Hi thanks for contacting health care magic. Stool can be loose as you are taking many drugs and lactulose also.... If frequency per day is less then 3 then no need for worry.... Because of hiatus hernia bloating and acid reflux can be there. For that antacid like omeprazole can be given.... Head elevation while sleeping. Avoid recumbent position immediate after meal.... Excess fatty and spicy food not taken. As you have COPD you might have smoking habit...So avoid it.... Coffe , chocolate less. If life impairment more then surgical correction needed. To avoid constipation more fluid and activity done with more fruits. Take care.