pls advice guyz..Thnks in advance

Hi barretts.

Your knowledge on this forum has been a massive help for me.

I would just like to ask you a question, I have been diagnosed with lpr not gerd as I NEVER have heartburn or indigestion.

I do suffer with coughing and wheezing in the mornings, the rest of the time I have it all pretty much under control with meds and lifestyle.

But I wanted to ask do you think with the refluxate entering the respiratory system it will cause any permanent airway or lung damage?

I'm concerned about this as like I say the rest of the day I have things under control now (before I read your advice it was crazy out of control) but I get this wheezing chest unproductive cough for about 3 hours a day from when I 1st get out of bed. I can live with it as I'm used to it now but I am concerned if it could be causing permanent damage? Is it actually acid that is getting into my respiratory system? Thanks for any advice x

Hi Laura. There's a surprisingly large number of reflux sufferers who never experience heartburn for some reason. (Estimated around 30% or more and mainly women.)

Reflux doesn't need to be acidic to cause problems in the respiratory system. I am now 67 but have had extra-oesophageal reflux all my life. I was always being sent to ENT. As a boy I had my ears syringed weekly and had my tonsils and adenoids removed when I was 6 (ineffectively).

It was until 20 years ago, discussing it with an intuitive doctor, that we reasoned the reflux was "coming up one tube and down the other".

My cough was so bad that I would get a fit where I practically blacked out at least once a day and would sit up for 2 hours between 3:00 and 5:00am every night couging and swigging far too much cough suppressant from the bottle.

Eventually I had to have a fundoplication to reduce the reflux and all the symptoms of LPR either disappeared or reduced to minimal and acceptable level.

Refluxate aspirated into the lungs can cause serious problems such as pneumonia and even bronchiectasis. Keepin the acid reduced may mean less harm but even the 80mg omeprazole daily I wa taking had had no effect on the upper oesophageal reflux.

I do hope you are able to get your reflux under control but if not, you may want to discuss the surgical options.

All the best. I fully empathise and know how miserable this can be.

Wow, your symptoms were exactly the same as mine... In the small hours of night I would wake up with coughing fits so bad I couldn't catch my breath, and would often blackout if I took a coughing fit whilst standing! It got so bad and so out of control I had to stop work as a busy hairdresser for about 12weeks, I was put on anti depressants, inhalers, steroids etc until I was finally diagnosed.

Its very interesting you mentioned ears as for a long time iv suffered on and off with earache, temporary deafness and ringing/underwater noise, the docs put it down to sinus issues, I never would have related it to reflux!!

Can I ask was the fundo op as awful as some people say? And do you mind me asking if you have ever had a sickness bug or need to vomit since having it and what you do about it?I have 2 little ones at home so unfortunately sickness bugs do happen in our house hold every now and then! Also what is your opinion on the lynx surgery?

Thanks for replies, sorry if I'm hounding you a bit, its just I don't seem to get any help from my doc at all

I was originally offered the fundoplication in 1999 but it would have been by open surgery and I was too scared. By 2007 I was desparate enough to have considered anything and I had read all the horror stories. But it was the best thing I ever did.

The blog of my own experience of fundo may be found on my personal wesbite ChrisRob co uk if you click on the Barrett's tab.

I went from all the chronic LPR symptoms and anaemia from hypochlorhydria induced by high level of PPIs over a number of years to being med and symptom free overnight.

Burping and vomitting can be an issue for some for a couple of weeks as the scar tissue heals but is usually OK fairly soon.

Unfortunately I did succumb to norovirus and was violently vommitting for 5 hours solidly. I feared my wrap wouldn't stand up to so much internal gymnastics and it had loosened. Gradually the symptoms all returned.

18 months ago I had it repaired witha  Collis-Nissen revision which is far less likely to come loose again.

