IBD/IBS/GERD
To clarify, you wait to use HCl until the patient is completely weaned off PPIs or just until they have lowered their dose significantly?
Dr. Amy Nett: Yeah, I generally wait until they’ve lowered their dose. Again, it can be a little bit tricky...
Steps one to three of GERD treatment summary—are they meant to be done sequentially, or do they overlap? Specifically, would you want to wait until someone is entirely off PPIs prior to introducing HCl, so complete step one prior to moving on to the next step?
Dr. Amy Nett: For people who can’t see, how we approach treating GERD, the first step is going to be...
s HCl with pepsin safe with gastritis, a hiatal hernia, or Barrett’s esophagus? How would you recommend handling long-term use of PPIs in these conditions?
Dr. Amy Nett: Remember you’re increasing stomach acid when you’re using HCl, so I would not use it with gastritis...
Male patient with gut symptoms from loose bowels to cramping. Doctor’s Data test showed no parasites but did have no-growth Bifida and elevated lactoferrin and calprotectin. Had an appointment with specialist who ran biopsy, and while it showed no IBD, it did show lymphocytic colitis. Patient also had elevated cholesterol from triglycerides and cholesterol/HDL ratio 4.1, high ferritin, low vitamin D. Patient has gone overseas for a month. I have advised to follow a Paleo reset diet with cholesterol modifications and recommended more comprehensive bloods and DUTCH test. Patient’s reluctant to spend more money on testing. Feeling unsure whether to do gut protocol with him seeing as there are no parasites. Can I go into prebiotic straightaway to Bifidobacterium up?
Chris Kresser: There’s definitely inflammation going on and in the gut with a calprotectin that high and lactoferrin that high....
