bland and easy to digest foods to start with and in small amounts

i would see a doctor if it keeps up it can be very dangerous

A parasite?!?!? What kind???!? EWwwww I hope i don't have one

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Plenty of liquids (coconut water is especially good) and activated charcoal are the best hom management. you need to drink enough fluid that your urine remains light in color.

i would advise against an antibiotic without first having a stool test but as you have already begun one, continue for the full course. If it persists, go to a hospital and get a stool test.

Likewise if you develop high fever, go to a hospital.

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Keep taking what the pharmacist suggested (maybe not the Ibuprofen)

The anti-biotic should be having an effect by day 2, if not back to pharmacy or doctor.

Monitor your urine, if it is very dark, you have a problem, if it gets DARKER see a doctor..

Have a glass/bottle of water with you at all times and sip constantly (add electrolytes to the water, from pharmacy, not expensive, not harmful)

Urine has been clear to light yellow in color... Today is the second day of the medicine... I still have loose stool but much less in frequency... been trying to drink more liquids... just had a bottle of gatorade, still feeling fatigued and out of it.

I posted this question on yahoo answers, too... Why are those people so horrible while you guys are so helpful?

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Keep taking what the pharmacist suggested (maybe not the Ibuprofen)

The anti-biotic should be having an effect by day 2, if not back to pharmacy or doctor.

Monitor your urine, if it is very dark, you have a problem, if it gets DARKER see a doctor..

Have a glass/bottle of water with you at all times and sip constantly (add electrolytes to the water, from pharmacy, not expensive, not harmful)

Urine has been clear to light yellow in color... Today is the second day of the medicine... I still have loose stool but much less in frequency... been trying to drink more liquids... just had a bottle of gatorade, still feeling fatigued and out of it.

I posted this question on yahoo answers, too... Why are those people so horrible while you guys are so helpful?

Seems like you are over the worst of in. Keep taking the anti-biotic until all finished. Don't be tempted by alcohol.

Carry round a half liter bottle of water with some added electrolyte. Sip constantly.

You can still take an Imodium tablet if you want the unpleasant symptoms to go away quickly (about 40bht for 6)

Good luck.

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i had bad case of diarrhea lasted for couple of weeks turned out to be an intestinal parasite.

You should stop eating solids foods drink plenty water and rehydration meds. when diarrhea stops should eat very bland and easy to digest foods to start with and in small amounts

i would see a doctor if it keeps up it can be very dangerous

A parasite?!?!? What kind???!? EWwwww I hope i don't have one

sorry cant remember the name it was a few years ago, but it is caused by bad hygiene in food prep usually found in third world countries but i picked it up in Romania

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Having lived here for several years, I have built up and immunity and no longer use the anti-biotic, and the problem is usually over in a half day.

Perhaps you're just more careful about what you eat. Food poisoning is pretty common with Thais who have been eating this food all of their lives.

I've been here for 6 years, and all that's taught me is to be very careful where I eat out. I can't say I've had full on food-poisoning, but have had diarrhea more times than I could count.

A good pro-biotic to keep the bowel functioning efficiently is a very good idea. I drink kefir to achieve that.

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I would have told you to go with Norofloxin 400 2x daily as well (this is my jungle doctor understanding and nothing more) if you were absolutely certain it was the seafood.

I think it's 800mg / 5 days. ???

You have been given the correct regiment. If you have taken any alcohol, keep taking your regiment - but start all over. You must do that regiment completely without alcohol if you are drinking and three days into treatment still have watery stool. If you have consumed a lot of alcohol at any time - you must start over as well.

Cipro is taken way too nonchalantly.

Other issues you may have which I often had in the past when I abused my tummy and THIS is the more difficult than no alcohol:

You must treat your tummy really well. That means no coffee or anything acidic. No spicy or fried foods. You might get some hot dogs and bread for dinner. Oatmeal for breakfast and Khao mahn gai for lunch. Relax and take it easy. Drink lots of water and get packets of electrolytes (B5)

Your stool should harden by now, but if not do not freak out if it has not. Give it time.

If you have finished your meds and simply must drink - have a quality beer (not Chang) and limit your drinking to just a few.

