argh.....

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I saw my doctor yesterday afternoon and they finally referred me to an ENT. She put me in as an urgent referral because of the length of tine its been going on with no improvement from PPI's. I'm really glad to get an urgent referral but now completely terrified that they've just rung and booked me in for the camera tomorrow afternoon! I haven't had any time to mentally prepare myself for this (which makes me feel sick just thinking about it!) plus I'm worried that they'll find something horrible or potentially nothing at all which leaves me at square one. I'm not really sure what outcome I could have which would be good?! Also, is it normal Togo straight in for the camera without any consultation with an ENT first? I had assumed I'd have a talk with them about my symptoms first. Do you normally get your results there or is there a wait? Any info I could get would be good. They said as I've got a last minute appointment they haven't got time to send out the usual info pack! Xx

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11 Replies

  • Posted

    Don't even worry about the ENT scope it is really easy and quick. All they do is spray some numbing stuff in your nose which drips down into your throat and numbs it all up so you don't feel much of anything. Then the ENT takes a thin tube with a camera on the end and threads it through your nostril down to your throat- takes a look and that is it and can tell you right then and there if he sees anything. I found out my throat was moderately inflammed and tried the PPI's but they did not work for me so I am either thinking LPR or nerve damage from the endoscopy that I had before I got this terrible lump in throat sensation. You will be fine and they probably won't find anything terrible- I know it is hard not to think that way I am the exact same way. Good luck and tell us how it went.

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    • Posted

      Thanks. I know its stupid but I'm just really worried they'll find something horrible even though i have all the symptoms of reflux and I'm not in any of the 'risk groups' for something nastier. I have mostly LPR type symptoms and Ive read a lot of people with LPR symptoms can have a normal scope which also makes me worry I'll also be back to square one sad

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  • Posted

    Hmm...

    I'm guessing your symptoms are mainly of reflux rather than acid?

    Reflux is a mechanical reaction whereas hyper-acidity is a chemical one.

    Whereas PPIs are good at reducing acid, they may not help with reflux. (A fact most of us who have suffere from reflux are aware but highlighted in a research paper published last week in Chest: "Chronic Cough due to Gastroesophageal Reflux in Adults: CHEST Guideline and Expert Panel Report." which has amongst its conclusions: "PPIs demonstrated no benefit". )

    I'm  not sure how helpful ENT will be, They are far more clued up on reflux issues now than the times I was referred to them. (They always started by testing my hearing - whch is poor at times due to damage from years of reflux. ) I also had sinuses flushed and was tested (negatively) for all known allergies.

    Acid reflux is a combination of two elements. Doctors have always concentrated on acid as it's the easier to manage - with medication. But Reflux is probably the greater issue for most patinets and can only be managed by lifestyle (losing weight, ceasing smoking, avoiding tight clothes, eating small portions etc) or reflux reduction surgery (fundoplication - which I had and gave me my life back) .

    The scope should reveal the bais of your problem and check there's no permanent damage to your oesophagus (Barrett's Oesophagus which in a few people can progress to cancer) .

    Read the chapter on "Extra-Oesophageal Reflux" in the free book / website: www DownWithAcid org uk. The book also has a chapter on ENT.

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    • Posted

      Thanks for the reply. Yes, I think my symptoms are more reflux then acidic. Gaviscon advance helps keep everything down but things that reduce acid dont help much at all. At the moment I've done everything I can to help (I've never smoked, not overweight, dont drink much - now i dont drink at all). The only thing I could do is eat slightly smaller portions but even then I don't over eat much. Hopefully the scope tomorrow will show whats going on and can at least give me access to someone who can start the path to recovery although I'm well aware there are doctors out there who (sometimes through no fault of their own) no very little about reflux other than to prescribe PPI's. Fingers crossed and I'll read the info on the link yo sent me.

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  • Posted

    Good luck hope it goes ok for you, try and relax and just concentrate on your breathing, let us know how you get on x
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  • Posted

    Brilliant you've got this cancellation basically. Is it an endoscopy or nasal camera. The nasal camera is no problem. If it's an endoscopy it manageable and doesn't last long. It also means the consultant will have the results In front of him for your consultation.

    if it's any help I was so poorly for 7 months with a continual cough.Like you I keeped thinking the worst......but no nasties where found. I was referred to Ent who have been brilliant.ive had a nasal camera every consultation no problem. My symptoms are now managed but they've not found out why I've got this problem. I've now been referred to gastro as I've got ceoliac disease anyway.

    Good luck try not to worry you will anyway but that's only normal

    Debs

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    • Posted

      Ah right,I didn't know there were different ones. She mentioned it going up my nose first so hopefully that's a good thing? Do you get the results straight after then? A lot of my symptoms are in my voice so I'm just worried they'll look at my oesophagus and see nothing so I'm back to square one. I assume that as my main symptom is my hoarse voice on and off they'll look at the right bits. I'm sat in work now but my appointment isnt until 2 and I cant focus at all! X

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  • Posted

    Hi all, just a note to let you know it went OK yesterday. It was the nasal scope so it wasn't nice but it wasn't as bad as I thought. The ENT said he could look to about half way down. He didn't see anything concerning but the back of my larynx was a bit red and irritated which looked like the result of reflux. He said the ppi's the GP had put me on was a "piddly" dose so unlikely to do anything especially given how high up my symptoms are. He's given me a much larger dose for now with the hope that if that works and allows my throat time to heal I might be able to reduce down a lot over time. He also said the issue may not be the acidity but the fact any liquid is reflux ingredients up to my larynx so he's prescribed a liquid like Gaviscon advance which should help to keep things down. I now have a follow up in 6-8:weeks and if it hasn't improved they might do another scope to look even further. At least that's some information for now and I'm now with the ENT's rather than the GP. X

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    • Posted

      Thanks for the update. It's good to get confirmation.

      The normal low maintenance dose for PPIs is 20mg omeprazole ( = 30mg lansoprazole = 40mg pantoprazole) but for initial healing of inflammation caused by acid refluxing, it's normal to give double that dose and it's possible to double that again. (I was on 80 mg omeprazole for a few years before surgery corrected my reflux. )

      As I expressed earlier, reducing the acid with PPIs will only make the reflux less harmful and the real concern must be your reflux.

      ENT will only have bee able to provide tracheoscopy rather than a gastroscopy which would need referral to a gastroenterologist - which the ENT could do.

      If your throat has become inflamed by reflux of acid, what about lower down the oesophagus? Nearer the stomach, it would be worse. If there is inflammation there, oesophagitis, not everyone feels it but the PPIs should help that.

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    • Posted

      Wow, that supports what the doctor said yesterday. My GP had me on 15mg of lansaprozole so virtually nothing! He was very good yesterday and said they'll send me an appointment for 6-8 weeks time anyway and unless it's completely under control by then they'll continue investigating.

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