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Would Smoking Cannabis Make GERD Worse?
Question: I am 33 , in 2008 Feb i got the 1st endoscopy done . 5 ft 6 inch ,and my weight varies from 56 to 60 kg.
It was gastritis , H pylori , GERD .
I was medicated.
I have always had tummy issues , stress/anxiety problems.
2013 on my 3rd endoscopy i was positive for H Pylory again ,and was 2nd time medicated.
I cant seem to get rid of PPI , as i face pressure in my chest. My stool stinks , get pale in color at time , which aggravates my acidity , i pass wind , loose weight.
In last 10 years 8 times i have got endoscopy done , 2 times colonoscopy.
I take VSL3 at times , and use PHGG guar gum (prebiotic ) , use PURE (brand name) enzyme supplements (plant extracts ) whenever i eat out or eat anything thats high on fodmap. which helped me quite a bit , i gained weight also little.
Long usage of PPI causes my D and B12 to go down , so i try taking vitamin supplements , which seem to upset my tummy more. I am considering injection of D.
I try Probiotics at times(VSL3 or a brand called PURE) , while i was on PHGG.
When my symptoms go bad , its usually , bad stinky wind , burping , sleeping less than 4 hrs , due to upper abdominal discomfort , floating pale stool , or too much of stool , noisy tummy and acidity .And i loose weight.
3 weeks back i had one day of full loose motons and then mucous (usually i never have loose motions ) , so i took rifagut 400 for a week.
The 4 days back i started having severe acidity , and sleeping problem , pale stool , and my nexium 20 twice a day didnt work .
12th April , 2018 endoscopy result is H pylory again and small Haitus Hernia.
Medication prescribed:
Cintapro and Nexpro twice a day and Sucrafil 3 times for next 4 weeks.
After that Px Amoxycillin Trihydrate Capsules IP and Razo 20 for a week
and then sequentially claribid 500 , razo and metrogyl for one more week.
My questions:
I am scared of the bacterial balance going for a toss for all these antibiotics that i am going to start . Any suggestions?
Why do you think i keep getting H pylori back to my system , can it be because of low immunity ?
Can i have curd (lactose free) while my h pylori is high?
Do you think i can overdose with prebiotic and pro biotic that makes my case worse?
What would you comment on my antibiotic medication , which is prescribed now to fight against H pylori (3rd occurrence now).
And do you think the small haitus harnia can cause high level of acidity?
Any food in general you would advise me to avoid?
If i smoke up occasionally , twice a month , will it make my symptoms worse? Are smoking cannabises make things worse for GERD or tummy upset.
Would you advise me to consult any yoga instructor , cause i am being too dependant on medicines at 33.
My acidity goes bad when my stool is bad , so the GERD is not only for my sphincter being loose. Do you suggest manometry?
Would you suggest any diet to balance my bacterial balance during the antibiotic treatment or after or any supplements?
It was gastritis , H pylori , GERD .
I was medicated.
I have always had tummy issues , stress/anxiety problems.
2013 on my 3rd endoscopy i was positive for H Pylory again ,and was 2nd time medicated.
I cant seem to get rid of PPI , as i face pressure in my chest. My stool stinks , get pale in color at time , which aggravates my acidity , i pass wind , loose weight.
In last 10 years 8 times i have got endoscopy done , 2 times colonoscopy.
I take VSL3 at times , and use PHGG guar gum (prebiotic ) , use PURE (brand name) enzyme supplements (plant extracts ) whenever i eat out or eat anything thats high on fodmap. which helped me quite a bit , i gained weight also little.
Long usage of PPI causes my D and B12 to go down , so i try taking vitamin supplements , which seem to upset my tummy more. I am considering injection of D.
I try Probiotics at times(VSL3 or a brand called PURE) , while i was on PHGG.
When my symptoms go bad , its usually , bad stinky wind , burping , sleeping less than 4 hrs , due to upper abdominal discomfort , floating pale stool , or too much of stool , noisy tummy and acidity .And i loose weight.
3 weeks back i had one day of full loose motons and then mucous (usually i never have loose motions ) , so i took rifagut 400 for a week.
The 4 days back i started having severe acidity , and sleeping problem , pale stool , and my nexium 20 twice a day didnt work .
12th April , 2018 endoscopy result is H pylory again and small Haitus Hernia.
Medication prescribed:
Cintapro and Nexpro twice a day and Sucrafil 3 times for next 4 weeks.
After that Px Amoxycillin Trihydrate Capsules IP and Razo 20 for a week
and then sequentially claribid 500 , razo and metrogyl for one more week.