PS: The impact of killing the bug you have is also killing much of the bad - and good flora in your gut so it is very important to eat really bland and safe foods (clean) for a few weeks.

PPS: I am not at all careful about what I eat, but look to hygiene of vendor and potential time/temperature abuse - BUT....NEVER EAT ANY SHRIMP OR CRAB SOLD ON THE BEACHES IN THAILAND :-))

I totally agree with Tropo - Thai's do succumb as farang. I recall some years ago an ad in Hualalampong Station for Imodium. :-) My GF gets the shits on rare occasion, just last week. Even myself like her, bad food usually = one quick trip to the toilet. This seafood thing = Norofloxin every time, you can't wish it away.

Hope this helps and stay out of the sun

Edited by bangkokburning
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Diarrhea for 6 days and you haven't been to a Doctor seem foolish. You come and ask advise from wanna be medical experts here. Shame on you go see a doctor and don't be so cheap about your health.

Edited by Nowhereman60
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I am just recovering from a 10 day bout of the same issue. I live way out in the sticks and was determined to tough it out. In the end I found a pharmacist who gave me Norvolfloxin and electrolytes. I took 4 more days, but today I am hungry for the first time and feel about 90% recovered.

I didn't know a lot of the things suggested here, I wish I had as I continued with coffee almost the whole time.

I lost a lot of weight, which I'll take as the silver lining.

What are some readily available probiotics in Thailand?

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Get on the coconut water and charcoal tablets (ask for carbon) and electrolyte sachets and drink plenty of fluids! This is what I always do if I have a bad case that lasts more than 24 hours.

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Charcoal isn't going to fix this problem. The tablets are very expensive. If you are going that route, better to eat burnt toast.

I always wait five days before I do myself with meds. I HOPE my body will heal itself. After five days - there is no hope. I have general rule which I use to separate if I should take Noro/Ciprofloxin or Flagyl. This incident surely is not related to Giardia.

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Charcoal isn't going to fix this problem. The tablets are very expensive. If you are going that route, better to eat burnt toast.

I always wait five days before I do myself with meds. I HOPE my body will heal itself. After five days - there is no hope. I have general rule which I use to separate if I should take Noro/Ciprofloxin or Flagyl. This incident surely is not related to Giardia.

If you do have food poisoning, charcoal tablets absorb all the bad stuff (i.e. the poison) also where on earth are you getting the information that charcoal tablets are expensive? It's less than 30 baht for 10 tablets from most pharmacies!

I would avoid taking any antibiotics unless you've had a stool test by a doctor and they have determined which antibiotic will respond to the bacteria in the stomach/gut.

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Charcoal isn't going to fix this problem. The tablets are very expensive. If you are going that route, better to eat burnt toast.

Charcoal is not intended to "Fix" the problem, its alleviates the symtoms....I assume you are joking about the burnt toast....but if you are serious...Charcoal tablets and burnt toast are not the same type of charcoal...the tablets are activated charcoal....go an look it up, the charcoal under goes addtional processing

The tablets are expensive....jeez, not as expensive as landing in hospital because to tried to eat burnt toast to fix food posioning...whistling.gif

Here is the Uncle Soutpeel tried and tested method, and been used in many countries in the world, endorsed by a phamacist friend of mine

first 24 hours - Charcoal tablets and lots of water/rehydrate powder ( 2 tablets every 4 hours)

Second 24 hours - as above

third 24 hours - continue charcoal/Water/rehydtate, and start taking antibiotics

if by 5 days you are not fixed up....go the hosptial

Do not..do not take immodium

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Once I ended up vomiting etc from drinking a coke with unclean ice on a bus in Thailand. After three days in a room (so sick) managed to get to a doctor who prescribed 4 tablets of Flagyl to be taken at once. All over in three hours

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Once I ended up vomiting etc from drinking a coke with unclean ice on a bus in Thailand. After three days in a room (so sick) managed to get to a doctor who prescribed 4 tablets of Flagyl to be taken at once. All over in three hours

My worst was in Pattaya where I ended up in BPH on an antibiotic drip after 5 days of Bangkok belly....nothing woudl shift it....2 hours on the drip...fixed

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Once I ended up vomiting etc from drinking a coke with unclean ice on a bus in Thailand. After three days in a room (so sick) managed to get to a doctor who prescribed 4 tablets of Flagyl to be taken at once. All over in three hours

My worst was in Pattaya where I ended up in BPH on an antibiotic drip after 5 days of Bangkok belly....nothing woudl shift it....2 hours on the drip...fixed..what caused it ?....no idea

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Ewww. After reading this thread I feel like I need to swab my 'puter with alcohol to kill off the germs.

