Undigested pills in toilet

Post by **tex** » Sun Feb 27, 2011 11:52 pm

Arlene,

If he or she didn't believe you, they probably wouldn't have believed me, either.

Tex

mzh · Post by **mzh** » Mon Feb 28, 2011 6:39 am

I hate the idea of omeprazole, especially since my symptoms suggest low acid, not high. My GI doc thinks I'm way off-base. This is the same guy who thinks pills in the toilet are from a short colon. I think I need a second opinion.

There was a medical piece -- possibly a very long paper online -- suggesting that focal Barrett's doesn't seem to progress to full Barrett's. I saved it to disk but it didn't open the next time I looked at it; now I can't find it again after sending a day looking for it.

I'm between a rock and a hard place. I really need a pH study but the GI doc says it's nasty. I may need to do the nasty test to know for sure.

Thanks so much for the link. If I show it to the doc he's say that's only 4 people. Well, I'm the fifth.

Off to the endocrinologist....

Marcia

Post by **tex** » Mon Feb 28, 2011 10:01 am

Marcia,

If you suspect low stomach acid, then you're probably right. Most doctors are notorious for incorrectly assuming that excess acid production is the problem whenever acid reflux is present, when in fact, the opposite is true. The problem is, they never check their work - they just assume that they are correct, so the problem is perpetuated, and they never learn to change their diagnostic routine.

The following is an excerpt taken from a post I wrote about a year ago:

When a patient goes to a doctor, complaining of heartburn, acid indigestion, or reflux, most doctors automatically reach for the prescription pad, and they write out a prescription for an antacid, PPI, etc. I'm not sure if it's a placebo effect, or what is going on, but apparently many patients seem to feel that it helps, (at least for a while), though it rarely seems to completely resolve the problem. The reality is, though, those doctors usually have it bass-ackwards, unless they actually test the pH levels present in the patient's stomach. Most patients do not have too much acid, rather, they have too little.

Indigestion, or heartburn, is usually a result of incomplete digestion, which is due to inadequate stomach acidity, (not too much acidity). Additionally, research shows that the robustness of the "seal" provided by the Lower Esophageal Sphincter, (LES), depends on the pH of the acid behind it. IOW, when the pH is lower, (that is, the stomach is more acidic), the LES holds more tightly, and as the pH increases, (IOW, as the stomach becomes less acidic), the LES tends to relax it's clamping pressure, thus allowing the possibility of an increased risk of reflux.

Sure, if reflux occurs, acid at a pH of 3 or 4 will burn the esophagus, and the assumption will be that the stomach is too acidic. However, in most cases, if the pH is maintained at a level of 1, or slightly over, (which is extremely acidic), or as close to it as possible, the LES will never open sufficiently to allow any reflux to occur, under normal conditions. The stomach is designed to operate with extremely low pH levels, and so is the LES. When antacids enter the picture, all bets are off, because the stomach just tries to create more acid, to counteract those "foreign" chemicals, and digestion suffers, in the process. Of course, the PPIs directly affect the capability of the stomach to produce sufficient acid, so they really throw a monkey wrench into the works. (Plus, they are a known trigger for MC, for many people).

Also, avoid sleeping on your right side. The only times that I have had reflux problems were when I was lying on my right side, (because that allows the stomach contents to put additional pressure on the LES, due to gravity).

Tex

mzh · Post by **mzh** » Mon Feb 28, 2011 11:06 am

Tex, could you please point me in the direction of the research about the acid-LES connection you wrote about? (It's under this paragraph.) I need to show it to the GI doc -- either my current one or the new one after GI doc #1 tells me he doesn't want me as his patient anymore.

<<Additionally, research shows that the robustness of the "seal" provided by the Lower Esophageal Sphincter, (LES), depends on the pH of the acid behind it. IOW, when the pH is lower, (that is, the stomach is more acidic), the LES holds more tightly, and as the pH increases, (IOW, as the stomach becomes less acidic), the LES tends to relax it's clamping pressure, thus allowing the possibility of an increased risk of reflux. >>

Thanks again!

