10-21-2005, 09:59 PM
Hi, [wcipÂ]Angel,
Sorry I missed this when my reply would have been more timely. Yeah, this is another one of life's little problems that people are uncomfortable talking about, yet is a fact of life for many people. I decided to write a lengthy reply in case of future problems for you or others, since it's an area I know a bit about.
It sounds like you are one of those blessed with a "constitution"/GI tract that isn't prone to this problem. Consider yourself blessed. Read up about "Irritable Bowel Syndrome" if you don't know what that is, or just didn't pay much attention to mention of it when you came across it. Imagine being like your recent condition almost every day of your life. That can be a real misery!
It's interesting that although women suffer from IBS more than men, some seasoned travelers I know say that men often have more GI tract problems when traveling than women do. This may not really be true, but it wouldn't surprise me. It could just be that men aren't as fussy about what they eat as women! :whistling:
I have had periodic problems with diarrhea over the past 20-30 years, sometimes frequently enough that I've wondered if I had IBS. Although I've concluded that I don't, that the cause was probably elsewhere, I know firsthand how restricting it can be in your lifestyle, and downright painful. :wacko:
So, this first-hand experience, combined with some innate interest from my biology-major background, has led me to learn a fair amount about all of this.
Although the ice cream can't be ruled out, I think it's much less likely the culprit than other dishes you ate, or the sandwich. Of course, the food poisoning could just be the result of handling of the food (i.e., someone on the kitchen or wait staff not washing their hands after going to the rest room), not food contaminated from the beginning, etc. Hmmm, was it in a thread here? - somewhere recently I read about someone who refuses to eat food in a restaurant if it's served by a man, citing statistics and personal observations about the high number of men who don't wash their hands after "going potty."
One side effect of being a biology major and taking classes like Microbiology and Parisitology, is to make you a little paranoid about things that most people take for granted. In some students that wears off fairly quickly, but in others (like me, cursed with an overactive imagination), it sticks with you, pretty much for life. :blink:
The article on what to do if you have diarrhea compares pretty well with what I've been told. An easy way to remember much of this is to think of BRAT (a doctor told me about the BRAT diet about 10 years ago during a visit concerning a recent series of episodes of diarrhea).
B - banannas
R - rice
A - applesauce
T - toast
I've found you don't have to be literally restricted to those four choices - if you compare this to that article cited, you can see how each of those 4 letters relate to similar items cited in the .pdf. I find it an easy way to remember what's acceptable to eat.
Now, as to treatment, there are two basic approaches.
A simplistic explanation of diarrhea is that the intestine becomes irritated and speeds up its actions, to, in a sense, "flush out" the irritant faster. So, the reason for the "loose stool" is that the intestine isn't absorbing as much of the water mixed with the solid matter as usual.
So, the oldest approach is to absorb more of the water, helping to solidify the solid matter, sort-of attempting to mimic the normal situation in the bowels. There are several things that can be used for this, of differing effectiveness. Probably the most effective is what's sold in the USA as Kaopectate. I don't know if that brand name is available outside the US or not, though I would think so. Kaopectate is basically a very fine-grained, highly absorbant form of clay (kaolin). It can absorb many times its weight in water, and so can help concentrate the solid matter in the intestine, leading to fewer bowel movements, and a more solid stool (though here, solid is relative...).
Not quite as effective are bismuth solutions or tablets (Pepto-Bismol is the most common brand in the USA, but I usually use generic versions, and they seem as effective). Nowadays, I always keep some bismuth tablets around (longer shelf life than the liquid), and then slowly crunch them into as small particles as I can before swallowing, so they can absorb more. Bismuth tablets (at least the ones I've tried) are usually pleasantly flavored; I don't care for the taste or texture of Kaopectate (though Kao IS more effective, i.e., it can absorb more water than the bismuth preparations). One minor, but startling-the-first-time-you-encounter-it side-effect of bismuth, is that it causes the stool to darken, to turn nearly black. Just a friendly warning... :whistling:
Now, there are some other products that can help solidify the stool, but I think they are much less effective than the above two, and I don't have much/any personal experience with them. IIRC, pectin (the substance used to cause jelly to set) is found in some fruits, maybe apple peels, if my memory serves. I think I've heard of some people recommending apples for this reason. But, on the other hand, apple peels would be fairly high in fiber, and from that point of view would be bad to eat early on in the recovery process. If you want to explore these alternatives, a web search should turn up some more authoratative information, don't go by what I've written in this paragraph.
