Q. Do you recommend probiotics for acid reflux?

Answered by
Dr. Anshul Varshney
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jun 14, 2018 and last reviewed on: Sep 16, 2020

Hi doctor,

I have acid reflux since 10 years. My H.pylori test is negative. I already overused Pantoprazole and it caused side effects like vitamin B12 deficiency, muscle weakness, etc. So, I would like to discontinue it. I heard that probiotics may heal my problem. Can I use probiotics? If so, then let me know the dosage too. Thanks in advance.

#

Hi,

Welcome to icliniq.com.

  • In fact the famous probiotic for this purpose available in market are Darolac-IBS and VSL-3 (lactic acid). You can take them twice a day.

For further information consult a medical gastroenterologist online --> https://www.icliniq.com/ask-a-doctor-online/medical-gastroenterologist

Hi doctor,

My digestion is fine. I do not have any constipation related problems. I have occasional diarrhea. So, please suggest the probiotics according to my condition. My major problem is heart burn and also bloatedness.

#

Hi,

Welcome back to icliniq.com.

  • Your condition is irritable bowel syndrome (IBS) only.
  • The preferred drugs are Mebeverine, which is a combination of Pantoprazole and Domperidone and VSL-3 probiotic.
  • This probiotic has very good response rate.

For further information consult a medical gastroenterologist online -->  https://www.icliniq.com/ask-a-doctor-online/medical-gastroenterologist

Thank you doctor,

I will go for probiotics only. Please suggest the better among Lactobacillus plantarum 299v and VSL3.

#

Hello,

Welcome back to icliniq.com.

  • In my opinion, the best probiotic for IBS is VSL3.
  • But, probiotics alone are not going to help you. You need to take the above discussed drug too.

For further information consult a medical gastroenterologist online -->  https://www.icliniq.com/ask-a-doctor-online/medical-gastroenterologist

Hi doctor,

As I said before, Pantoprazole is causing damage for me. It seems that my liver gets affected by it. So, I do not like to continue it. What is the dosage of Mebeverine and how many days should I have it? Also please give the dosage of VSL3?

#

Hi,

Welcome back to icliniq.com.

  • Pantoprazole does not affect the liver. I do not know how you got that derivation.
  • You may take Ranitidine and Domperidone for acid reflux in that case.
  • Capsule VSL-3 is also given once a day before going to bed.
  • Mebeverine is commonly used in dose of 200 mg retard tablets twice a day.

For further information consult a medical gastroenterologist online -->  https://www.icliniq.com/ask-a-doctor-online/medical-gastroenterologist

Hi doctor,

Does you mean I shall use both the drugs that is Mebeverine and PPI along with probiotics?

#

Hi,

Welcome back to icliniq.com.

  • In my opinion, you should take any one of Ranitidine or Pantoprazole along with Mebeverine and VSL-3.
  • You need to take all these 3 drugs and see the wonderful response within two weeks.

For further information consult a medical gastroenterologist online -->  https://www.icliniq.com/ask-a-doctor-online/medical-gastroenterologist

Hi doctor,

I am taking Mebeverine before breakfast and tablet Ranitidine, Domperidone and capsule VSL3 together after dinner. Correct me if I am wrong. When shall I take the Mebeverine second dose?

#

Hello,

Welcome back to icliniq.com.

  • Mebeverine second dose should be taken before dinner.
  • The schedule is perfect in my opinion.
  • However, we always advice you to share the online opinion with a doctor in person and take the prescription.

For further information consult a medical gastroenterologist online -->  https://www.icliniq.com/ask-a-doctor-online/medical-gastroenterologist

Hi doctor,

Yesterday I did not take tablet because my stool was pale in color. When I read in internet, I got to know PPIs over usage can cause obstruct bile and stool will be in pale color. Today post lunch I got right lower abdomen pain for 3-4 minutes. Then, immediately I took Pantoprazole plus Domperidone. I do not have the pain now. I have minor pains coming and going in the muscles around the stomach. What do you suggest for this?

#

Hi,

Welcome back to icliniq.com.

  • What you have read is right but is very rare and even more common in people who have pre-existing liver disease.
  • Pale colored stools are commonly found in IBS. If you want to be sure then you can have your liver function tests done.
  • The pain in abdomen that you are feeling is because of IBS only. Mebeverine would help you in that.
  • In fact, if your ultrasound abdomen has never been performed then you should get it done.

