Dr. Amy Nett: Yeah, I generally wait until they’ve lowered their dose. Again, it can be a little bit tricky because sometimes it’s actually getting more acid in there that can help the patient get off the PPIs, so I think sometimes it’s trial and error, and a lot of it … I think what I’m trying to say is might be psychological and sort of what your patients are open to, so it’s a good conversation to have with your patients, but I would probably get them off the PPIs because that’s going to be increasing, hopefully, their stomach acid production naturally to some extent. Once the dose is lowered, I would probably bring in a little bit more HCl, but you can certainly bring in digestive enzymes, again, maybe the Digestzymes product. Digestzymes has something like 200 milligrams of HCl versus like a straight betaine HCl capsule, which sometimes has more like 500. I might do a little bit of HCl and digestive enzymes with some GastroMend and probiotics and sort of give them the encouragement that, “Hey, this is going to do a lot for your digestion, and it’s going to help you so that when we take you off the PPI, you’re not going to experience that pain.” Give them some reassurance. Explain the mechanism so that they understand and are sort of prepared for what’s going to happen and that it’s going to be OK. That’s probably how I would recommend doing it.
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- To clarify, you wait to use HCl until the patient is completely weaned off PPIs or just until they have lowered their dose significantly?
To clarify, you wait to use HCl until the patient is completely weaned off PPIs or just until they have lowered their dose significantly?
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- Should HCl be avoided in IBD patients, given that they, by definition, have ulcers all over their GI tracts?
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