jmc

Suddenly, without warning, Howard McCollister exclaimed (3/15/2006 4:38 AM):


Ok, I knew that. Let me rephrase: Can lansoprazole dramatically and
somewhat suddenly lose it's ability to control reflux symptoms? I'm
still trying to figure out what is triggering this night cough; I am
pretty sure it's reflux but as I'm on 30mg of lansoprazole, sometimes
take Zantac at bedtime, which doesn't help, and take Maalox at the onset
of a cough (hard to tell if this is working or not), all without
appreciable success, I'm left wondering if it's reflux at all.

jmc

jmc

Suddenly, without warning, Howard McCollister exclaimed (3/15/2006 4:38 AM):

Howard:

Interestingly enough, I picked up a product at the chemist today (UK)
that calls itself a "reflux suppressant". It's a really thick
suspension. Active ingredients: sodium alginate Ph Eur 1000mg and
potassium bicarbonate Ph Eur 200mg. Has calcium carbonate and some
other stuff as well. The package says "[it]forms a protective layer
that floats on top of the stomach contents. This layer prevents reflux
and keeps the stomach contents away from the lining of the food pipe."
Says it's good for controlling hiatus hernia symptoms...

This is a well-know, respected brand in the UK, the product is called
Gaviscon Advance - it a pharmacy only med (here, there's three types of
meds - OTC, pharmacist only, and prescription).

I'm wondering what you think of the product's claims?

jodi

howard mccollister

Gaviscon has been around for many years. It's function is as described, but
it acts and an antacid that neutralizes acid before it can come into contact
with the esophageal lining. It doesn't stop reflux, just neutralizes the
acid that IS refluxed. Gastric contents can still get up the esophagus and
into the posterior pharynx. Anything that hits the vocal cords can cause
coughing.

HMc

jmc

Suddenly, without warning, Howard McCollister exclaimed (3/15/2006 6:42 PM):


Well, the Gaviscon Advance is new. I don't have some old gaviscon handy
to compare ingredients, just assumed (after talking to the pharmacist)
that this was indeed something new and different. At any rate, I think
it's working.

I know the old stuff just neutralized. This stuff says it does more,
but I'm unfamiliar with the UK laws concerning truth in advertising...

Is Gaviscon available in the States? I don't remember seeing it there.
Before I got on prescription meds, I always found it worked better
than malox or the other US antacids.

jmc

howard mccollister

Yes, still available. As I've said - whatever works in controlling symptoms.

HMc

pete

Howard...I was going to comment on this, but decided not to. I follow your
posts in here and in sci.med, and I have been quite active in here in the
last six weeks or so, as I'm sure you know (let me change that to "I know
you know").

IMO, you are a very dedicated doctor (volunteering your time and knowledge
to this ng and the sci med ng), and I have continually praised you for this.

One major problem with newsgroups is that you have to continually say the
same thing over and over (you do it, and I do it - all the time), not only
to new people who may have just joined (and didn't search previous posts),
but also to existing people who have been reading your (and my) posts, but
perhaps what we said just didn't sink in, or they just chose not to pay any
attention to it.

I would like to have a dollar for every time you said that drugs only change
the nature of the refluxate, and do not effect the reflux mechanism, and
that GERD is a surgical disease. And I would like to have the same dollar
for all my posts about the H2 blockers versus the PPI's :-) .

So let me ask you, at what point do you become uninterested because of the
repetition, and quit...Pete

howard mccollister

Medicine's a tricky landscape, and people get lot of bad information -- from
their friends, from the internet, and sometimes from their doctors. I post
here and sci.med about things where I have some expertise just doing my
little part to try to counter some of that. I find the whole process
fascinating, and I'm always interested in understanding what people think
about medical subjects and why. Sometimes it's outrageous, sometimes
pathetic, sometimes even accurate, but it's always interesting.

HMc

pete

Let me ask again Howard...are you saying you don't mind saying the same
"kinds" of things over and over (I gave you examples - ie about the nature
of the refluxate versus the reflux mechanism). It would seem to me that
after a while you would lose interest.

Let me give you another example. The guy named "Bill" [hell of a nice guy -
I still haven't called him yet :-)], who was against surgery (like me) and
was the ginger juice advocate, and also posted the H. pylori articles. He
and I went through several exchanges and now it is over. So does he sit
back and relax now, or does he repost every month or so about the ginger
juice and raised bed.

I think you see my point. That is great that you "find the whole process
fascinating", but it seems to me that the repetition (of you stating your
case to new posters, and even previous posters) would eventually get to you.
No??

Pete

howard mccollister

Nah. It doesn't bother me.

HMc

jmc

Suddenly, without warning, Pete exclaimed (3/15/2006 11:52 PM):

Well, keep in mind that some of us erroneously use wording that reads
like we think it's controlling reflux, when we're well aware it's only
controlling, as you say, the nature of the refluxate. Sometimes it's
just easier, and sometimes it's just lazy typing.

jmc