[2026 update] Reflux appearing for the first time at a dose step

Posting this under the heading it deserves: Reflux appearing for the first time at a dose step Everything below is what sits behind that.

Reporting something rather than asking about it, in case the pattern is useful to anyone else.

Over 20 weeks I logged this consistently: date, dose, time of day, and a simple severity score from 0 to 4 for each symptom. That is 82 data points, all self-reported, all unblinded, and collected by someone who knew what he expected to find. Treat it accordingly.

The reason I am posting is that my experience does not match the shape people usually describe here, and I would like to know whether that is unusual or whether the usual description is just the loudest version.

Everything in the opening post holds. The case it does not cover is the one I have.

Gastrointestinal effects in this class are dose-related and escalation-related. Both are true simultaneously, which is why symptoms typically return at each step and then settle again.

I am describing what is, rather than arguing for what should be.

Taking the opening post at face value and following it one step further.

Effects that improve with time and effects that improve with dose reduction are different findings. Working out which you have requires holding the dose steady long enough to see.

I would not lead a decision with this, but I would not ignore it either.