Anyone with LPR pain one ONE side of throat? Trying to decide if I have LSN or LPR..

Hi, thanks for your reply! 

Not intending to scare anyone - I'm sure you don't have the same thing! I'm just trying to figure out if this was even *caused* by the viral at all -- since it started only a few weeks later. It could just be regular Laryngo-pharyngeal Reflux, and not nerve pain at all. I'm seeing a neurologist today.

My whole life, I've never had any alcohol at all, never smoked either, and NEVER had any reflux. I still don't experience any heartburn. So it can't be that..I did (do) follow a completely non-acidic diet too for the past 4 months. Also -- sorry if I gave that impression - but it's not like it's agonizing pain anymore (like it was in the beginning when i couldn't speak at all.) Now it's just a constant vocal sensitivity and the burning can range from REALLY mild to very acute, all based on how stressed I am. Food doesn't *particularly* seem to affect it. (After 4 months, for once yesterday I ate some chocolate yesterday and absolutely nothing bad happened.) So I don't know.

I did try to take PPIs but they aggravated the pain so badly I stopped after a few days. Gaviscon doesn't help and makes things much worse. I haven't had Zantac either. I'm not on any medicines at all, and it's bearable but I'd really rather find a way to cure it. That's why I'm having the Stretta therapy procedure next month, which (if it's LPR), should cure it for good. 

What soothes it is cool coconut water, so far. And not feeling stressed. But I'm just trying to figure out if it's hypersensitive laryngeal nerves, or if it's reflux (in the throat). I have no heartburn at all.

Thanks a lot for trying to help! About your situation: - it doesn't sound like anything very serious! I'll bet the hoarseness should eventually go away - it's quite normal sometimes to have hoarseness still in the throat post a virus. I wouldn't worry myself too much - perhaps coconut water would help you too? I also took an antibiotic in the last days of the virus and it cleared up within days. Feel better soon! x

I dont mean you wan to scare me. Your symptoms is called "silent reflux" which doesnt give you any symptoms at all but it is there. Sometimes it is in another form as burning throat instead. I learnt this from this site, a lady who declared that she sometimes smells of feaces in her breath and she did not know why and then she discovered the diseases. Anyway, I hope you will get well with the new method and that one is for GERD as I google it and it is very effective. All the best.

Hi Todd,  I only just saw this, and would be so glad to be able to share my experience, given the similar symptoms! It does seem uncanny how our symptoms matched. A lot has happened in the past 2 months and here's my story:

-Yes, I did try taking Amitripylane 10 mg (or Elavil as it's also called) for 1 day and it's effect on me was pretty strong -- so I stopped it (the doc said I'm slender so even mild doses might be too much for me.)  Anyway, while on it I just had a lethargic, drowsy feeling, but I could still feel the throat pain under the layer of drowsiness. It basically just kind of dulled all my senses, and I felt uncomfortable under it. Since it didn't help me I kind of ruled out nerve damage (the neurologist also said it didn't seem like nerve pain.)

The number 1 thing that did help my throat during that time was drinking coconut water (raw, straight from the coconut, or a cold pressed version, and having a more alkaline diet.)

Anyway, so then I decided it must be LPR and I've taken the following full spectrum of tests to check for LPR: 1) a Manometry study to confirm normal esophageal motility- mine was normal, 2) a Gastric Emptying study to confirm normal stomach emptying time - mine was normal, 3) a Gastro-Enterogram which tests nuanced aspects of normal stomach motility - in my case it was discovered I had a mild pyloric stenosis from birth (narrowing of the valve between the intestines and stomach which was causing the reflux) - and they were able to fix that easily with a balloon dilation of the pylorus, 4) an endoscopy which showed a lax LES or lower esophageal sphincter and mild LA grade A esophagitis, 5) a 24-hr Restech pH study  - this is by FAR the most sensitive test specifically designed to catch LPR or aerolized reflux. It's also the most painless and comfortable ph test there is -- the catheter is SUPER skinny and only stays high up just behind uvula and doesn't go all the way down the throat, nor does it affect swallowing or breathing or eating.

Anyway, so the Restech test results were the most revealing. I DID have LPR, and the intensity of my reflux events were moderate and primarily at daytime. Which meant I was a daytime, UPRIGHT refluxer and NOT a nighttime refluxer -- which is why my throat always felt best right upon waking.