Purely personally, I am not a fan of LINX. It may be the best artificial alternative to fundo but I have concerns. It is highly promoted on scare stoires that fundoplication won't let you burp or vomit and that LINX can be reversed if necessary. Actualluy fundoplications can be reversed if necessary but I've never heard of it being necessary. It is possible (rarely) for fundo wraps to be too tight and cause swallowing difficulties but easily dilated. LINX causes swallowing problems in 63% of patients receiving it. If the food bolus is not solid or heavy enough, it can remain stuck in the oesophagus.

But I am concerned about its long term effects. Results are only available for 10 years reporting 85% satisfaction from recipients. (Whereas Laparoscopic fundoplication results are available for 20 years with recipients reporting 90% satisfaction.)

Over time, the movement of the titanium magnets against the advetia (outer "casing" of the oesophagus) might cause erosion. And will tissue overgrowth reduce the movement of the magnets causing the device to lose effectiveness?

I discussed LINK with it's manufacturers, Torax medical, dome years ago and they confided inme that they were concerned about the possibility of erosion and migration over a long period.

If you visit the Down With Acid website, you can also read of Angelchik - an artificial device similar to LINX but using what was effectively a rubber band to keep the oesophagus closed. 40 years ago, everyone was clamourng for it in a similar way to LINx now. But 20 years later problems of erosion started to become apparent and there was a clamour to have it removed.

I hope that doesn't happen with LINX.

And don't worry about "houding" me. It's a role I have taken on by founding and chairing a patient support charity that works closely with consultants filling a need they do not have the time to provide.

Thanks for being so open

Its so reassuring to hear a positive response to fundo, as I suppose people only usually post up negative experiences.

The lack of time research about the linx does give me cause for concern, and in my head I had written off fundo as id heard such bad things about it, but maybe I need to look into that option if my severe symptoms return or my wheezing and coughing in morning does not improve.

Thanks for advise you have given me some food for thought, and I'm so pleased that you are now able to enjoy the rest of your life without this horrible debilitating illness taking it over, and I thankyou and commend you for taking so much time to advise, help and support fellow suffers. 😊

Sir thanks for ur valuable time and reply... Sir avoide the foods that irritates me.. Stoped smoking and drinking completely... Avoided junk foods also... After having break fast its fine for five hour or so after that it vil start to burn.. Why is it so sir.. Is it because of ulcers or something... But in the endoscopy nothing was wrong... Raised the head end... Sir pls do help me.. Looking forwrd to ur reply..

Sir am bit worried because i lost my weight considerably reduced 5 kgs with in one mnth since my sypmtoms got flared up...sir is der any book or something that i can download it for free regarding reflux.. If yes can u pls forward me the lin.. It vil be sonmuch usefull... Pls.. Thnks in advance.. Gid bless

Have no easy answer but if it's five hours after food, it's possible your stomach needs to use any acid it has produced. You need to eat small amounts frequently.

Sir thanks for the reply.. Sometimes by evening discmfrt vil start to appear.. I dnt knw... Why?? Vil try to hav some small diet in between... Am realy fed up with this situation... Used to sit and work.. May b dat might be a reason... Symptoms vil flare up when am having tensions also.... I cnt even brush in the mlrning... Will be realy nauseous... Is it because of this acid reflux..

Hello Barretts, I was wondering who did your Nissen revision?

I also had a question for anyone out there. I find my teeth getting more sensitive. I'm sure this is overnight reflux despite PPIs and Gaviscon Advance before bedtime. Amy ways of mitigating reflux damage to teeth?

Many thanks

Hi PizzaMan, I had my revision done by one of our excellent surgeons at Southampton under the NHS.

Teeth are affected by acid reflux. PPIs and Gaviscon will help reduce the acid but not the reflux.

I used to get very sharp edges to my teeth. In discussing this with my dentist he said refluxing acid softens the enamel which can then be partially removed by brushing. He suggested not to brush if there's acid possibility but to use a good flouride mouthwash.

Wise wise words. I will add this to my routine. Thank you so much.

Anyway sorry dear.. Anyway thanks for ur reply.. Hope u r doing good.. God bless