Now, the more modern approach, is to affect the muscles in the intestine. Because the muscles have "kicked into overdrive" to flush out the "bad" stuff, slowing down their activity level will allow the intestinal wall to absorb lots of water like usual, causing the frequent bowel movement to decrease or even stop. The muscles of the intestine are, IIRC, "smooth" mucles, which are only found in certain parts of the body, and researchers found a compound which selectively affects this type of muscle tissue.
Loperamide is the name of the "active ingredient" in Immodium-AD, and it is now available in generic versions, as well as from the makers of Immodium (and probably other manufacturers overseas). What loperamide does is slow down the activity level of the muscles in the intestinal wall (i.e., decreases peristalsis), allowing more water to be absorbed.
Now, we are talking "serious medicine" here, though loperamide was made over-the-counter (i.e., non-prescription) several years ago. Some people might prefer to stick to more traditional approaches, but, bottom line, I have found that serious cases of diarrhea that aren't adequately controlled by Pepto or Kao, are usually stopped by loperamide. I've only had a couple of episodes over the past 15 years or so that were so severe that even loperamide couldn't "contain" them.
I sometimes go weeks or even months without problems, but this problem has occured often enough over the past third of my life for me that I now make it a point to keep on hand both bismuth (usually tablets, which are easy to tuck in a pocket, etc., though some might prefer the easier-to-take convenience of the liquid form) and loperamide pills.
So, there you have it, some frank talk from me - and, probably more than you EVER wanted to know about this subject. :D
Hope you find it helpful.
Regard,
Dako-ta
"God is a comedian playing to an audience too afraid to laugh."
--Voltaire
[wcip]Angel,Oct 19 2005, 09:41 PM Wrote:Diahrrea! Hard to spell, even harder to cope with.
The backstory
I went to England last week-end where we partook in some of the local eateries, among others a chinese restaurant and a shady-looking Indian place. We had some hot food both places. At the Indian place, I also had the chocolate ice cream for dessert.
I should mention that I've contacted everyone I had dinner with in London, and none of them are experiencing anything similar. Granted, I was the only one who had the ice cream saturday evening, but that was 3 days before it started. I had a BLT sandwhich at Stansted airport monday afternoon, but I checked the expiration date, and it was fine. I don't know what's causing this. Divine retribution?
I'm looking for more helpful hints and tips on how to cope with this. I'm drinking plenty of fluids (water and coke), but is there anything more I can do? I suspect most of you have gone through this one time or another and have a good idea of what works and what doesn't. Also, Doc, if you see this, and if you are indeed a Doc(tor), please tell me what to do. The pain from having to go the bathroom so frequently is so intense, I feel short-winded when I'm done.
Apologies in advance if this post upsets anyone. I don't know what to do.
[right][snapback]92690[/snapback][/right]
Sorry I missed this when my reply would have been more timely. Yeah, this is another one of life's little problems that people are uncomfortable talking about, yet is a fact of life for many people. I decided to write a lengthy reply in case of future problems for you or others, since it's an area I know a bit about.
It sounds like you are one of those blessed with a "constitution"/GI tract that isn't prone to this problem. Consider yourself blessed. Read up about "Irritable Bowel Syndrome" if you don't know what that is, or just didn't pay much attention to mention of it when you came across it. Imagine being like your recent condition almost every day of your life. That can be a real misery!
It's interesting that although women suffer from IBS more than men, some seasoned travelers I know say that men often have more GI tract problems when traveling than women do. This may not really be true, but it wouldn't surprise me. It could just be that men aren't as fussy about what they eat as women! :whistling:
I have had periodic problems with diarrhea over the past 20-30 years, sometimes frequently enough that I've wondered if I had IBS. Although I've concluded that I don't, that the cause was probably elsewhere, I know firsthand how restricting it can be in your lifestyle, and downright painful. :wacko:
So, this first-hand experience, combined with some innate interest from my biology-major background, has led me to learn a fair amount about all of this.
Although the ice cream can't be ruled out, I think it's much less likely the culprit than other dishes you ate, or the sandwich. Of course, the food poisoning could just be the result of handling of the food (i.e., someone on the kitchen or wait staff not washing their hands after going to the rest room), not food contaminated from the beginning, etc. Hmmm, was it in a thread here? - somewhere recently I read about someone who refuses to eat food in a restaurant if it's served by a man, citing statistics and personal observations about the high number of men who don't wash their hands after "going potty."
