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drcaplan
drcaplan, Board Certified Physician
Category: Medical
Satisfied Customers: 71
Experience:  I have specialized in common problems for men, women, children, and the elderly.
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ARE TAKING PRO-BIOTICS A GOOD THING.

Resolved Question:

ARE TAKING PRO-BIOTICS A GOOD THING.
Submitted: 5 months ago.
Category: Medical
Expert:  drcaplan replied 5 months ago.

drcaplan :

Hello there -

drcaplan :

I am a Family Medicine doctor, with certification in Internal medicine, Pediatrics, Obstetrics and Gynecology, as well as Integrative Medicine, with advanced training in Neurology, Cardiovascular Medicine, Gastroenterology, Endocrinology, and Psychiatry. I'm also well-versed in Naturopathy and Functional Medicine

drcaplan :

I have many patients who take pro-biotics, and I'm familiar with the research in pro-biotics, across several different fields of medicine.

Customer:

Looks like you studied everything

Customer:

i have mild acid reflux. i take prevacid daily.

drcaplan :

I've been in school for a while, yes. But,that's also a burden I would happily take on again :)

drcaplan :

I see. And not finding relief ?

Customer:

yes get relief but wanting to try something different

drcaplan :

I see. Have you ever been tested for H Pylori?

Customer:

yes, negative

drcaplan :

great!

drcaplan :

...although clearly not helpful testing for you

drcaplan :

the short answer to your specific question is "yes" pro-biotics have clearly shown us that there is reproducible benefit.

drcaplan :

That said, it can sometimes take time, and it may not address what is causing your reflux

drcaplan :

Have you discussed your case with someone before?

drcaplan :

(I don't want to bore you with details if you've heard them before)

Customer:

not about pro-biotics. just acid reflux. always say watch diet dont eat late ect,ect

drcaplan :

yeah.

drcaplan :

have you reviewed the things you eat to see if there are any culprits?

drcaplan :

things like : coffee, mint, peppermint, acidic juices, chocolate

Customer:

yes and i avoid them, most of the time

Customer:

but sometimes anything will bring it on

drcaplan :

good.. understandable. we're only human

drcaplan :

there are certainly some people that are simply prone to reflux for other reasons.

drcaplan :

may I ask some questions?

drcaplan :

have you been bothered by your weight?

drcaplan :

has exercising caused you trouble with reflux?

drcaplan :

could stress play a part in your reflux?

Customer:

I am over weight 5.9 220...........................do have stress

drcaplan :

sometimes excessive weight around your stomach (inside not outside your body) can warp the tissues that hold your stomach sealed shut, and makes for worsening acid splashing up into your esophagus.

Customer:

10 years ago i was 185 and had acid reflux been on prevacid for 13 years

drcaplan :

also, stress increases acid production tremendously

drcaplan :

I see.

drcaplan :

that is useful information, thanks

drcaplan :

I have noticed many patients in similar situations, on this medicine for so long, where it really has not been studied to be safe for longer than 6 months

drcaplan :

sure, many people have clinically proven it to be safe, but the point is that it is not meant to be used this way. In your case, as with many others, it may be masking a true problem, and I think it's not ideal for anyone to have to take a medication that way for so long.

drcaplan :

have you tried any other meds, including pro biotics?

Customer:

l have trade tagament proloce and all other otc meds. havent tried pro-biotics

drcaplan :

I see.

Customer:

what would you suggest for acid reflux?

drcaplan :

there are some who believe in medications more than I do, but I would encourage you to investigate the root cause, not merely to mask the symptoms of the reflux (which I am not suggesting you ignore, by any means)

drcaplan :

the root causes are either an overproduction of acid (from chocolate, soda, fried foods, alcohol, mints, high fat dairy products, high fat meats, caffeine, etc)

drcaplan :

or a problem with your body's ability to keep it inside the stomach (a problem with your Lower Esophageal Sphincter) that could be related to weight, or herniation or position for some other unclear reason

drcaplan :

As for specific suggestions:

drcaplan :

consider keeping a written journal of what you're experiencing, and how it relates to what you're eating. It doesn't have to be long or wordy, but it will be helpful (to you and to a healthcare provider that could review the journal later) to have more data about the symptoms, (timing, what makes it better or worse, if anything you're doing (or medications you're taking) effect the reflux, and what else is going on (end of a work day, or spending long hours on your feet or worrying, etc) Clinical medicine works best with patterns, and sometimes those patterns only show up when we write things down. Plus, sometimes the act of writing them down helps get them out of our minds, and reduces the burden of stress - which is an important factor in reflux, and one that is commonly underestimated.

drcaplan :

I would recommend keeping a bottle of water with you, and washing down the acid throughout the day.

drcaplan :

Tums (or maalox or mylanta) are also OTC medications that people find helpful, and I often recommend

drcaplan :

I recognize that you still had symptoms when you weighed less than you weigh now, but it's more likely that symptoms will go away when your stomach has less adipose tissue weighing it down (less internal fat)

Customer:

i love Maalox.....................but cant get it anymore. been cleaning the factory for 2 years now....it always worked great.......generic version never works good for me

drcaplan :

you may consider ranitidine, or cetirizine. They are medicines that sometimes help with acid, like the PPI you're taking, but act faster

drcaplan :

terrific! why can't you get it anymore?

Customer:

wed site says dont make it

drcaplan :

ah.

drcaplan :

I wasn't aware.

drcaplan :

Mylanta is comparable, I think. As is Tums. The idea is to have an alkali chemical that can counter act the acid

drcaplan :

milk, to some extent, could do that too.

drcaplan :

Remember, the more thinking about food, chewing, swallowing you do, the more acid is produced

drcaplan :

if you can minimize production, you'll be helping

Customer:

tried all those things work for few minutes.................................

drcaplan :

the next step with medications should be to try the prevacid twice a day

drcaplan :

have you discussed that with your doctor?

Customer:

already take 30 mg twice a day

Customer:

could pro-biotics help? or waste of money for my cause

drcaplan :

some trials have shown that patients improve with treatment of H pylori, even when results are negative.

Customer:

ill talk to my doc about that

drcaplan :

I think pro-biotics are useful in general,and in your case, but I think you would do better to figure out what's causing the acid first.

drcaplan :

taking pro-biotics in your case would be an effort to replace less healthy bacteria with more healthy ones

drcaplan :

it's more of a hail-mary than you might want

Customer:

gotcha ya

drcaplan :

I would ask your doctor if he would try you on "triple therapy" (to treat H pylori)

drcaplan :

if that doesn't work, you could consider one of two things.

drcaplan :

you could consider a referral to a gastroenterologist for an upper endoscopy (camera to look at what's going on)

drcaplan :

or, you could start from scratch, doing a very careful diet and activity history... review what you may be missing thus far

drcaplan :

you seem to be doing all the right things, but clearly you and the doc are missing something

drcaplan :

plus, I hate to see you taking medication like that for so long. That's not the way it should be

Customer:

ill skip the probiotics and talk to doc about triple therapy. thanks for you time

drcaplan :

sounds like a good plan. Have I been able to address your question to your satisfaction?

drcaplan :

Got any more questions I can answer?

Customer:

no all good here thank you

drcaplan :

You are welcome
Please click on EXCELLENT - That is always my only goal.
Thank you.

drcaplan, Board Certified Physician
Category: Medical
Satisfied Customers: 71
Experience: I have specialized in common problems for men, women, children, and the elderly.
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