Hi,
Thanks for posting your query.
I am Dr.R.K and I am pleased to assist you.
The answers for your questions -
1. Yes gastroesophageal reflux can cause left sided chest/rib pain. This is the reason why sometimes individuals get scared that they have heart issues and get a cardiac evaluation done before they consult a gastroenterologist for reflux.
2. Any exercise that involves contraction of the abdominal muscles can worsen the reflux symptom. But they do not cause an increase in the acid production. Dieting does not increase acid production.
3. Yes , panic is a form of stress and this can worsen the reflux symptom by increasing the acid production.
4. Since I am an allopath and not qualified in homeopathy, I cannot give suggestions about homepathic medications. But I can assure you that PPI are quite safe medications and are very effective also.
Let me know if I can assist you further.
Regards,
Dr.R.K
Patient replied :
What are your recommendations from an allopathic perspective on gastric reflux? I had an ultrasound exam today and the tech was not too talkative, the entire procedure was less than 30 minutes. Is this a good sign? Also, I had no abdominal discomfort in all the places she was prodding with the wand? You can probably see that i have this phobia about pancreatic cancer- any advice on how to deal with this issue?
thank you for your help
Lastly, can you provide your opinion as to whether feces are supposed to float, sink or be variable. The internet seems to link floating stools to pancreatic cancer. thanks again
Hi,
Thanks for getting back to me with more questions.
For reflux disease, in addition to proton pump inhibitors ( to be taken for 4-8 weeks), dietary and lifestyle changes are also important to get a complete relief. Weight reduction if obese. Avoide coffee, citrus, tomatoes, fatty food, mint, alcohol, smoking . Do not eat full stomach. Eat smaller, frequent meals. Go to bed at least 2-3 hours after food.
Regarding the question on feces, it is variable. It depends on the fecal fat content. If the fat content is high in the feces, it may float. The fat content of the feces depend on the amount of fat you take and the degree of digestion.
I hope that answers your question.
Please let me know if I can assist you further.
Regards,
Dr.R.K
Patient replied :
Thank you again for your help. Regarding the feces and floating perspective. I have been eating a very low fat diet for three months now and find that the stool character has all three characteristics ie. sinks, floats, sometimes loose. Fat in the stool cannot explain this as my diet has very little fat in it. An acupuncturist has told me that sometimes the amount of time that the feces spends in the colon can also lead to density issues ie., less time it's there the less time for compaction? The reason for the big deal with floating stool is the fear of a correlation of floating stool and pancreatic cancer (early sign).. So from a GI specialist perspective can you tell me what characterizes a floating stool? Again, not to sound too obsessed, but what if the stool doesn't sink all the way but lays just below the water surface? Would this be considered a floating stool?
thank you for your advice
Hi,
Thanks for getting back to me with more questions.
Though increased fat can cause stool to float, there are other causes as well. If the gas content of the stool is high, then again stool will float. For example, a high fiber diet can increase intestinal gas. So this increased gas in the stool can cause it to float. Infection can also increase the intestinal gas and cause a floating stool.
if it due to increased fat, then the stool would not only just float, it would be oily/greasy, bulky, offensive. And if it is due to pancreatic cancer, in addition to these, there would be weight loss also.
Floating stool floats on the water surface.
I hope that answers your question.
Let me know if I can assist you further.
Regards,
Dr.R.K
Patient replied :
Hi, I've received the result of my ultrasound. I supposedly have a fatty liver and also clinical assessment of GERD. So my questions to you are: does citric fruit make reflux worse? I haven't had issue with this in the past, but lately, eating oranges makes my belly a little burning. Secondly, any thoughts on the reversibility of fatty liver? I read that losing too much weight too quickly is not good for this situation?
thank you for your help
Hi,
Thanks for getting back to me with more questions.
Yes citrus fruits worsen GERD symptoms.
Regarding fatty liver, it is reversible if the precipitating factors are eliminated. Some of them are alcohol intake, obesity, diabetes, high cholesterol . So if any of these is responsible for your fatty liver, it has to be eliminated. This will normalize the liver in 1-3 months time.