For further information consult a medical gastroenterologist online -->  https://www.icliniq.com/ask-a-doctor-online/medical-gastroenterologist

Hi doctor,

I have done liver function tests and ultrasound recently and there were no issues. Only yesterday I observed pale color and I thought it might be due to PPI. Regarding Mebeverine I found something called Colospa 135 mg. Is it fine? Or should I use 200 mg retard? What does retard mean? Is it sustained release? Also you said 200 mg twice which I think as high dose. Can I take PPI and Mebeverine together? Or should I give some gap?

#

Hi,

Welcome back to icliniq.com.

  • You may use PPI (proton pump inhibitor) or H2 blocker (histamine H2 blocker) like Ranitidine.
  • Yes, you can take PPI and Mebeverine together.
  • Colospa Retard 200 (Mebeverine) is widely available in market.
  • Initially we start with retard formulation and later convert to 135 mg formulations.
  • Retard means sustained relief only.

For further information consult a medical gastroenterologist online -->  https://www.icliniq.com/ask-a-doctor-online/medical-gastroenterologist

Hi doctor,

From yesterday night I have right side lower abdomen pain and it reduced by early morning. I had Pantoprazole plus Domperidone before breakfast. Today, I did not have pain after lunch. Only last two days the pain was there and also for just couple of seconds. So, shall I use only Pantoprazole? Or is Mebeverine a must? I have bought VSL3 but not yet started. My plan is to start by today night.

#

Hi,

Welcome back to icliniq.com.

  • Mebeverine is not just for the pain.
  • Its role is also in IBS associated diarrhea and constipation. In my opinion you should take both VSL3 and Mebeverine.

For further information consult a medical gastroenterologist online -->  https://www.icliniq.com/ask-a-doctor-online/medical-gastroenterologist

Hi doctor,

It seems stomach acid deficiency also can cause the symptoms like vitamin B12 deficiency, dry skin and white patches on nails. I have all these. I heard that vitamin B6 is required for HCl production and so planning to get tested for vitamin B6 and zinc. How do I get a test for HCl deficiency? In case of HCl deficiency, what treatment should I take?

#

Hi,

Welcome back to icliniq.com.

  • No special test is indicated for HCl synthesis.
  • The concept is actually opposite. Vitamin B12 synthesis occurs inside stomach in presence of acidic medium.
  • You can get tested for Vitamin B12 levels.
  • You should also get your thyroid profile and anti-tTG antibody test done.
  • Anti-tTG antibody test is done for the diagnosis of celiac disease.

For further information consult a medical gastroenterologist online -->  https://www.icliniq.com/ask-a-doctor-online/medical-gastroenterologist

Hi doctor,

I have tested for thyroid and I do not have thyroid problem. As I already took the shots, my vitamin B12 is fine now. For HCl and pepsin, could you suggest any brand available in market?

#

Hi,

Welcome back to icliniq.com.

  • It is great news that your thyroid is normal. You do not need to take HCl from outside. It is produced by stomach only and excessive production causes acidity.
  • However, to improve digestion you can take tablet Aristozyme that contains diastase and pepsin.
  • We usually prescribe it as one capsule thrice daily with meals.
  • Share my opinion with your doctor, before you act upon it.

For further information consult a medical gastroenterologist online -->  https://www.icliniq.com/ask-a-doctor-online/medical-gastroenterologist

Hi doctor,

Thank you for your support. Today, I am feeling better. I am having one apple before each meal. In the morning, I had both apple and tomato and I am feeling better now. My ulcer also seems to be coming down. I will use Aristozyme tablets whenever required. I hope these can be used even I have ulcer. I am feeling hungry around 3 AM and I am having some buttermilk or fruit at that time. I thought having some protein food during dinner might help. Please suggest. As of now I am using curd only as probiotic, not taking any tablet.

#

Hi,

Welcome back to icliniq.com.

  • Good to know that you are improving. I would advise you to have cold milk in night before you sleep.
  • Avoid any spicy food item.
  • In case you feel acid reflux in the middle of night, then take syrup Gelusil.

For further information consult a medical gastroenterologist online -->  https://www.icliniq.com/ask-a-doctor-online/medical-gastroenterologist


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