Anyway, in addition to fixing the pyloric stenosis, which I was told was mild case and so they could fix it with balloon dilation, I then underwent the Stretta procedure. I'd heard so many horror stories about it so was fearful I'd end up with bad side effects, but I'm thankful to say that it's been over 5 weeks since that procedure and now i feel NO throat pain or burning. No mucus, no difficulty speaking. I'm still being cautious and keeping a relatively alkaline diet, because I know that the Stretta takes sometimes a full 12 months for the sphincter muscle to bulk up and remodel itself, but as for my throat pain, it's wayyyy better. No pain talking, and even when I eat something spicy, there's way less mucus than before. And I'm not going through that constant throat pain anymore.

So there's lots of hope is what i'm trying to say!! Especially since our symptoms matched. 

The thing that's making me sad is that because the past 6 months have been so incredibly stressful for me, and I've had additionally a LOT of family stress going on to this day, I developed these really bad neck muscle spasms which haven't gone away and I've been googling it and there's all kinds of scary stuff about fibromyalgia and how it's chronic etc. i've had X-rays which show normal bones, but an MRI showed my muscles were in spasm. Anyway -- I have an appointment tomorrow with a doctor so I hope I can be successful in overcoming this muscle pain like I got rid of the LPR.

Sorry to have rambled -- I really hope this information is helpful to you and provides some assurance - i'm pretty sure you'll be able to conquer your LPR (which i suspect it is too) and incidentally, the PPIs never helped me either, plus i didn't want to be on them longterm.

And also - while it's certainly a strange coincidence we both had colds a few weeks before this throat pain hit us, the fact that we were feeling OK for a bit (like a week or so) AFTER the viral went away means it's probably not a nerve thing. At least that's what my doc said when I asked him.

Wishing you the best luck!! Do keep me posted. xxx

 

Thank you so much Tyra!! I really can't say what it means to hear exactly what you went through in order to treat the LPR. In fact I didn't even hear about the Stretta or the restech, and hopefully other people sharing the same symptoms as us can learn a lot. I'm sorry though about neck muscle spasms. But I know how much stress LPR related symptoms can cause. Hopefully you can overcome this obstacle as well.

For me I am starting to see some improvement since I've taken the Elavil. It's going on I think the 3rd week now and my Mucus and sore throat have gone away. Most of the throat clearning and globus have actually decreased significantly as well. I'm definetely not 100%, but the improvments are relieving a lot of stress and anxiety that the symptoms have caused. The main problem I feel now is tightness in the throat, but that comes and goes through the day. At this point I really can't rule out PVVN or LPR as the cause, or maybe a combination of the 2. But I don't see any correlation now between what I eat and my symptoms. Everything they have said for me to avoid doesn't help. I can pretty much eat whatever I want and the symptoms are the same. The PPI didn't seem to help, however I have continued to take them just in case it is LPR. The only thing I noticed that make the symptoms worse is stress, especially stress at work. 

It just seems that most doctors are so unfamiliar with LPR, that they don't know even the steps to diagnose it. I have a specialist I will talk to Monday to get his opinion. If he suspects LPR I will surely ask him abouthe Restech and about Stretta. I guess in some ways I hope it is LPR and not PVVN, because I think even less is known about that, and besides taking Elavil for life I don't know if that is something that will go away. My question is why coconut water helps with our symptoms, I drink at least a few bottles a day, but if LPR is caused by the pepsin, the PH from coconut water wouldn't deactive the pepsin would it? I did order a peptest, and guess will try not to drink the cocunut water a few days prior to taking the test just in case.

Please keep me posted would love to know you are able to treat the msucle spasms, as well as making sure the LPR doesn't come back. I will also post updates for you and anybody who is dealing with these very same problems.

Best of Luck with your journey to recovery!

Sorry just a few more questions after reading about Stretta, where did you get your stretta performed at? Was it an ENT who requested you get the Stretta done? Also what were if any problems after you received the treatment? Would somebody be able to get this done and go right back to work the next day? I think the tricky thing is to find the right doctors who know how to treat it, and pretty much all the doctors where I live in California have about 1-2months just to see them.

Thanks again!

