Acute LPR or GERDS?

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Hello all smile

I would really like to explain what has been happening to me and get the community's advice and knowledge. So thank you in advance for taking the time to read this!

To start, I am a 35 year-old male who has never smoked or drunk alcohol. This past December, I was working a lot of hours at work due to the holidays and also doing A LOT of shoveling snow at home (huge driveway) and I began to feel a bit under the weather. Nothing serious, but rather only a slight cough (even though my lungs were clear according to the doctor), occasional headaches, a bit of pressure near or behind my ears, and a slightly scratchy throat. I had a vacation coming up on January 8th so I did not take any sick days as I was not truly feeling that bad.

Jan. 8th came around and I began my vacation. However, I was taking a shower and I felt a small bump on the back of my neck, below the hairline. It was not large but I had never felt it before. So I went to the local walk-in clinic and saw a doctor who told me it was a lymph node and that I was indeed sick. I had a temperature of 100, my throat was slightly swollen and my ears were also slightly inflamed. He proscribed some Doxycycline and sent me home.

Within two days of taking the Doxy, my symptoms EXPLODED. I was hit with the worst exhaustion and fatigue I had ever experienced in my life. I am a very active/athletic guy who plays sports/lifts weights ... and I could barely walk up stairs. Holding a cup to my lips made my bicep feel as though I had just done 20 curls. In addition to this, my throat was assaulted with feelings of thickness, inflammation, the most horrific thudding and popping feelings when swallowing, tightness in various parts of the throat, as well as hoarseness when talking and seemingly constant throat clearing.

After a few days I visited the same doctor at the walk-in and he said I had developed a very bad case of post-nasal-drip, in addition to whatever else I was fighting. He proscribed Dymista and salt-water gargling and using a humidifier in my room.

So after finishing the 10 days of Doxycyline, I started to feel better. My energy and strength slowly returned. Within 2 weeks of this all starting, I was working my full shifts at work + overtime and back to lifting weights. However ... what did not improve at all was my throat. I was still experiencing sensations of tightness and thickness and extremely uncomfortable swallowing. Sometimes the tightness would be under my jaw, or instead around my larynx, or sometimes in the part of the throat right above the collarbone, which I guess is more like the upper esophagus. I was having no pain at all in the typical "sore throat" sense. Swallowing was uncomfortable, not painful.

I returned to the same doctor and he checked my throat again and said he could not see or feel anything strange and also felt my thyroid and found nothing of concern. He said that clearly I had been quite ill and this all was likely a result of that. He told me to give it time and see how I did.

So 4 weeks after January 8th, my symptoms were the same and I got an appointment with another doctor who is now my Primary Care Physician. He also looked at my throat and felt around and could not find anything out of place. He proscribed Sudafed and put me on 1,800mg of Ibuprofin a day. He thought my post-nasal-drip was still causing havoc and inflammation in my throat.

Another two weeks past and still NOTHING changed. If anything, things seemed to be worsening. In addition the tightness, thickness, excess mucus, and swallowing discomfort, I also developed a terrible "thudding" feeling when I swallowed on the left side of my upper throat, above and slightly to the left of the Adam's Apple and below the jaw. I could feel something catching or popping or thudding in that exact area. People standing next to me could even hear it if they listened closely. It did not hurt, except in the sense that after 30+ times the whole area would become tender. It was at this time that I also noticed how that area would bulge slightly more than the other side when I swallowed. It was not like a bull-frog or anything that extreme, but it was becoming more and more obvious. So my doctor decided to send me to an ENT.

So I have been waiting weeks for my ENT appointment, which is next week. During this time, my symptoms have continued. I wake up every morning to the thudding feeling when I swallow, in addition to random attacks of tightness. I have also noticed that when I lay down on my back with my head on a single pillow for reading, I sometimes feel a tightness or pinching sensation in my lower throat (upper esophagus?) in the area right above the collarbone. If I don't change positions, it sends me into a coughing spell. Even if I am standing up, if I put my chin to my chest, the same choking/tight feeling triggers. In addition to this, I am having feelings of heaviness on my chest when I lay down simultaneously with the choking feeling. When I sit up, the chest heaviness goes away. This seems especially true if I lay down after eating. Yes, for many many years I have been a late-night eater and have often slept soon after eating.

Needless to say, it has been nearly 2 months since this all started and I am getting worried about what is actually happening. Does it sound like I have GERDS or LPR?