My questions:
I am scared of the bacterial balance going for a toss for all these antibiotics that i am going to start . Any suggestions?
Why do you think i keep getting H pylori back to my system , can it be because of low immunity ?
Can i have curd (lactose free) while my h pylori is high?
Do you think i can overdose with prebiotic and pro biotic that makes my case worse?
What would you comment on my antibiotic medication , which is prescribed now to fight against H pylori (3rd occurrence now).
And do you think the small haitus harnia can cause high level of acidity?
Any food in general you would advise me to avoid?
If i smoke up occasionally , twice a month , will it make my symptoms worse? Are smoking cannabises make things worse for GERD or tummy upset.
Would you advise me to consult any yoga instructor , cause i am being too dependant on medicines at 33.
My acidity goes bad when my stool is bad , so the GERD is not only for my sphincter being loose. Do you suggest manometry?
Would you suggest any diet to balance my bacterial balance during the antibiotic treatment or after or any supplements?
Brief Answer:
Please go through detailed answer.
Detailed Answer:
Hi,
Our gastrointestinal tract has a forward propulsive movement (peristalsis) that moves the food material forward as it is digested, absorbed and finally expelled as feces. If somehow this movement gets hampered, food along with the digestive juices would stagnate, stomach acid will reflux into the food pipe and on the other hand the bowel habits would not be proper. Degradation of undigested food in the intestines by the intestinal bacteria would lead to the excess gas formation. This gas compresses the intestines and surrounding nerves hence would cause pain in abdomen loss of appetite bloating belching heaviness. Use of excessive antibiotics disrupts the normal gut flora and causes bad bacterial colonies to form as in your case.These bacteria cause incomplete fermentation of food hence releasing large amount of gas. So it can be SIBO also. Small Intestinal Bacterial Overgrowth can be a cause of severe gas problem in your case floating stools is again suggestive of gas in stools. Small intestinal bacterial overgrowth (SIBO) refers to a condition in which abnormally large numbers of bacteria are present in the small intestine, and the types of bacteria in the small intestine resemble more the bacteria of the colon than the small intestines causing improper and disturbed food digestion. Curd is very good for you have it with each meal its full of lactobacillus. Probiotic and prebiotic should be taken regularly by you. They would help to maintain and restore your depleted gut flora.
No smoking and drinking. Hiatel hernia is the main cause of reflux disorder so you can plan for hernia repair surgery.
Please enclose the regimen for Hpylori you have received.
Were you given
Amoxicillin 1000mg
Clarithromycin 500 twice
Metronidazole 400 mg thrice
Omeprazole 40 mg twice daily for 21 days?
Tests suggested-
Right now as endoscopy has been done manometry is not required rather go for small bowel imaging and a gastric-emptying scan.
Food suggestions-
I would suggest you Zantac (ranitidine) 150 mg twice a day. Zantac is an acid reducer that decreases acid production by 70%, allowing the tissues to heal. You may need to take this for a month or longer. I prefer Zantac to the proton pump inhibitors (Nexium, Prilosec, etc) because it is safer and does not have the risk of discontinuation rebound hyper-acidity when it is stopped.
2. Do not lie down for 2-3 hrs after eating.
3. Avoid acidic foods - citrus, tomatoes, juices
4. Decrease caffeine (colas, coffee) and sodas in general.
5. Decrease alcohol or completely stop it.
6. you smoke cigarettes, now is the time to stop. They increase acid production and delay healing.No cannibis or other things.
7. Eat smaller amounts at a time so there is less pressure in the stomach which can reflux acid into the stomach.
8.Avoid eating/drinking mint (it relaxes the lower esophageal sphincter which can allow more acid up).
9.Drink apple cider vinegar.
10.Take isapghul husk 2tsf twice daily.Drink.one glass of chilled milk in morning and evening.
Hope I have answered your query. Follow up with reports. Feel free to follow up.
Regards,
Dr. Ramesh Kumar
Gastroenterologist
Please go through detailed answer.
Detailed Answer:
Hi,
Our gastrointestinal tract has a forward propulsive movement (peristalsis) that moves the food material forward as it is digested, absorbed and finally expelled as feces. If somehow this movement gets hampered, food along with the digestive juices would stagnate, stomach acid will reflux into the food pipe and on the other hand the bowel habits would not be proper. Degradation of undigested food in the intestines by the intestinal bacteria would lead to the excess gas formation. This gas compresses the intestines and surrounding nerves hence would cause pain in abdomen loss of appetite bloating belching heaviness. Use of excessive antibiotics disrupts the normal gut flora and causes bad bacterial colonies to form as in your case.These bacteria cause incomplete fermentation of food hence releasing large amount of gas. So it can be SIBO also. Small Intestinal Bacterial Overgrowth can be a cause of severe gas problem in your case floating stools is again suggestive of gas in stools. Small intestinal bacterial overgrowth (SIBO) refers to a condition in which abnormally large numbers of bacteria are present in the small intestine, and the types of bacteria in the small intestine resemble more the bacteria of the colon than the small intestines causing improper and disturbed food digestion. Curd is very good for you have it with each meal its full of lactobacillus. Probiotic and prebiotic should be taken regularly by you. They would help to maintain and restore your depleted gut flora.