I have only had one significant illness in several years in Thailand ... a bit like the OP's problem but culminating in spots all over my body! At this stage I went to hospital because I was due to travel on a plane and worried I would cause a hot-zone situation with people in hooded outfits running around. The doctor didn't do a stool test but diagnosed entero-virus and said it was OK to go on the plane as the risk of infection would have ceased by the time I got the spots. I can't remember what drugs they gave me. I went online some time later and put all my symptoms into one of those "heal thyself' web sites. They didn't match entero-virus at all. The web site told me I had typhoid. Anyway I started eating again and the spots went away some time later.

Onwards and upwards thumbsup.gif

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Thai Visa is full of qualified doctors... best place to ask!

If people were interested in the advice of professional Thai doctors they wouldn't be chatting here, would they? This is purely discussion and these discussions can be very fruitful at times as well as saving a lot of money seeing the wrong professionals or going to the wrong hospitals. Apart from that, it's not easy to find communicative Thai doctors who don't want to rush you out of their surgery in 5 minutes clutching a script for thousands of baht's worth of medicine without explanation.

In 6 years I've wasted a significant amount of cash with doctors and specialists I'd prefer to forget.

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I am very serious about the burnt toast - burnt toast and flat Sprite. If that is all you have about, use it. Charcoal won't help at all for this situation, but good luck.

I actually carry charcoal tablets along with Bismuth subsalicylate from my old backpacking days. This is all well and good for tummy upsets - when you are rocked by stated illness or Giardia, you are screwed. I want to give my illness five days without hope before I start medication. If I am a position that I do not have to travel, I may wait seven. After seven - might as well be 70.

It is as Sheryl stated, highly advisable to go to a clinic and get a stool test. Do it here and not in your home country where it may be far more expensive and in the case of Giardia, many labs will not have a clue what they are looking for.

The seafood dish you mentioned pimping might have been far too spicy for you with the additional *benefit* of time/temp abuse on the seafood. Fish is generally fine (some species you must be careful for histamines and parasites) but shellfish especially you must be very careful in Thailand. Thai's get a lot of shellfish off trawlers and trawl catch is always dead. Not good to eat dead shellfish and the longer it is dead the more deadly it can become. It is best to eat seafood only at seafood venues near the sea.

Edited by bangkokburning
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Thailand gives great lab. You have to learn to read lab here to save yourself. Doctors for whatever reason just don't do their jobs and at B4-500 a visit, it is no longer a cheap 10 minutes. Annual checkup few weeks back, major BKK hospital - all lab, no check. Lady doctor looked at my eyes, mouth and ears. OK done. thumbsup.gif

At least she did lecture my GF on her insane cholesterol

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Thai Visa is full of qualified doctors... best place to ask!

If people were interested in the advice of professional Thai doctors they wouldn't be chatting here, would they? This is purely discussion and these discussions can be very fruitful at times as well as saving a lot of money seeing the wrong professionals or going to the wrong hospitals. Apart from that, it's not easy to find communicative Thai doctors who don't want to rush you out of their surgery in 5 minutes clutching a script for thousands of baht's worth of medicine without explanation.

In 6 years I've wasted a significant amount of cash with doctors and specialists I'd prefer to forget.

I have actually found this section of Thaivisa forum to be EXTREMELY beneficial to me and whilst in some cases I have had to still go and see a specialist or a doctor, sometimes just getting an insight off someone who may have been in a similar situation or knows about it can be really helpful. There are definitely some members here who know what they're talking about... Take Sheryl for example, she never fails me!

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