Symptoms I have had:

Throat tightness (especially in the area below the larynx/above the collarbone), excessive mucus, hoarseness, post-nasal-drip, throat clearing, coughing, occasional ear pain, feelings of "thudding" or "crunching" when swallowing, uncomfortable swallowing, muscle tightness on side and back of neck, chest heaviness when laying down (especially after eating).

Symptoms I have not had:

Typical Soar throat, trouble eating or drinking or breathing, weight loss, vomiting, nausea, heartburn.

Before I became very ill on January 8th, literally NONE of these symptoms were affecting me as far as I could tell. But since then, it has been every day/all day. Does this sound like LPR/GERDS? And can LPR/GERDS be so acute?

I know this was long. My apologies. Thank you again for reading!

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  • Posted

    Hi there it doubds to me like you have a inflamed esophagus I would stop taking ibuprofen they will irritate it more you could have silent reflux wee as you don't know acid is creeping up into your esophaud and throat get a endoscopy done it could show what's happening if your inflamed it will take a long time yo heal fully and eat healthy no fatty foods stay off coffee fizzy drunk alcoholic beverages and fish veg and leans meats fruit like apples bananas no oranges 🍊 citrus fruits will make it worse  and don't eat three hours before bed 

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  • Posted

    Hi NC10

    I have read your posting and all sounds too familiar, I am much older (66) and do not excercise as you do but I do suffer from GERD/LPR/Acid Reflux. My symptoms are as yours and I find it hard to accept that they are all caused by this problem. I have had an Endoscopy and Barrium Swallow which shows I have some Acid problems. I have been on various types of Omeprazole which seemed to help at first but recently (yesterday) I had an episode of feeling very confused and aggitated so I checked the leaflet for possible side effects and it states that this is indeed a side effect. I am hoping to be prescribed an alternative today. I know that this does not help you but thought I would reply saying that you are most certainly not alone with this problem.

    All the best

    Robin

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    • Posted

      Thank you, Robin smile It does indeed help to know that others are facing similar symptoms. Prayerfully you can find an alternative to Omeprazole that does not have such disconcerting effects.
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  • Posted

    Hi it sounds that u could be right suspecting lpr or gerd.

    Im surprised none of the foctors clicked.

    Have u tried gavuscon? Or over counter ranitidine or nexium?

    Endoscopy would be good to see whats happening inside.

    Google how to sleep with reflux and the diet as lifestyle changes are important. Do not lift heavy objects, do not work bending down, no tight clothes round waiste.

    Also tell yr doctor yr suspicions.

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  • Posted

    Hey all smile

    Thank you so much for your responses, everyone.

    I have indeed stopped taking the Ibprofin, yes. It did nothing to help as far as I could tell and, as you say, possibly only inflamed my problems. I have not tried anything like Nexium, however, as none of the doctors I have seen thus far have said anything about reflux. And I understand why they have not. Everything started when I became very sick and they all assumed, as I did as well, that my symptoms were related to that. Granted, it is now many weeks later. My ENT appointment is mid-week, so waiting for that. I will assuredly bring this ALL up to him.

    Another question I had is, in anyone experience, can illness cause or worsen LPR/GERDS? Being sick as I was for that first week was also the starting point for my throat discomfort. And even when I improved in other areas, my throat/esophagus issues only seemed to worsen. But everything started that week. It is all so odd.

    I have also stopped eating before bed and have been inclining my bed. I am still waking up in the morning with the same problems, however. I read somewhere that severe LPR can happen even in the day when standing? So ugh ... who knows lol.

    Thanks all!

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  • Posted

    Hey all smile

    So I had my ENT appointment today. He felt my throat and said he felt nothing out of place or alarming. I demonstrated how there was/is a slight bulging during swallowing on the left side of my upper throat and he said he could not feel anything there that alarmed him. He said it might be muscular.

    He also performed an endoscopy .... through the nasal passage and into the throat. He said he saw nothing wrong at all. He did not mention seeing any bad inflammation but did say that I had mucus on/near my vocal chords that I was not clearing when swallowing. He gave me some water and that did clear it.

    He was most concerned with how my voice was so hoarse and the consistent throat clearing. He did say that my symptoms sounded like they were reflux related but he could not say for sure. So he is sending me for a CT scan. They set it up for me for tomorrow, which is really nice and quick.

