Archie29621, in another thread you posted, “I have been advised not to use Imodium AD for the shits. Lomotil is the recommended medication in SEA.” I’m wondering where this suggestion came from, and why one drug over the other.

I’m not disagreeing with your assertion as I’ve found Lomotil to be most effective. Thus, I include it in my travel kit. But, I’ll admit that I’ve never used Imodium, so I have no basis for comparison.

Just wondering if there’s a pharmacological reason for using one over the other. One way or the other these types of drugs can literally save a trip that might otherwise be a disaster.

TIA,

StrikeEagle

Let me take a run at this issue.

I have used Imodium in various forms over the years and it has always seemed to be very beneficial. Last weekend in Ensenada, MX I had a problem and the frontdesk man at our hotel gave me Imodium.

I do know that you are suppose to talk to your doctor before using, if you are taking antibiotics or have liver disease. Since most mongers fit the profile of bad livers and the use of antibiotics, maybe that is what he is referring too.

Also other side effects, but nothing important like impotency

The info came from my doctor. Also, when I used the Imodium AD in the Philippines (before consulting with my MD), I found it did no good whatsoever. I also have a friend living in PI and he had a stomach disorder that none of the conventional medications that his doctor gave him would cure. He went to another doctor and was prescribed an amoebacide(SP)and was cured.

As a doc myself , let me say both are equally effective. No reason to choose one over the other. Imodium is readily available in any Thai pharmacy for a reason. There are some types of infectious diarrhea that neither will help and in fact can be dangerous to use- amoebic dysentery is one. Shigella another. Most travelers trots are adequately and safely treated by either one. If persists for more than 2-3 days best to get to a doc or hospital though.

Thank You, Gentlemen.

Khun Mor, given your profession, do you have an opinion on a traveler bringing a supply of antibiotics (Cypro or equivalent) with them for ‘emergency use’?

I am not seeking treatment advice, as I am well aware of the ethical challenges of that type of question. However, if a patient came to you and said that they wanted a script for something as he was getting ready to head to BKK in a few days, how would you respond?


StrikeEagle

Suffice it to say I carry Cefzid and Tequin- a cipro clone on my mongering trips for various purposes. I also carry Valtrex - in case of herpes exposure. Never got it - do not want it- but drug will cut your down time if you get it. Drugs are damn expensive but fortunately I get free samples- nice little perk.
In SEA in particular however there are some nasty strains of various diseases that are notoriously resistent . Do not hesitate to go to local QUALITY hospital if any symptoms persist.In BKK this would be Bumrungrad- conviently located within walking distance of Nana Plaza.

Khun mor,

You still around? I picked up a BAD case of the trots early last week in Rosarito, went to my Doc and got a 3 day course of Cipro, no effect. It ran out on Saturday so I went to TJ and bought the equivalent of double strength Bactrim (160/800 mg, brand name Vanadyl) after speaking with the Doc who also ran the pharmacy. Two days and I'm feeling fine, although I will follow the 5 day dosing schedule.

I'm wondering why my American doc tried Cipro. I have to believe that Mex docs are THE experts in treating infected guts.

Also, even with insurance, the copays cost $25 plus insurance premiums and missed work to go the American route. In Mex, free consultation, and $8 meds on a Saturday.

In this all too common case:
American - expensive, ineffective, inconvenient
Mexican - cheap, effective, convenient

Ldvee
Trots ain't my specialty , but I have no idea what the gringo doc thought he was treating. Doxycycline Bactrim or flagyl would make more sense as the Mexican doc advised. I agree that a doc in Mexico would be much more familiar with the local "touristas" and what they responded to best.

Khun mor,
How about eating a lot of Yoghurt as a preventive? Last year I visited Mazatlan and had a bad case of Montezuma's Revenge towards the end of my stay. This year I ate yoghurt daily for one month prior to my trip. I then ate it once or twice a day while in Mexico. I ate a lot of the same foods in Mexico this time around, but did not develop any diarrhea. I read an article in a magazine that said that yoghurt is a natural preventative because it encourages the growth of helpful "normal flora" in the bowel which in turn discourages the growth of unhealthy bacteria.