Appreciated. The plain phrasing does more work here than a longer post would.
7 likes 4mo
Clinical · Comorbidities · continued
Gastro-oesophageal reflux: improving or worsening? posts 31–59
This is a continuation of a long topic, addressed by post number rather than by page. Start at post 1 · go to the accepted answer.
Collapsed as off-topic by two members at trust level 3 or above
Everything in post #28 holds. The case it does not cover is the one I have.
My position on gastro-oesophageal reflux is current rather than settled. I have revised it once already and I expect to again, so treat it accordingly.
a.wikstrom, post #25: Post #22 put the caveat in the right place and I want to underline it. The practical value of this subcategory is helping somebody frame the question they take to an appointment, and that is worth being explicit about. Not a strong opinion, just a consistent one. Go to post
The arithmetic on gastro-oesophageal reflux is the easy part and it is where the errors are, which is an uncomfortable combination. Show your working and someone will catch it.
Post #34 answers the question as asked. The question underneath it is different.
If you are new and reading this thread for the answer to gastro-oesophageal reflux: the answer is conditional, the conditions are in the third reply, and the rest of the thread is worth skipping.
4 likes 4mo
e.lokken, post #23: I had read the opposite somewhere and cannot now find where, which tells me something. Go to post
I read post #33 twice before replying, because I had assumed the opposite.
Offering a way to settle gastro-oesophageal reflux rather than another opinion about it. Two measurements, taken the same way, a fortnight apart. If the difference is within the noise, the question was not answerable at this precision.
t.brandt, post #32: Everything in post #28 holds. The case it does not cover is the one I have. My position on gastro-oesophageal reflux is current rather than settled. I have revised it once already and I expect to again, so treat it accordingly. Go to post
Post-authorisation safety studies are the place where under-studied populations eventually appear, and they are public.
That has been true for the cases I have seen and I have not seen many.
Post #38 is right about the mechanism and I think understates the practical bit.
Reframing gastro-oesophageal reflux slightly, because I think the disagreement is about the question rather than the answer. If the question is "does it happen", yes. If it is "how often", nobody here knows.
17 likes 3mo
isotonic_sheet, post #13: Asking about a population rather than about yourself is a legitimate framing and generally gets a better answer, because the general case is answerable. Go to post
Where two conditions pull in opposite directions, that is a clinical judgement rather than a lookup, and it is the kind of question a forum answers worst.
Take the reasoning and check the arithmetic; I do not always get it right.
On gastro-oesophageal reflux the community has more anecdote than the confidence in this thread implies, and I include my own contribution in that.
4 likes 3mo
c.falk, post #38: Something worth flagging about gastro-oesophageal reflux: the strongest-sounding claims in this thread are the ones with no source attached, which is the usual pattern and not a coincidence. Go to post
Bariatric surgery history: altered anatomy after surgery affects absorption. That matters for oral medications and for reconstituted solutions. Discussing specific medications and doses with a clinician familiar with bariatric surgery is prudent.
I have separated what I observed from what I concluded, which does not always happen.
Where I part company with post #41, and it is a narrow parting.
Small methodological point on gastro-oesophageal reflux: repeating a measurement is cheap and resolves most of what is being argued about here at no cost to anyone.
0 likes 3mo
Where somebody is on several medicines, the interaction question and the comorbidity question are entangled and both belong with a pharmacist.
That is all I can say without guessing.
8 likes 2mo
MJayawardena, post #2: The arithmetic in the opening post is right; the assumption feeding it is the part to check. The practical version of gastro-oesophageal reflux is three sentences long. The rigorous version is three pages and reaches the same conclusion with the conditions attached. Go to post
The arithmetic in post #45 is right; the assumption feeding it is the part to check.
The thing about gastro-oesophageal reflux that took me longest to accept is that a plausible mechanism is not evidence of an effect. It is a reason to look, not a result.
Post #45 put the caveat in the right place and I want to underline it.
Careful with the language on gastro-oesophageal reflux. "Not detected" and "not present" are different findings and the first is a statement about the method.
0 likes 2mo
Worth separating two things that post #45 runs together.
The practical value of this subcategory is helping somebody frame the question they take to an appointment, and that is worth being explicit about.
12 likes 2mo
Thank you for the correction. I would rather find out here than later.
0 likes 2mo
Collapsed as off-topic by two members at trust level 3 or above
Two things can be true about gastro-oesophageal reflux at once: the mechanism is plausible and the evidence for the size of the effect is thin. Most of the argument here is people defending the first against attacks on the second.
m.vukovic, post #44: Post #41 is the version of this I will quote in future. One addition. Where I would push back on the gastro-oesophageal reflux consensus is the confidence, not the direction. The direction looks right. The confidence is borrowed. Go to post
Nothing here is medical advice and clinicians posting in this subcategory say so on their own account rather than because a rule requires it.
The conclusion is tentative; the arithmetic underneath it is not.
I had written a reply contradicting post #50 and deleted it. Here is what survived.
For anyone finding this later: the short answer on gastro-oesophageal reflux is that it depends on one thing, and the rest of the thread is people identifying which thing.
29 likes 2mo
Asking about a population rather than about yourself is a legitimate framing and generally gets a better answer, because the general case is answerable.
9 likes 1mo
np_gilmore, post #41: On gastro-oesophageal reflux the community has more anecdote than the confidence in this thread implies, and I include my own contribution in that. Go to post
Before the thread moves on from gastro-oesophageal reflux — what is the sample size behind the claim? I am not being difficult; I have seen the same figure quoted from an n of four and from an n of four hundred.
Adding the boring version of gastro-oesophageal reflux, because the interesting version keeps getting posted and the boring one is usually right.
Check the ordinary explanations, in order, and stop when one of them accounts for what you are seeing. Most of the time the second one does.
0 likes 1mo
Where a condition is well controlled and where it is not are different questions and the published data rarely distinguishes them.
Caveat: everything above assumes the paperwork is what it says it is.
5 likes 1mo
This topic was referenced in
- Osteoarthritis and mechanical versus metabolic improvementClinical › Comorbidities · 6 replies
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