I typed out a reply but somehow it didn't get sent. Here's what I could save: 

Hi again,  That's so great that the Elavil is working for you! That's really wonderful! Yes, stress definitely makes symptoms worse, so it's great that the improvements are helping alleviate anxiety. I had to look up PVVN because I hadn't heard of it before. They do seem like such rare obscure conditions. I'm guessing the only way to definitely tell its LPR, and not LSN/PVVN, is to get tested if you still feel the need after Elavil. In your case, you're already really improving and the symptoms are going away, so maybe you won't even need to!

Anyway, I had the Stretta by Dr. Mark Noar who is I believe the most experienced Stretta practitioner in the world, or at least in the US.  He's an outstanding doctor and with a lot of humanity. In terms of post the Stretta:

1) I felt no pain, just a mild sore throat which went away in a day or two. Some mild nausea for the half hour immediately after, which also went away quickly. I would say you could probably go back to work the same day itself, but if not, then definitely the next day. Some people experience mild chest pain after, but that's also supposed to go away completely in a few days (I had no chest pain.) 

I sought the Stretta myself because most doctors here (with some caring, wonderful exceptions) were completely oblivious to the pain I was in, and told me to live with it or take PPIs. A lot of them made unscientific statements or said I seemed healthy and just wanted attention, so I was probably making it up or it was all in my head. Finally, one gastro said since I wasn’t taking PPIs (he couldn't seem to fathom someone who could do without the PPIs) then maybe I could go in for the Stretta, as it was considered a midway between taking PPIs and undergoing something as drastic as surgery. Honestly I think it was the best decision I made. I'd been so many times to the ENT who couldn't understand why I was still in pain when my second laryngoscopy showed my vocal chords had healed. Also, for people with LPR, we rarely have any heartburn. Finally, the thing that really helped (both in managing to get the Stretta done, since I had to travel to the US to do it, and also for working up the courage) was I would pray a LOT with real faith. Like I just trusted that if I was determined enough, the universe would help me overcome the LPR forever.

Now I’ve experimented and I’m able to eat chocolate/ tomato soup, spicy foods, pretty much anything without pain or any ill effects. No throat pain or trouble speaking either.

Thanks so much for your support about the muscle spasms! That really means a lot. The pain's pretty bad and it's been like this for 2 months, and I'm going to pray about this too. I went to the doc and he confirmed there was nothing wrong with my bones or anything else (no signs of cervical spondylosis, no arthritis), and that in someone fit and young to have this muscle pain was entirely "stress related". The thing is I don't know how to "de-stress" myself, since I keep hoping this will go away on its own. He prescribed curcumin (turmeric) 1000 mg for 3 months, and mild amounts of red wine which apparently has melatonin (a sleep aid) in it. I’ve also decided I’m going to start green juicing every morning for an added vitamin boost. He didn't "say" it was fibromyalgia (and said that was really a dustbin term for anyone with muscle pain for a longish time – my case 2 months - with no seeming cause.) He said if the stress goes, it WILL go away but if I don’t get over the stress it could stick around for 2 years even. He also said it wasn't nerve pain, but it could develop into nerve pain if I didn't de-stress now. I think the things that might have caused it are: 1: I've been on the laptop a lot, both for my doctoral exams and for months googling LPR symptoms! 2: lots and lots and LOTS of stress this year (family oriented.) So I'm just really confused but am going to pray that this also just goes away for good, and that it's not fibromyalgia…if it is, then I *must* cure it somehow! I can’t live in chronic pain, that would be a death sentence L (even if they say fibro is not curable.)

Thanks so much for your good wishes they mean soo much and wishing you such great luck and the most positive thoughts for your journey to complete recovery too! We're all here for each other.

X Tyra

Woops forgot to mention the Stretta was performed in Baltimore, Maryland. It's a 40 minute procedure, and it feels like a breeze.  You're under anaesthesia so you're asleep and remain asleep for a few hours after, but it's not general anasthesia. Just adding that info.

All the best!

Hi Todd,  Sorry just had a quick question for you - how do you feel on the Elavil, side effects wise? I was wondering if I should try giving Elavil a go for this muscle pain...perhaps it will heal it or calm the nerves if taken for a course.. thanks!