    He said that he doubts the scan will "find anything" but he just wants to get an idea of what is happening below my larynx and also if there is an explanation for the slight bulging when  swallowing. He talked about the Hyoid bone possible being out of place and running into the Thyroid cartilage.

    He also prescribed Omezaprole 40mg. I got them and already started my first dose. So ya, we will see what happens! As for how I am feeling ... pretty much the same. On that note, I have a question for anyone who has dealt with the "lump in the throat" symptom of LPR/GERD. I see so many people describe a lump "in the throat," but where exactly? For myself the pressure/choking/lump sensation has really localized in the area that is below my larynx but above the collarbone. It seems to be directly behind the windpipe, which I guess is the upper esophagus. That is where I am feeling it now, pretty much all day. Is feeling pressure/lump sensation in this area symptomatic of LPR/GERD?

    Thank you all again for your time and advice!

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  • Posted

    Hey all smile

    So updates .... my ENT called me today with the results of my CT scan and said "everything looked perfectly normal which is good but also disappointing because I'm not totally certain what is wrong."  LOL.

    He had really hoped the CT scan would reveal some clue as to why i was feeling the "thudding/popping" above my larynx but as far as he could tell, nothing was there. It is crazy because we both could feel that the area was slightly larger and thus the bulging out a little more during swallowing, but he insisted that both he and the radiologist saw nothing in that area: no mass, no abnormality, nothing.

    He suggested the possibility that because my entire throat has been attacked with these symptoms, the way in which I swallow has been altered and created muscular strains and inflammation. It certainly does feel like the tendons/muscles around my neck and throat have been extremely tight and painful.

    As far as the possible diagnosis of LPR/GERD, he seemed convinced that I was suffering from that and asked me to continue on the Omeprazole (40mg/day) for the next 6 weeks and then see him again. He also advised that I make some moderate lifestyle changes as far as what/when I eat. He said everything in moderation was alright.

    Starting over the weekend, I started making many of the changes suggested by Gillian1956 (thank you!) and have started sleeping on a wedge pillow, not eating 3 hours before sleeping, and avoiding caffeinated/carbonated/citrus drinks of all kinds. Admittedly, I never really had A LOT of those things. I weight lift so I have always emphasized water intake over juices or coffee. The only caffeine I ever have has been from the no sugar Monster Energy drinks ... and even those were in moderation. 

    As far as diets go ... I have a question for everyone. I read that acidic drinks are, of course, bad for someone with LPR/GERDS. And also foods like oranges. But I started reading the ingredients of several different things I was eating and saw "citric acid" in EVERYTHING. Even the whole wheat bread I was having had citric acid in it. So my question is that with regards to avoiding highly acidic items, should I stringently avoid ANYTHING with even a little citric acid in it? Like bread? Or even the protein shake I had yesterday had citric acid. Is that enough to make these things dangerously acidic?

    Thank you so much all. Your time and advice is much appreciated, truly. biggrin)

     

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    • Posted

      Wow. I've never before written in to an online discussion. I've been reading about LPR for weeks and came across your description and my situation is almost identical to yours: the symptoms, the way it started, the location of the feeling in my throat, working out, etc. My issues started in mid December. About the only difference is that I very rarely have the "thudding" symptom (only on occasion), and although mine started with a virus, I was not prescribed antibiotics. My most frustrating symptom is a dry cough.

      My ENT did a scope and said everything looked normal, with a tiny bit of redness on the larynx but not much.

      The respirologist sent me for a CT scan of my chest and I am waiting the results.

      Like I said, I've never written to a forum before, but I'm struck by how exactly your situation matches mine. I could basically copy paste your post and make it mine.

      Therefore, I wanted to ask - has your situation improved? Was it LPR after all? What is the status?

      Thanks for any info you have.

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  • Posted

    Further to my post yesterday, I received my chest CT scan results and they are normal. Does anyone know if a chest CT covers the upper esophagus and/or trachea?

    NC10, I am wondering how you are progressing and if it was LPR? My symptoms are so identical to yours, I even get a tight feeling in my lower throat when my head is propped up on a pillow, and if I put my chin to chest I automatically have to cough and then it feels tight in my throat.

    Anywone with LPR experience this?

