What did Thailand trip do to my tum?

I went in holiday to Thailand for three weeks. Now I’m back, and my bowels aren’t right. My movements are much looser and very smelly. I have lots of wind and I taste sulphur when I burp. Could I have picked up something? The toilets were terrible where I was staying.

YES, it’s possible you have caught something. Giardia would be top of my list as a possible

cause.

It’s a condition caused by a parasite and is very common in areas where sanitation is poor.

Symptoms are similar to those you describe,with sulphur burps being commonly cited. Contaminated water is a source but so, too, is cross-infection from other travellers or contact with people who might be carrying this parasite.

So if someone uses the toilet and doesn’t wash their hands, they can spread it to you if they handle your food for example.It can take anywhere between five to 25 days from the contact to experience clinical symptoms. It usually resolves in a couple of weeks but generally requires treatment with antibiotics.

You could also have traveller’s diarrhoea. Typically, this occurs after eating contaminated food or water and begins abruptly during or after a trip. Usually you will pass three or more motions a day. You need to go urgently and you may experience cramp,gas, nausea or fever. This usually passes after a couple if days without treatment.

The best thing to do is take a specimen of poo to your doctor and get it sent to the lab.This will identify the organism. Sometimes you need to do three consecutive specimens to yield a result.

In the meantime keep the diet bland and try to remain well hydrated. Caffeine, spicy foods, junk food or rich food will all serve as irritants. It’s advisable to also avoid alcohol and give dairy a miss as these, too, can trigger a reaction.

If at any point you pass blood, spike a fever or develop severe abdominal pain, seek immediate medical help. Based on your vaccination history, if the cause of your symptoms isn’t obvious and you have been in high risk areas a full screen for everything from hepatitis to malaria may be required.

Last week I twisted my knee while I was going down the stairs. I thought it would get better in a few days as it seemed OK, but it’s now swollen and I can’t fully straighten my leg. My physiotherapist says it’s my meniscus and that I just need exercises. But because it is so swollen, I’m worried I might need a scan or even surgery as it doesn’t seem to be improving.

YOUR knee contains two rubbery pads of cartilage called the menisci. They act as shock absorbers taking pressure from the top of the leg articulating in the knee.

Twisting movements carried out while the knee is bearing weight tend to trigger this type of injury. Typically rugby and skiing are the types of sports in which you see this complaint. Your description of your own injury totally fits the bill for this type of trauma also.

Pain is very typical of this type of injury, especially when you try to straighten the leg. The knee will also swell and can sometimes lock so it can have a big impact on your mobility. In the initial stages of injury you should do the standard RICE treatment. That’s rest, ice, compression and elevation. You can also take regular pain killers.

Your physio will be experienced in examining your joints, and can diagnose a tear clinically or at least have a good hunch as to what’s wrong. An xray won’t tell you much but an MRI will identify a tear. The good news is that most minor tears will heal on their own without surgery. The larger tears require surgery which is usually done by keyhole.

It takes six to eight weeks to recover from this type of surgery and the same time for the meniscus to heal on its own. The blood supply to the area isn’t great so any major issue is likely to require surgical intervention. Whatever happens you will have to rethink your exercise regime and rest for a few months.