I live 3 months in Vietnam or Thailand and 1

Posted on Thu, 3 Jan 2019

Question: I live 3 months in Vietnam or Thailand and 1 month in Denmark. When I’m in Asia I’m plagued with almost non stop diarrhea to be just fine when coming back to Europe. Any ideas what could be the course of this? I’m cautious about what I eat and drink. No tap water or even ice cubes. I rarely eat spicy food.

I hope you can help me.

Thank you

Answered by Dr. Ramesh Kumar (14 minutes later)

Brief Answer:
Travellers diarrhoea.

Detailed Answer:
Hello and Welcome to 'Ask A Doctor' service.
I have reviewed your query and here is my advice.

The symptoms you are describing are mostly suggestive of travellers diarrhoea.When you visit a place different from your native region the climate or sanitary conditions etc are different so you have an increased risk of developing infection due to a bacteria called E.coli which causes traveler's diarrhea.The most common species involved is enterotoxigenic Escherichia coli bacteria.

Stool analysis and culture are required to confirm the diagnosis.

Treatment-

Tab Rifaximin 550 mg once daily 9 a.m
Cap Pantoprazole 40 mg once daily in morning empty stomach 6 a.m
Tab Buscopan 10 mg twice daily 9 a.m-9 p.m
Cap econorm thrice daily(probiotic)
5 days course of medication to be taken for complete eradication of bacteria and intestinal inflammation.

Hope I was helpful,
Follow up are welcome.
Thanks!

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Answered by Dr. Ramesh Kumar (24 minutes later)

Brief Answer:
Follow up.

Detailed Answer:
Hello again,
How long did you take Norfloxacin?
waiting for answer.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Ramesh Kumar (0 minute later)

I should have mentioned that my travels have been going on for 10+ years. So has the problem. I doubt I get E. coli every time and by magic it clears up when returning.

Follow up: Dr. Ramesh Kumar (22 minutes later)

The last time was a month ago. It only helped a short while. I can try your suggestions and see if it works.

Answered by Dr. Ramesh Kumar (0 minute later)

Brief Answer:
Follow up.

Detailed Answer:
Hi again,
Basically Norfloxacin is an antibiotic which covers gram negative bacteria's like E.coli.
Therefore every time when you have this problem you take it along with imodium and was relieved.However a full course of therapy should be taken once to erradicate the bacteria completely.
Yes take medicines I suggested and follow up after 5days.
Thank you!

Above answer was peer-reviewed by : Dr. Kampana