Hi Tyra, Really no side effects except the first few days of feeling very tired, after that I felt normal. I am on 20mg Doctor suggested going up on the dosage. Oh and for the first few weeks it seems to slow down your bowel movements so might need stool softener for the first few weeks. Hope it can help your neck spasms, do you see any improvements?

Hello Tyra,

Hope you are continue evolving well with your issue and the stretta procedure.

I've been dealing with very similar health issues as you described.  This has been going on for close to 2 years now, and i'm currently off PPIs since they didnt do anything for me.

Every test I'v done came back normal, the next test I will be doing is a 24 hour impedanse test or restek to fully confirmed LPR.

I currently have ups and downs with my symptoms (heavy mucus in my throat, irritated vocal cords and when the mucus is very thick difficulty swallowing).

i was curious about your experience with the Stretta treatment; I've been looking into it and it appears a suitable alternative if I get diagnosed w/ LPR.

how did you contacted Dr Noar?  did you do multiple visits or was some consultation over the phone?

I've read about him and his experience on this procedure and his humanity (common comment across most of his patients)

How are you doing so far with your problem?  did the stretta really resolved it?  how long has it been since the procedure?

thanks in advance for your feedback

Alex

Hi Alex,

I'm glad if my experience can help share some perspective for you then! Yes this LPR thing is not great to deal with, but I can say the stretta DID do some good - I'm in my 5th month, and it's been pretty wonderful for some months. I think the first few weeks were a little bit tricky still - because if I ate trigger foods - i thought i could get away with it but i would start coughing and feel a bit of burning.

But then, after the 5th week mark it went away totally and I could eat or drink anything. Or so i thought - but the thing is- this procedure takes time. Typically 8 to 12 months or more, really. I'm still recovering and I'm currently in my 5th month post the Stretta - and I can say - my symptoms are WAY better than they were before. Only today -- as an exception - i have a slight feeling of burning in my throat but that's because I've reallly done some dietary abuse in the past few days (got over confident and ate lots of chocolate, tomato soup, acidic foods, you name it etc, lol.) I have to remind myself i'm not completely healed yet and not get complacent. I have to go back to my relatively alkaline diet till the stretta fully allows my sphincter to heal.

But to answer you, YES, the stretta has been a success for me I feel, at least so far, and I'm very glad I did it -it does work and I'm better off for it. Although i have to add (as a reminder to myself right now), no procedure in the world can excuse dietary abuse just months after-- so i still have to stick to a relatively alkaline diet for a few months more to be safe. 

Hope this helps give a perspective. It was also a very safe and relatively easy procedure to go through, side-effects wise and recovery and pain wise (no pain really.) So I wish you good luck and all the best! One thing i've learnt is not to stress too much, like I was doing before the stretta for 6 months, worry certainly doesn't help when one's trying to heal. All best wishes! x

Hi o hope u don't mind me asking I got a hiatal hernia and acuid refux if u have stetta treatment and it works can you eat what u want as I read your post I don't know if you got a hiatal hernia as well ty

I think I have your same symptoms. My throat feels pretty good in the morning when I first wake up. Then it kind of varies on when the heat slowly starts to return to my throat. And then my throat stays warm/have slight trouble breathing for the rest of the day. Then I go to bed, and I wake up fine the next day. I'm thinking about maybe trying this Elavil you speak of. I was on Omeprazole for 2 months, it didn't help. I was taking 20 mg twice a day. I'm pretty miserable for the last half of the day. I hope I can find something that works. How are you doing now? Did upping the dose of Elavil help?

Hey Zack, sorry to hear about your throat. Its been a long Journey and I thought I had it completely under control for a few months, but seems like I have been slightly feeling the throat irritation. I am at 35mg Elavil, I was at around 30mg when I felt it pretty much gone. If the PPI wasnt helping then I wouldn't go back on, I was on it for a long time but it never helped and I am not taking it unless I feel heartburn. You can ask the doctor to prescribe Amitriptyline low dosage to start maybe 10mg, not much complications other than slowing my bowel movements. You will be tired for the first week, but I am now at 35mg without any issues. Are you under a lot of stress? I think that seems to make me feel worse. I like taking 3mg melatonin at night, this seemed to help me when my symptoms were worse.

