Stalled, needing perspective

[Fisherman2356]

Advice for heartburn with GLP-1s:

Clinical Recommendations to Manage Gastrointestinal Adverse Events in Patients Treated with Glp-1 Receptor Agonists: A Multidisciplinary Expert Consensus - PMC

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are indicated in type 2 diabetes and obesity for their high efficacy in controlling glycaemia and inducing body weight loss, respectively. Patients may develop gastrointestinal adverse events (GI ...

pmc.ncbi.nlm.nih.gov

Patient education with a focus on increasing meal frequency consisting of smaller portions; avoiding stimulant/secretory compounds (coffee, tea, spices, cola drinks) and those inducing lower esophageal sphincter relaxation (fat, fried or processed foods, tomato, mint, chocolate); avoiding alcoholic and carbonated drinks; avoiding lying down shortly after meals.

Recommend PPI use for a short time to relieve gastroesophageal reflux symptoms before continuing with dose escalation.

Gastroesophageal reflux is common in obesity. GLP-1 RAs have occasionally been described to exacerbate its symptoms, possibly because of the transient delay in gastric emptying subsequent to treatment initiation. Suitable diet habits and PPI use are usually enough to relieve symptoms. Furthermore, these improve as weight decreases. Thus, there is no need to keep pharmacological support for a long time.

I just do tums, and it always works. I do however think that taking too many tums will eventually lead to bowl movement issues/constipation, and for that I use MiraLAX.

 

[Calm Logic]

My favorite OTC is Alka Seltzer and also drinking alkaline water.

My biggest heartburn triggers are coffee, bending down, and sleeping flat. I have switched to a low-acid functional coffee (Everyday Doze). And I sleep in a recliner if it's really bad.

Before I started tirz, I did a good amount of TUMS for a few days (but not excessive), and it showed up on a blood test as hypercalcemia. So I had to get retested, and I was fine. But I like TUMS for the portability since it's easy to have them in the car.

My heartburn has been getting better with increasing the dose of tirz. I assume that's from the weight loss.