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Treatment options,diet for GERD - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: GERD
Answered by

General & Family Physician
Practicing since : 2009
Answered : 594 Questions
User :   hiwe chatted last week on my gastritis and acid reflux. i am on kapidex 60mg once a day for 1 month and librax twice a day for 2 weeks.
there is only 80 % improvement. i have had gastritis and acid reflux for 3 months already.
now this is what happens every morning.
after i wake up empty stomach i take kapidex and then in 15 mins my mouth gets bitter or burning. this is the main thing. how do we stop this thing in morning. can i take kapidex 60 mg twice a day?
Doctor :   Hi
Doctor :   the problem seems to be continuation in the acid reflex
User :   yes so what do we do now
Doctor :   have you consulted a gastroenteritis ?
Doctor :   gastroenterologist**
User :   o yes he has put me on kapidex 60 mg once a day and librax twice a day.
User :   i will see him again tomorrow
User :   but now after reading above situation what would be you r next step
Doctor :   from how many days you are on the kapidex 60 mg
User :   1 month
Doctor :   so in one month there is 80% improvement
User :   this along with librax twice a day
Doctor :   the treatment options are only medical and surgical
Doctor :   by the use of kapidex 60 and librax a 80% improvement is achieved in one month this is very good
User :   o really ok
Doctor :   hope to continue the same for the other month or so
Doctor :   because the next options are surgical
User :   my concern is can i take kapidex 60 mg twice a day
Doctor :   and surgery is the last option to be done in cases which is very much not responding to medicines
Doctor :   yes it can be taken
Doctor :   let the gastroentrologist have the information regarding this
User :   whats your experience with surgery
User :   i read that its not that successful may be 50% rate
Doctor :   surgery has its own risks and adds further restrictions in the food habits
Doctor :   the success rate is very high in appropriately selected candidates like
Doctor :   who do not respond to the medical line of management
Doctor :   as you are responding and the improvement is above 80%
Doctor :   it is strongly evident that medicines are good choice in your case
User :   i spoke to a pharmacist can he told me that you cant take kapidex more than 60 mg once a day, thats y i am asking you if its ok to take 60 mg kapidex twice a day
User :   trust me i dont want surgery.
Doctor :   kapidex can be taken 30 mg in two divided doses
Doctor :   and also 60 mg once a day or twice a day as per the directions of the treating doctor
User :   ok what do you think about nexium
User :   we didnt even try nexium yet
Doctor :   kapidex and nexium and many others like prilosec are all belong to same group and same family - proton pump inhibitors
Doctor :   the difference is the doseage form and the absorption
Doctor :   both the drugs are effective
Doctor :   kapidex is a much more potent than nexium as it is newer generation
User :   have you used reglan successfully with your patients without side effects
Doctor :   yes
Doctor :   it is been used very commonly
User :   does it cause any adverse effects
User :   is it to be used life long
Doctor :   it is basically an drug used to prevent acid reflux
Doctor :   it may have to be used life long if the reflex continues
User :   have your patints seen any side effects with it
Doctor :   apart from the loose stools initially no major side effect is noticed clinically
User :   have your patients complained of acid reflux with pear, apple, banana, daal, beans
Doctor :   though it can cause involuntary movements, and dizziness
Doctor :   long term usage has the risk of tradive dyskinesia so it is given for short intervals and than given a drug holiday period
Doctor :   usually the citrus fruits cause the reflux citrus fruits are lemon, orange, even mango can cause and not the banana
User :   and apple pear daal beans?
Doctor :   red appleas, pears, tomato, strawberry, grapes cranberrypeach,raspberry all increases the acid reflux
Doctor :   banana, dates,pappaya, pinappeles age GOOD
Doctor :   even apricot is good and can be used
User :   isnt pineapple acidic?
Doctor :   pineapple has digestive enzymes and will cause forward movement of the stomach so it prevents reflex
User :   what about melons like cantalope, honeydew watermelon
Doctor :   yes melons are alkaline forming and will neutralize the acid
User :   what about psyllium husk?
Doctor :   they are bulk forming and not a choice for acid disorders, it is for constipation
User :   but i do have constipation and also had surgery for anal fissure
User :   so i have to take atleast 1 tsp of psyllium husk
Doctor :   you need to have a high fiber diet in the form of spinach, green leafy vegetables. regular and timely food
Doctor :   using husk should be for short intervals and should always be replaced by diet interventions
Doctor :   otherwise constipation will become a life long problem
User :   i am trying to give up psyllium husk but i wanna know if it aggravates acid reflux?
User :   i am also taking prune juice for constipation. is that ok or will that also increase reflux?
Doctor :   defective diet habits have caused anal fissure and acid reflux
Doctor :   if you correct the diet pattern probably constipation and acid reflux will settle
Doctor :   prune juice will INCREASE THE acid reflux
User :   daal, beans?
Doctor :   it can be taken no problem with them
User :   ok
User :   oatmeal?
Doctor :   i strongly suggest you to take the diet which is the staple food from your child hood
Doctor :   from the child what breakfast you used to take, the lunch in the afternoon and the dinner
Doctor :   let it be same or as near to it as possible
User :   o no i was complete non veg no fruits or veg
Doctor :   in the child hood ?
User :   yes
Doctor :   did you face any stomach problems at that time ?
User :   no
User :   constipated now n then
User :   but nothing major
Doctor :   your body is used to it and the sudden change is not been able to accept by it
User :   ok
Doctor :   be near to the child hood staple diet with increased vegetables for the constipation part
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