Best way to diagnose LPR/Silent Reflux?

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Hi

i am going a bit mad with my throat problems that i strongly suspect silent reflux/LPR. 

There are a variety of tests, I just want to get a solid diagnosis if I am right about this, but I don't know which route to take, or if I go privately what tests to do!  The doctors know nothing about this stuff at all.

What are the best tests to diagnose LPR/Silent reflux, and in what order would you do them?

It seems the options are :

Endoscopy

Oesophageal Manometry 

24/48 hr pH monitoring, or the newer Bravo Ph 

Barium Swallow

Am I missing something?

?Thanks, from a desperate sufferer!

1 like, 16 replies

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16 Replies

  • Posted

    Hi Rob,

    I had endoscopy, manomatory and 24hr tests done and 3 concluded I had hiatus hernia and reflux. I didn't have the barium thankfully.

    I had fundloplication almost 12 weeks ago to fix everything, I had a long list of symptoms related to it, I'm still recovering but getting there..

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    • Posted

      Hi Mag2

      Thanks. What kind of reflux were you suffering from?

      Which one of those tests can diagnose a Hiatal Hernia?  Did the endoscopy just go as far as the vocal cords, or all the way down?

      Im a bit confused about all of the tests and which you need to find out what!

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    • Posted

      Hi Rob,

      My endoscopy went all the way down to small bowel they took pictures of the inside of my stomach and took biopsy while in there. They saw small hiatus hernia and the valve ( sphincter) at the top of my stomach wasn't closing properly.

      It was GERD I had.

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    • Posted

      Thanks Mag

      Are you in the UK, was it done on the NHS?  I wonder if I have a hiatal hernia, or even if I havereflux at all. I have many symptoms, but no proper diagnosis!

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    • Posted

      Hi Rob,

      Yes I'm in the UK and had everything done with NHS.

      It took a year from GP referral letter to operation. In between I had the tests done and had to badger upper gi department with lots of phone calls to remind them about me. When I did finally get my date for op everyone was so nice and couldn't do enough for me I can't fault the medical side.

      You need to be assertive and keep badgering them and you will get results. You know there is a problem needs investigation so you need to have the endoscopy again all the way down also the 24hr and manomatory tests to define what exactly the problem is.

      I wish you all the very best in you journey.

      Do let me know how you get on :-)

      Margaret

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    • Posted

      Hi Mag]

      Thanks. Wow, thats such a long time to wait!  Did you get the manometry or PH testing too? Or the Upper GI test was enough?

      I will see if I can start badgering.

      I have ordered a Peptest, so  will see what results that gives first

      thanks again

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    • Posted

      Hi mag, out of interest how long did it take from your doctors referral to the first tests? I'm trying some PPI's at the moment but they aren't working so the doc said if they haven't worked by the end of the course (2 more weeks) they'll refer me to an ENT. I haven't noticed any difference on them but frustratingly what started out as just LPR symptoms now is a burning chest pain too. I feel like the longer I leave it the worse its getting because of the constant damage so I'm impatient to be referred to sa specialist rather than just seeing my GP! X

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    • Posted

      Hi Rob

      Yes I had 24hr and manomatory tests done, they do them both in same appointment, the manomatory is to make sure your swallow is OK which thankfully mine was fine, on the 24hr acid test they saw quite a high amount during the day and lower at night surprisingly.

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    • Posted

      Hi Gem,

      I don't think I waited too long for the letter from the hospital after GP referral, what took the time was the NHS funding before they could do the op, I had the tests done quite soon and waited almost a year for consultant and their secretary to get their bottoms int gear with signing letters, at one stage I had a letter which was a copy of one sent to GP from funding to say as they hadn't signed the letter they assume there was no longer need for funding etc so I was off the list.. I was furious, made appointment to see GP and was told they literally had just sent off an apology letter to funding people and to continue with procedure, I had my operation date sent to me within a week of that..

      I understand these people are very busy but all that was needed was a signature. I probably should have had operation in February not June.

      You need to keep them on their toes.

      Good luck with your journey :-)

      Margaret

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    • Posted

      Thanks Margaret. All my GP wants to do is keep trialling different PPI's without actually confirming I have reflux (GERD or LPR). None of them are working and since I started this long trial I've now started getting burning chest as well, although I wouldn't say its quite like usual heartburn. I'm so fed up of waiting already but I think I'm only at the start of a long journey. I don't seem to have many of the usual food triggers, I think mine is anxiety so its limited what I can do to help myself and because I feel rubbish I cant get rid of the stress! The worst part is that i spend a year with crippling back and pelvic pain after my son was born. The doctors kept fobbing me off and telling me that it was just back pain and take pain killers. I ended up taking in all my own research and demanded a referral to an endometriosis specialist. I have one op which confirmed I had loads of scar tissue from endometriosis (which the doctor said he didn't think I had), a other op to remove the scar tissue. I then had 2months of feeling great before the sore throat started and it got progressively worse from there. It seems I had a tendency towards chronic, hard to diagnose illnesses! X

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    • Posted

      Hi Gem,

      Gosh poor you, you've been through the mill.

      I was taking ppi for over 10 years before a different GP considered me for fundloplication op after I asked for more expensive ppi Esomeprazole, I actually found the over the counter version Nexium is better. I have had si many different ppi over the years, I was on omeprazole for 10 years. I got so used to symptoms I wasn't aware how bad it was till I had all the tests done.

      I've got mild scoliosis which I've had since a child and told it won't get any worse but every now and again I have bad pain in the Base of my back, I've been to physio etc. So at the moment while I'm trying to not hurt my stomach after op my back is protesting and been sore the last few days..

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    • Posted

      I've been tried on omeprazole and lansoprazole but if they don't give me anything else to try while I (hopefully) wait for a referral i might even try nexium or another over the counter one. Maybe something will work but given that most of my symptoms are in my voice I know that can point towards LPR so might not response as well to meds like that. X

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  • Posted

    Thanks for the replies

    I have been seeing a speech therapist as I was told I need to rehab my voice. I am now going for a second endsocopy with a strobe thnis time, to look at my vocal cords and see if they are functionning properly. 

    I just want to find out if I do have reflux so i can treat it properly.

    So do you think the next most useful test would be manometry and ph test, or the endoscopy that goes down in to the stomach? 

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    • Posted

      Hi Rob,

      Your consultant should request all 3 tests if they think it's reflux that is causing all your problems. Sometimes you almost need to tell them how to do their job.. If you think that's what the problem is then ask them for all the tests..

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    • Posted

      Thanks mag

      yeah well I spent a lot of time out of the country, so its really hard for me to get the ball rolling for anything on the NHS. Its difficult.

      But thanks, I will start badgering them to get these tests done.

       

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