No smoking and drinking. Hiatel hernia is the main cause of reflux disorder so you can plan for hernia repair surgery.
Please enclose the regimen for Hpylori you have received.
Were you given
Amoxicillin 1000mg
Clarithromycin 500 twice
Metronidazole 400 mg thrice
Omeprazole 40 mg twice daily for 21 days?
Tests suggested-
Right now as endoscopy has been done manometry is not required rather go for small bowel imaging and a gastric-emptying scan.
Food suggestions-
I would suggest you Zantac (ranitidine) 150 mg twice a day. Zantac is an acid reducer that decreases acid production by 70%, allowing the tissues to heal. You may need to take this for a month or longer. I prefer Zantac to the proton pump inhibitors (Nexium, Prilosec, etc) because it is safer and does not have the risk of discontinuation rebound hyper-acidity when it is stopped.
2. Do not lie down for 2-3 hrs after eating.
3. Avoid acidic foods - citrus, tomatoes, juices
4. Decrease caffeine (colas, coffee) and sodas in general.
5. Decrease alcohol or completely stop it.
6. you smoke cigarettes, now is the time to stop. They increase acid production and delay healing.No cannibis or other things.
7. Eat smaller amounts at a time so there is less pressure in the stomach which can reflux acid into the stomach.
8.Avoid eating/drinking mint (it relaxes the lower esophageal sphincter which can allow more acid up).
9.Drink apple cider vinegar.
10.Take isapghul husk 2tsf twice daily.Drink.one glass of chilled milk in morning and evening.
Hope I have answered your query. Follow up with reports. Feel free to follow up.
Regards,
Dr. Ramesh Kumar
Gastroenterologist
Above answer was peer-reviewed by :
Dr. Prasad
Hello Doctor,
Thank you so much for the detailed answer.
1)
>>I prefer Zantac to the proton pump inhibitors (Nexium, Prilosec, etc) because it is safer and does not have the risk of discontinuation rebound hyperacidity when it is stopped.
I have been on PPI for around 3 years already , on and off. Usually i take nexium 20 , once or twice a day and i am fine with no problems.
My acidity problem seems to be bad when my stool is pale , or stinks , and not clear , floats.
I need to stop using PPI anyhow. Thinking of starting Yoga , if that works.
2) I use digestive enzyme pills (plant extracts) when i eat food which are on the higher fodmap , what do you think of this practice or dependancy?
3) So with PPI usage i assume the acid level in my stomach is already low and I read to digest meat we need acid.
My diet consists of regular chicken or egg , do you think consuming this lean meat or egg make it worse in a stomach with less acid? I dont eat much pulses as most of them are high on fodmap. No paneer or soya either.
4) can I drink milk , as you suggested , cause i am not sure of lactose.
5)Omeprazole 40 mg twice daily for 21 days?
I have been prescribed Nex pro 40 twice a day and centipride twice a day and then sucrafil also 3 times a day , even with all of them I feel some air stuck in my chest at times , mostly when i am hungry. I get hungry quite often . Do you think i need to change any dosage?
6) My symptoms do sound like SIBO. Taking the antobiotics might disturb the balance of bacteria even more , so do you think i should take VSL3 or probitocs? after i finish the antibiotic course?
7) do i need to take Husk or i can take PHGG guar gum prebiotics?
8) Can I take vitamin D lumia 60k once in a week while i am on this medication? My D level is usualy low due to PPI usage. B12 also i need to get checked.
9) Hernia found in the endoscopy seems new , since 4 months back in the last endoscopy they didnt find it. DO you think i can delay the hernia repairing surgery?
10) I was thinking to finish the medication of 2 months 1st and then get the scanning of abdomen done . Do you suggest i should them in hurry? Or i can wait.
I dont smoke at all ,cannabises may be once in a week , but i am thinking to stop that .
Thanks & Regards XXXXXXX
Thank you so much for the detailed answer.
1)
>>I prefer Zantac to the proton pump inhibitors (Nexium, Prilosec, etc) because it is safer and does not have the risk of discontinuation rebound hyperacidity when it is stopped.