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    • Posted

      Hello Ryan smile

      After reading your posts, we do indeed sound extremely similar in the way this nasty thing has affected us. With regards to the coughing and tightness whenever we bend our heads downward, I was told that this was due to an inflamed esophagus. The gastroenterologist I saw a few weeks ago told me that even if the esophagus is inflamed towards the bottom, symptoms can still be felt near the top. So in our cases, that choking/coughing/tightness/pinching feeling is due primarily to inflammation. The area where it seems the worst (below the adam's apple and above the collar-bone, right behind the windpipe) is a very common area for reflux-related discomfort to occur. This is what the ENT and GI doctors told me.

      For myself, this inflammation was caused by reflux, yes. Interestingly, my ENT also scoped me and said he saw nothing too bad at all. But he suspected a look into my esophagus would show more. So a few weeks ago I had an upper endoscopy which revealed inflammation and even a little erosion. The only remedy for this was for the esophagus to heal. So I have been on daily doses of Omezaprole to reduce stomach acid and have also made some "lifestyle changes" to reduce the possibility of reflux. You said that you have been researching LPR so I have no doubt you have come across many lists of things to do/eat/drink to reduce reflux.

      As far as how I have been improving, yes ... that nasty feeling of choking/coughing whenever I would look down or prop my head on a pillow has disappeared for the most part. It is certainly not as intense as it was when this all began. So with proper treatment, the esophagus will indeed heal.

      Regarding your chest CT scan, I believe the scan would indeed cover the whole esophagus. When they did my CT scan, then went from my chin all the way down to the end of the esophagus. Basically, they covered the whole throat and esophagus. If your doctor expressly ordered a "chest CT," perhaps it did not cover above your collar-bone. But that seems unlikely to me if, based on your description of events, they were looking for signs of reflux. However, a respirologist specializes in lung/breathing/asthma related issues so I suppose it is possible they did not scan your entire esophagus but instead were looking more at your lungs? A quick call into the office will give you the exact details.

      Has your primary care doctor or ENT suggested the possibility of reflux?

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    • Posted

      Thanks very much for taking the time to reply. Turns out my CT scan was specifically a "chest CT" but was told it covers "almost all" of my esophagus and trachea as well.

      For yourself, was it only the upper endoscopy procedure that identified the inflammation? In other words, your CT scan did not show issues with your esophagus?

      Yes, my ENT has suggested the possibility of silent reflux and has prescribed Nexium to see if it addresses the issue. Apparently my larynx had minor redness. I've been taking Nexium less than a week, but it has seemingly made the tight feeling in my throat worse at this point (if that's possible).

      The respirologist has suggested consulting a GI, so that will be my next step.

      Thanks again, appreciate the reply and knowing your progress.

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    • Posted

      Thanks very much for taking the time to reply. Turns out my CT scan was specifically a "chest CT" but was told it covers "almost all" of my esophagus and trachea as well.

      For yourself, was it only the upper endoscopy procedure that identified the inflammation? In other words, your CT scan did not show issues with your esophagus?

      Yes, my ENT has suggested the possibility of silent reflux and has prescribed Nexium to see if it addresses the issue. Apparently my larynx had minor redness. I've been taking Nexium less than a week, but it has seemingly made the tight feeling in my throat worse at this point (if that's possible).

      The respirologist has suggested consulting a GI, so that will be my next step.

      Thanks again, appreciate the reply and knowing your progress.

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    • Posted

      Hey Ryan smile

      My CT scan did not reveal anything out of the ordinary, according to my ENT. Yet my symptoms at the time of the scan and after were as bad as ever. So my understanding is that, at least in my case, the CT scan did not/could not reveal esophageal inflammation or erosion. So the next step was indeed an Upper Endoscopy. This is the primary procedure used to detect esophageal inflammation. You said you are being advised to see a GI, so you are likely on that path. It is an easy procedure ... nothing to worry about at all smile

      As far as how being on Nexium is making you feel worse, I also experienced "more" discomfort and throat tightness when I began taking Omeprazole. But my ENT suggested this was due more to the fact that my issue had just started being treated and would possibly even feel worse before feeling better. He told me that for most of his patients, it takes several months for them to feel even 75% back to normal, especially if the inflammation is sever. So if you have been on treatment for only a week, it is entirely possible that you are still experiencing the unpleasant effects of the original acid reflux damage. For myself, that choking tightness decreased in intensity and finally disappeared after a month+

      Hang in there. You are getting to the bottom of it all smile

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