One side effect of being a biology major and taking classes like Microbiology and Parisitology, is to make you a little paranoid about things that most people take for granted. In some students that wears off fairly quickly, but in others (like me, cursed with an overactive imagination), it sticks with you, pretty much for life. :blink:
The article on what to do if you have diarrhea compares pretty well with what I've been told. An easy way to remember much of this is to think of BRAT (a doctor told me about the BRAT diet about 10 years ago during a visit concerning a recent series of episodes of diarrhea).
B - banannas
R - rice
A - applesauce
T - toast
I've found you don't have to be literally restricted to those four choices - if you compare this to that article cited, you can see how each of those 4 letters relate to similar items cited in the .pdf. I find it an easy way to remember what's acceptable to eat.
Now, as to treatment, there are two basic approaches.
A simplistic explanation of diarrhea is that the intestine becomes irritated and speeds up its actions, to, in a sense, "flush out" the irritant faster. So, the reason for the "loose stool" is that the intestine isn't absorbing as much of the water mixed with the solid matter as usual.
So, the oldest approach is to absorb more of the water, helping to solidify the solid matter, sort-of attempting to mimic the normal situation in the bowels. There are several things that can be used for this, of differing effectiveness. Probably the most effective is what's sold in the USA as Kaopectate. I don't know if that brand name is available outside the US or not, though I would think so. Kaopectate is basically a very fine-grained, highly absorbant form of clay (kaolin). It can absorb many times its weight in water, and so can help concentrate the solid matter in the intestine, leading to fewer bowel movements, and a more solid stool (though here, solid is relative...).
Not quite as effective are bismuth solutions or tablets (Pepto-Bismol is the most common brand in the USA, but I usually use generic versions, and they seem as effective). Nowadays, I always keep some bismuth tablets around (longer shelf life than the liquid), and then slowly crunch them into as small particles as I can before swallowing, so they can absorb more. Bismuth tablets (at least the ones I've tried) are usually pleasantly flavored; I don't care for the taste or texture of Kaopectate (though Kao IS more effective, i.e., it can absorb more water than the bismuth preparations). One minor, but startling-the-first-time-you-encounter-it side-effect of bismuth, is that it causes the stool to darken, to turn nearly black. Just a friendly warning... :whistling:
Now, there are some other products that can help solidify the stool, but I think they are much less effective than the above two, and I don't have much/any personal experience with them. IIRC, pectin (the substance used to cause jelly to set) is found in some fruits, maybe apple peels, if my memory serves. I think I've heard of some people recommending apples for this reason. But, on the other hand, apple peels would be fairly high in fiber, and from that point of view would be bad to eat early on in the recovery process. If you want to explore these alternatives, a web search should turn up some more authoratative information, don't go by what I've written in this paragraph.
Now, the more modern approach, is to affect the muscles in the intestine. Because the muscles have "kicked into overdrive" to flush out the "bad" stuff, slowing down their activity level will allow the intestinal wall to absorb lots of water like usual, causing the frequent bowel movement to decrease or even stop. The muscles of the intestine are, IIRC, "smooth" mucles, which are only found in certain parts of the body, and researchers found a compound which selectively affects this type of muscle tissue.
Loperamide is the name of the "active ingredient" in Immodium-AD, and it is now available in generic versions, as well as from the makers of Immodium (and probably other manufacturers overseas). What loperamide does is slow down the activity level of the muscles in the intestinal wall (i.e., decreases peristalsis), allowing more water to be absorbed.
Now, we are talking "serious medicine" here, though loperamide was made over-the-counter (i.e., non-prescription) several years ago. Some people might prefer to stick to more traditional approaches, but, bottom line, I have found that serious cases of diarrhea that aren't adequately controlled by Pepto or Kao, are usually stopped by loperamide. I've only had a couple of episodes over the past 15 years or so that were so severe that even loperamide couldn't "contain" them.
I sometimes go weeks or even months without problems, but this problem has occured often enough over the past third of my life for me that I now make it a point to keep on hand both bismuth (usually tablets, which are easy to tuck in a pocket, etc., though some might prefer the easier-to-take convenience of the liquid form) and loperamide pills.
So, there you have it, some frank talk from me - and, probably more than you EVER wanted to know about this subject. :D
Hope you find it helpful.
Regard,
Dako-ta
"God is a comedian playing to an audience too afraid to laugh."
--Voltaire