Thursday, 5 October 2006

Travelling broadens the mind and opens the bowels

I had imagined this particular story to be about the science of the amazingly developed city of Hong Kong. I thought it would make a fantastic tale to contrast the role of science in people’s lives between India, the Philippines and Hong Kong.

However, unfortunately, my experiences during my week in Hong Kong were largely confined to public toilets and the bathroom of my friend Aaron, with whom I stayed. But this in itself makes a good story, so this week on Mr Science, we are going to look at the diseases that my brother and I picked up during our tour of Asia, and how they were treated.

It is ironic that, having been so careful with the water and food in India, that my brother James and I should get sick from eating at McDonalds, but all the evidence is pointing that way. They probably made the Coke we ordered using tap water. James’s illness hit within 12 hours, with vomiting and severe dehydration. He was so dehydrated that he took in about 2 litres of saline drip in the Indian hospital before he even went to the toilet.

I did not react with vomiting, and perhaps because of James’s sickness, did not think much of my own until I’d left the country. It was on landing in Hong Kong, incredibly tired from the 3.00 am start, that it all hit. And it hit hard, and explosively! My body erupted, not from my mouth like with James, but from the other end.

With remarkable Hong Kong efficiency, the hospital prescribed me 5 separate drugs to treat the problem. They did not know exactly what the problem was, and without a proper examination, blood test, urine test and stool sample, they were never going to know. I had a plane to catch.

So, introducing the top 3 contenders for inducing sickness in the West Brothers:
  1. Giardia - Giardia Lamblia is a parasite that infects the gastrointestinal tract and gives you Giardiasis, a type of gastroenteritis that manifests itself with severe diarrhoea and abdominal cramps. Other symptoms can include bloating, flatulence, fatigue, nausea, vomiting and weight loss. In some patients, vomiting or nausea is the major symptom.
  2. Traveller’s Diarrhoea - Also known as Delhi Belly or the Ragoon Runs, traveller’s diarrhoea has a host of causes, and can have very mild symptoms or kill within hours. The most common cause is the bacteria e-coli. The reason this is not top of the list is that e-coli­ infection usually only causes diarrhoea for 3-7 days, and then the discomfort stops. Perhaps James had a severe case of this, however, the fact that my discomfort was must more prolonged and that I had had some e-coli­ preventative medication before I left, makes me think it is not the cause.
  3. Cholera - I believe that this is unlikely, as I had preventative treatment for Cholera before I left, however the symptoms of Cholera are exactly as I had. Also, the risk of contracting Cholera is very low and I would have hoped that had if either James or myself contracted such a potentially deadly disease, that the hospitals would have picked it up.

As for the cocktail of drugs that I was prescribed, I am still taking some of them in order to complete their course. They are:

  1. Lactol Forte - These pills contain Lactobacillus acidophilus, which is considered a probiotic or “friendly” bacterium. These types of healthy bacteria live in the intestines and protect against some unhealthy organisms. When L. acidophilus breaks down food, it produces lactic acid and hydrogen peroxide that make the environment hostile for undesired organisms. It can also out compete harmful bacteria by consuming the nutrients they need. Antibiotics will kill L. acidophilus, as well as bad bacteria, so often after a course of antibiotics you will need to take L. acidophilus to recolonise the gastrointestinal tract. It’s also used to make yoghurt from milk.
  2. Ciproxin - These pills contain Ciprofloxacin HCL, which is a broad-spectrum antibiotic. Broad-spectrum antibiotics are commonly used, and in my situation were used for the following reasons: a) Where there are many possible causes of the illness, but where delaying treatment to more accurately identify the cause could result in the illness getting much more serious; b) Where there are multiple bacteria causing the illness. Broad-spectrum antibiotics are often avoided as they cause bacteria to become resistant to treatment. However, as I was in Hong Kong for such a short time and needed the treatment rather urgently, in the absence of a more thorough diagnosis and to get me on the plane home, the broad spectrum was our best option.
  3. Profenil - The active ingredient in Profenil is Alverine Citrate, which is a smooth muscle relaxant. Smooth muscle is a type of muscle that is not under voluntary control, such as in the gut. It acts directly on the muscle in the gut, causing it to relax and preventing muscle spasms. Muscle spasms result in symptoms such as heartburn, abdominal pain and bloating, constipation or diarrhoea.
  4. Oral Rehydration Salts - This dissolvable powder contains mainly sodium chloride, sodium citrate, potassium chloride and Dextrose Monohydrate, and is possibly the most important mixture of my drug cocktail. Diarrhoea saps the body of important electrolytes, as well as causing dehydration – this is how diarrhoea kills millions in the third world each year.
  5. Biogesic - Biogesic simply contains Paracetamol, which we all use as a painkiller.
  6. Doxycycline - In addition to this cocktail of drugs, I had to continue taking my anti-malaria tablets to complete their course.

So for about a fortnight, I’ve had a little cup to hold all my medicine – I felt like my grandparents!

Thanks for joining me on my all-too-brief scientific tour of South Asia. The podcast for this story contains extra recordings from Hong Kong, a small commentary on my final thoughts of India, and a few extra musings attempting to capture my feelings at the time. You can my thoughts on Hong Kong hospitals and sicknesses in this episode, and James’s thoughts (sometimes with sickness induced incoherence) on their Indian counterparts in the previous episode.

Listen to this show here


  1. I thought this article was cool - sciency yet entertaining in a very personal way.

    Well done Mr Science.

  2. Thanks anonymous! I'm glad you liked it and thanks for the comment.

  3. It is interesting that God doesn't use microencapsulation technology or enteric coating to deliver probiotics through the harsh environment of the stomach and into the GI tract. Like everything in nature, it is a numbers game; and to the survivors go the legacy. When probiotics are ingested - whether in raw or fermented foods or in supplements - not all of them make it to the lining of the intestine where they perform their vital role in health.