Reflux appearing for the first time at a dose step

Reflux appearing for the first time at a dose step — setting out what I have, and where I think it stops being reliable.

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

Over 26 weeks I logged this consistently: date, dose, time of day, and a simple severity score from 0 to 4 for each symptom. That is 74 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.

A symptom that starts weeks after a dose has been stable is a different observation from one that starts after an escalation, and it deserves a different explanation.

The opening post describes the usual case. This is about the unusual one.

Reflux and eructation are the two most under-reported effects in the first-hand accounts here, and both follow directly from delayed emptying.

Adding the measurement that post #3 says would settle it.

Gallbladder complications: rapid weight loss increases the risk of gallstone formation. The mechanism is not specific to this drug class. The risk is greatest in the first months when weight loss is most rapid.

The general answer and the answer for your case may diverge here.

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.