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iCliniq / Answers / Medical gastroenterology / Acid Reflux / Which is the best probiotic for acid reflux?

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.

Dr. Anshul Varshney

Dr. Anshul Varshney

Critical Care Physician Diabetology General Medicine Internal Medicine Medical Gastroenterology Nephrology Pulmonology (Asthma Doctors) Rheumatology
#

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

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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.

Dr. Anshul Varshney

Dr. Anshul Varshney

Critical Care Physician Diabetology General Medicine Internal Medicine Medical Gastroenterology Nephrology Pulmonology (Asthma Doctors) Rheumatology
#

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

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Thank you doctor,

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

Dr. Anshul Varshney

Dr. Anshul Varshney

Critical Care Physician Diabetology General Medicine Internal Medicine Medical Gastroenterology Nephrology Pulmonology (Asthma Doctors) Rheumatology
#

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

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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?

Dr. Anshul Varshney

Dr. Anshul Varshney

Critical Care Physician Diabetology General Medicine Internal Medicine Medical Gastroenterology Nephrology Pulmonology (Asthma Doctors) Rheumatology
#

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

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Hi doctor,

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

Dr. Anshul Varshney

Dr. Anshul Varshney

Critical Care Physician Diabetology General Medicine Internal Medicine Medical Gastroenterology Nephrology Pulmonology (Asthma Doctors) Rheumatology
#

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

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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?

Dr. Anshul Varshney

Dr. Anshul Varshney

Critical Care Physician Diabetology General Medicine Internal Medicine Medical Gastroenterology Nephrology Pulmonology (Asthma Doctors) Rheumatology
#

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

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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?

Dr. Anshul Varshney

Dr. Anshul Varshney

Critical Care Physician Diabetology General Medicine Internal Medicine Medical Gastroenterology Nephrology Pulmonology (Asthma Doctors) Rheumatology
#

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

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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?

Dr. Anshul Varshney

Dr. Anshul Varshney

Critical Care Physician Diabetology General Medicine Internal Medicine Medical Gastroenterology Nephrology Pulmonology (Asthma Doctors) Rheumatology
#

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

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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.

Dr. Anshul Varshney

Dr. Anshul Varshney

Critical Care Physician Diabetology General Medicine Internal Medicine Medical Gastroenterology Nephrology Pulmonology (Asthma Doctors) Rheumatology
#

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

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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?

Dr. Anshul Varshney

Dr. Anshul Varshney

Critical Care Physician Diabetology General Medicine Internal Medicine Medical Gastroenterology Nephrology Pulmonology (Asthma Doctors) Rheumatology
#

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

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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?

Dr. Anshul Varshney

Dr. Anshul Varshney

Critical Care Physician Diabetology General Medicine Internal Medicine Medical Gastroenterology Nephrology Pulmonology (Asthma Doctors) Rheumatology
#

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

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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.

Dr. Anshul Varshney

Dr. Anshul Varshney

Critical Care Physician Diabetology General Medicine Internal Medicine Medical Gastroenterology Nephrology Pulmonology (Asthma Doctors) Rheumatology
#

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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