I have been on PPI for around 3 years already , on and off. Usually i take nexium 20 , once or twice a day and i am fine with no problems.
My acidity problem seems to be bad when my stool is pale , or stinks , and not clear , floats.
I need to stop using PPI anyhow. Thinking of starting Yoga , if that works.
2) I use digestive enzyme pills (plant extracts) when i eat food which are on the higher fodmap , what do you think of this practice or dependancy?
3) So with PPI usage i assume the acid level in my stomach is already low and I read to digest meat we need acid.
My diet consists of regular chicken or egg , do you think consuming this lean meat or egg make it worse in a stomach with less acid? I dont eat much pulses as most of them are high on fodmap. No paneer or soya either.
4) can I drink milk , as you suggested , cause i am not sure of lactose.
5)Omeprazole 40 mg twice daily for 21 days?
I have been prescribed Nex pro 40 twice a day and centipride twice a day and then sucrafil also 3 times a day , even with all of them I feel some air stuck in my chest at times , mostly when i am hungry. I get hungry quite often . Do you think i need to change any dosage?
6) My symptoms do sound like SIBO. Taking the antobiotics might disturb the balance of bacteria even more , so do you think i should take VSL3 or probitocs? after i finish the antibiotic course?
7) do i need to take Husk or i can take PHGG guar gum prebiotics?
8) Can I take vitamin D lumia 60k once in a week while i am on this medication? My D level is usualy low due to PPI usage. B12 also i need to get checked.
9) Hernia found in the endoscopy seems new , since 4 months back in the last endoscopy they didnt find it. DO you think i can delay the hernia repairing surgery?
10) I was thinking to finish the medication of 2 months 1st and then get the scanning of abdomen done . Do you suggest i should them in hurry? Or i can wait.
I dont smoke at all ,cannabises may be once in a week , but i am thinking to stop that .
Thanks & Regards XXXXXXX
Brief Answer:
Follow up answer.
Detailed Answer:
Hello,
1) In that case yes you can take ppi's as and when required by you overall nexium is a very safe drug and can be taken for years and the dose you are taking is very low it can be used at doses as high as 160mg per day.
Yoga can help.
But a perfect answer can be given only by some one who is specialist in yogic kriyas. I am practicing modern medicine so yes as per me yoga could be helpful but you have to learn things under an instructor.
2) No its no dependence. You can take external enzymes.They are just supplements.
3) The doses of PPI you are on does not effect the baseline secretion of acid rather would prevent only formation of excessive acid.So i don't think that baseline acid levels would be effected in your case.
4) If you are lactose intolerant then don't drink other wise taking chilled milk would be very helpful.
5) If you are on Nexium then there is no need to take Omeprazole both are ppi's.
For air add activated charcoal it would absorb air and avoid too much heavy proteins. Fish protein would be good for you.
6) Yes, at least for 21 days after you finish antibiotic course.
7) Husk would be much more effective.
8) Yes you can.
9) If symptoms are in control there is no need for any surgery right now.
10) No don't be in haste to stop them rather focus on properly controlling symptoms.
Hope I have answered your query.
Regards,
Dr. Ramesh Kumar
Gastroenterologist
Follow up answer.
Detailed Answer:
Hello,
1) In that case yes you can take ppi's as and when required by you overall nexium is a very safe drug and can be taken for years and the dose you are taking is very low it can be used at doses as high as 160mg per day.
Yoga can help.
But a perfect answer can be given only by some one who is specialist in yogic kriyas. I am practicing modern medicine so yes as per me yoga could be helpful but you have to learn things under an instructor.
2) No its no dependence. You can take external enzymes.They are just supplements.
3) The doses of PPI you are on does not effect the baseline secretion of acid rather would prevent only formation of excessive acid.So i don't think that baseline acid levels would be effected in your case.
4) If you are lactose intolerant then don't drink other wise taking chilled milk would be very helpful.
5) If you are on Nexium then there is no need to take Omeprazole both are ppi's.
For air add activated charcoal it would absorb air and avoid too much heavy proteins. Fish protein would be good for you.
6) Yes, at least for 21 days after you finish antibiotic course.
7) Husk would be much more effective.
8) Yes you can.
9) If symptoms are in control there is no need for any surgery right now.
10) No don't be in haste to stop them rather focus on properly controlling symptoms.
Hope I have answered your query.
Regards,
Dr. Ramesh Kumar
Gastroenterologist
Note: For further follow up on digestive issues share your reports here and Click here.
Above answer was peer-reviewed by :
Dr. Remy Koshy
Answered by
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