Marcia

mzh · Post by **mzh** » Mon Feb 28, 2011 11:09 am

Tex, could you please point me in the direction of the research about the acid-LES connection you wrote about? (It's under this paragraph.) I need to show it to the GI doc -- either my current one or the new one after GI doc #1 tells me he doesn't want me as his patient anymore.

<<Additionally, research shows that the robustness of the "seal" provided by the Lower Esophageal Sphincter, (LES), depends on the pH of the acid behind it. IOW, when the pH is lower, (that is, the stomach is more acidic), the LES holds more tightly, and as the pH increases, (IOW, as the stomach becomes less acidic), the LES tends to relax it's clamping pressure, thus allowing the possibility of an increased risk of reflux. >>

I've been searching for this info for months and just can't find it.

Thanks again!

Marcia

Post by **tex** » Mon Feb 28, 2011 1:08 pm

Hi Marcia,

I'll have to try to research that whenever I can find some time, but I'm at work, and it seems to be a busy day/week, so it's going to take a while, because as you know, that information is not easy to find, and I don't have it bookmarked, as far as I am aware.

I hope you don't need it immediately, because as I recall, the information we're looking for is sort of hidden in some research reports. Most researchers approach the problem from the upstream side, and that doesn't provide the data that's needed.

Tex

mzh · Post by **mzh** » Mon Feb 28, 2011 1:51 pm

Thanks, Tex. No rush. I'm going to stop the omeprazole to see if Norman comes home.

I'll keep searching. If anyone else finds anything on the low acid-LES connection, I'd love to hear it. I know it's slightly off-topic but it's related to MC in its own way, I guess.

Marcia

TooManyHats · Post by **TooManyHats** » Mon Feb 28, 2011 6:32 pm

Apparently this was my exact problem. The medication never even dissolved so I've been switched to Ascol today, but even this medication has an enteric coating.

Post by **tex** » Tue Mar 01, 2011 6:54 pm

Marcia,

I posted the research reference that you were searching for, here:

http://www.perskyfarms.com/phpBB2/viewtopic.php?t=13391

Tex

mzh · Post by **mzh** » Tue Mar 01, 2011 7:29 pm

That is exactly the kind of material I was looking for. Thanks Tex! :)

In my research today assembling other info I found out a couple of things. First, it appears that more people have Barrett's than originally thought and they are not examined for it; this is discovered on autopsy. Second, this discovery may well mean that Barrett's and other reflux issues may well not be as dangerous as they originally thought.

I always felt low acid, not high. An (acidic) apple a day keeps the doctor away!

Marcia

Post by **tex** » Tue Mar 01, 2011 8:54 pm

Marcia wrote:Second, this discovery may well mean that Barrett's and other reflux issues may well not be as dangerous as they originally thought.

Quite a few diseases have been "created", (by the pharmaceutical industry), in order to utilize drugs that Big Pharma wanted to develop a market for, and doctors are usually quite willing to go along with them, because it's good for business. (Besides that, many patients demand the drugs from their doctors, because the advertising campaigns easily win over patients who are looking for an "easy fix", which makes them vulnerable to such sales pitches). GERD is one of those "created diseases", as a matter of fact. Have you ever heard of "branding", in regard to diseases? You may find the article at the following link to be quite interesting, if you've never seen it before. Here is a quote from it:

When AstraZeneca introduced Prilosec (and later Nexium) for heartburn, for example, it famously repositioned heartburn as gastroesophageal reflux disease, or GERD. But it also commissioned research to demonstrate the devastating consequences of failing to treat it. Once physicians are on board, a company can get a concept like overactive bladder or reflux disease into widespread circulation simply by funding CME events, journal supplements, and disease-awareness campaigns. “That’s easy,” says Whitehouse. “You just have to have enough money.”

http://www.kevinmd.com/blog/2011/01/cre ... -drug.html

Tex