Yea, I stopped taking the PPI like 30-40 days ago. And I feel better not being on it. I read so much bad things about PPIs. I have a question about Elavil. Is this something that you need to keep taking forever? Or will your body heal itself while you are on it? And then you can wean yourself off of it? The only stress I'm under is related to this throat problem. I try to not think about it, but it is pretty in my face. Now it seems like my symptoms are worse in the evening. It seems also eating certain things for dinner, sometimes the symptoms will go away temporarily but then maybe come back. I seem to always be symptom-free every morning. My most prominent symptom seems to be a warm sensation in my throat. Like heat is just radiating. And it feels like my throat is closed up, like I'm being strangled by a really weak person and it can be slightly difficult to breathe. I really don't like the idea of taking Elavil forever. I hope it would only be a temporary thing. I've done tons and tons of reading about LPR over the past few months, have you heard about the Vitamin D stuff? I've read a few testimonials on forums about people claiming that they were low on Vitamin D, and they began supplementing Vitamin D, and they saw great improvement. Have you ever had your Vitamin D levels checked? I haven't. I did start taking Vitamin D supplements just incase that might help. I know I don't go outside much, so it's very possible I might be low on Vitamin D.

Well I'm glad that the Elavil is helping you. I mean I'll take it too if that's the only thing that will help. Sorry it took so long for the reply, for some reason I forgot to bookmark this page, but I now have it bookmarked and will try and check back here more often.

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Also about 3 months ago, I went to the emegency room because I was really having trouble breathing, and the GI Doctor recommended to me that I go. Well the ER Doctor there thought I was just having trouble breathing from my anxiety. So he prescribed me 5 anxiety pills called Lorazepam. I think that's how it's spelled. Anyway I do remember that those pills helped tremendously. Whenever I took one. It seemed like all my symptoms went away. Like my breathing was normal, and I felt fine. I wonder if those anxiety pills have a similar affect to nerves as what Elavil does to nerves?

Hi Todd!

     I am new to this forum.  Nine months ago I had a horrible reflux reaction to a medication.  I have improved some.  Recently, my manometry, endoscope and 24 hour pH tests all came back normal.  My doctor would like me to try amitriptyline to soothe the constant burning sensation in my throat.  Are you still taking this medication, and if so, is it working for you?  I am most curious because I am planning on trying it myself in a week when I am on vacation.  I figure if it slows me down I can sleep at home!  Your response is greatly appreciated.  This has been a painful, surreal experience and I would love to just go back to my normal, happy old self.

Thank you in advance.  

Hi Carla,

Sorry to hear about your problems, and I would be happy to share my experience with Amitriptyline with you. First realize that even with similar symptoms with other people we may not get the same benefits as others on the same treatment. Since you had a case of bad reflux I would make that your top priority to keep that under control. You should also try to avoid irritating the throat so be careful what you eat and drink.

As for the drug I take it at night while you get use to the medication. It will cause drowsiness at first, and you will feel lethargic for the first few days. With that said, try starting off at a low dosage like 5mg and working your way up to 25mg. If you see improvement even slight improvement at 5 or 10mg after a few weeks I would keep going up in increments of 5mg every few weeks. I think it is easier to gradually work your way up. The only other side effects with Amitriptyline I had was some constipation, but I just changed my diet added some extra fiber and lots of fluids.

For me I feel it did help, and now I am almost 100%, but on occasion the symptoms come back very mildly and for a short time. I think I did have pvvn, so maybe that is why it helped me, from what you described I probably wouldn't have thought to put you on it. However since the side effects are so mild, it doesnt hurt trying.

Oh also try to keep your stress and anxiety to a minimum, and if you go on vacation and your symptoms improve it would be interesting to hear. I noticed like many when we are on vacation the symptoms are milder. Good luck and keep us posted.

Thank you for your reply.  It is so encouraging to hear that you feel almost fully recovered.  It would be wonderful if one day you could be off all medication and be fine.  Did you have any tests done to know for certain that you had pvvn?  Do you know how long your doctor would like you to take the amytriptilyne?  Were you tested for any food alergies?  What type of doctor are you working with?  I have been to an otolaryngologist, GI doctor and now I have an appointment with an esophagus specialist.  I feel like a hot potato being bounced around and never getting a complete answer from anyone.  So, I thank you once again for sharing your knowledge.  We all must help each other out.