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Published on October 3, 2007

This is what I've always heard in travel advice.

A few days earlier, though, The Nation's editorial advised Bangkokians to stop wasting money on bottled water and instead drink tap water, "which is now perfectly safe to drink in Bangkok and the vicinity.

 "The Metropolitan Waterworks Authority (MWA) has been trying to promote tap water as an alternative to bottled water through a public awareness campaign backed by scientific evidence, with limited success. This is despite the fact that Bangkok's water-supplier uses state-of-the-art production processes to supply the city's residents with clean tap water that meets or even exceeds the standard set by the World Health Organisation."

 What's your opinion of the latest evidence on the potability of Bangkok's tap water?

    Doug

    Bangkok

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Dear Doug,

 You bring up a very interesting point. I did read The Nation editorial and have been aware of this controversy for some time.

 When water leaves the Bangkok processing plant it is, probably, perfectly safe to drink. I believe the problem lies with the city infrastructure as well as that of the end users themselves.

 We've all seen the common flooding of Bangkok streets accompanied by unspeakable manner of flora and fauna. Hard to believe that this does not contaminate the water distribution system at some points where its integrity has broken down.

 In addition, many buildings in the city have their own storage and distribution systems, which are possible sources of contamination. The water that finally emerges from your tap may not be the same as when it left "Bangkok's water supplier".

 Last week my own tap disgorged a product the colour of slightly bloody tea.

 I doubt it would be fatal, but personally, I wouldn't drink it.

 Bottled water is more expensive, contributes to the waste disposal problem and is now politically incorrect. I don't know what standards the local water bottlers are held to and what quality is actually delivered, but the product looks, smells and tastes better than what comes out of the tap. I think it is the safer choice.

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Dear Dr Mike,

 I have been going to Bangkok's leading hospital where I was recently diagnosed with ulcerative colitis. They have been giving me medication but I keep having bouts of stomach cramping and diarrhoea, which is sometimes bloody.

 On my last visit they said they needed to operate to remove my colon. This just didn't seem right and I don't believe it. I'm only 41 years old. I'm healthy and very active and I wouldn't agree to this surgery.

 I would appreciate your advice or a recommendation for a second opinion.

    Thank You,

    Chuck

    Bangkok

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Dear Chuck,

 I think your instincts are likely correct. Most cases of ulcerative colitis are mild to moderate and are usually manageable, although not curable, by medical treatment. Surgical treatment consists of removal of the entire colon, regardless of which portion is affected. Total colectomy will have an enormous impact on your lifestyle. It is a drastic remedy and a last resort for treatment of complications such as severe illness, intractable bleeding or rupture of the colon. About 25 per cent of ulcerative colitis patients eventually require surgery.

 It doesn't sound like you have exhausted your medical options.

 I suggest you see a gastroenterologist, not a surgeon, for a second opinion and a more aggressive trial of medical management.

 It's highly likely that your disease can be controlled without surgery.

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Dear Dr Mike,

What are the chances of getting Aids from oral sex? Is there any need of protection?

    Tom,

    California

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Dear Tom,

 That sort of depends on whether you're giving, or receiving.

 I suppose it is theoretically possible either way, but it's unlikely.

 I have, personally, never seen a case of HIV infection from oral sex, but I have seen multiple incidents of pharyngeal gonorrhoea and even genital warts in the upper respiratory system.

 I have heard reports of males contracting STDs from receiving oral sex, but this is quite rare.

 At any rate, you probably should err on the side of caution and use a condom.