LPR/Silent Reflux - desperately in need of a miracle. Has anyone recovered from this?
Posted , 270 users are following.
Hi - I'll be as brief as possible. For almost a year I have had symptoms which have worsened, starting with throat clearing and progressing to regular spiting out of white, frothy stuff, post nasal drip, lump in throat or sharp sensation, streaming or blocked nose and hoarseness. These are all unpleasant and irritating but because I talk for a living my work is becoming badly affected so it is now making me depressed and anxious as well. I was referred to ENT, had the camera up the nose and down the throat to rule out anything sinister and was given Omeprazole and Gaviscon Advance. No advice, no explanation. I had to find it all out myself. (and I'm not confident/assertive with docs, either).
The drugs haven't helped, I'd go so far as to say the reflux significantly worsened. I had faith in the Gaviscon Advance having read how it works but that hasn't made any difference either. I have monitored everything I eat and drink and can't find anything that triggers it with the possible exception of bread, and I may be grasping at straws there. Certainly coffee, alcohol, spicy food etc don't trigger it and ginger, acidophillus, apple cider vinegar don't help. It does seem to be cyclical - I'll have a week or so of decreased symptoms then it gradally works up again to two or 3 weeks of hell. No heartburn, and the reflux is almost always upright, no problems sleeping...just the other 17 hours a day! The ENT was brusque on my return visit and said that, aside from speech therapy, there was nothing more he could do for me. This can't go on, though. At it's worst it makes me tearful and desperate at work and speech therapy isn't going to stop me spitting up into a whole toilet roll each day, or reduce the other symptoms. I'm also worried my teeth will rot and I fear for my job. Has anyone experienced this with the same pattern/lack of triggers etc? I would love to hear any positive experiences that don't just repeat the same old same old, ie, raise the bed 6 inches, dos and donts with food etc.
28 likes, 899 replies
mcson
Posted
Thank you for your message.
I am already on PPIs, Gaviscon Advance and NAC 600 (the form we have in Turkey).
My main symptoms are slighly different from yours in fact; I have coughing only after eating, and this is a sticy cough of mucus and I feeel that PND starts after eating which causes the caugh. So this PND goes deep into my vocal cords and affects my voice as well. I can hardly get out the mucus by way of caughing. And sometimes feel a little soear throat. Similar to you, no pain in stomach just sometimes bloated .
I am currently on 2x1 PPIs, 3x1 Gaviscon Advance, Avamys nasal spray before bed and 1x1 NAC 600. I will also try the tea you have prescribed with ginger.
Please keep in touch!!
All th best!!
mcson
Posted
Thank you for sharing with us your sypmtoms.
In my case everything started after 2 cold infections I cought up in April and May. Ever since then I had this mucus, caughing and soar throat after eating.
My ENT told me that I have sinisutis, my vocal cords and larynx were red and thus he suspected LPR, although I have not yet had any pepsin test or sth.
I do not have feeling of a lump and tightness in my throat however I do have hoarseness after caughing (as the mucus sticks to my vocal coards I believe).
I am on PPI, Gaviscon Advance, NAC, Sinus Rinse and Avamys nasal spray over 10 days now and it is no better.
Exactly like you; some days it is less severe but caughing and mucus after eating is always there..
Please keep in touch and inform eachother with recent developments!!
Wish you all the best!!!
JPT
Posted
The Pepsin that gets embeded in your airway, nasal, and throat tissue is v hard to shift.
You need to read Professor Chandu Bardhan on Pepsin and its role in LPR.
It goes deep into the cell structure 'endocytosed' I believe is the term.
Even after surgery with LINX It took months for me to clear the Pepsin with high pH water. This is not an overnight fix.
I must say the more research I do on this the more things we need to do to get back to normal.
Avoid chemical ingestion (additives drugs, teeth whiteners etc etc
Lose weight now!
Eat less.
Fast 2 days a week
Breath from the diaphragm
Improve digestive transition.
Use alkaline water to kill acid and Pepsin in oral nasal and airways.
Peptest gives tou a benchmark for your Reflux level and is non invasive.
Also when you repeat after trying a new technique you can tell if it works.
Best JPT
mcson
Posted
Thank you for the useful information.
First of all I really need to find out that it is really pepsin that causes these symptoms in my airways. Thus I am thinking of ordering the peptest from the UK.
In the meantime I am going to read about the article you have suggested.
Some further information about my condition; I am not overweight and I have started to pay attention to my diet.
I try to drink pH 8 and over water.
The strange thing is that I have never had any symptoms of Acid Reflux. Conversely, I am better at sleep and during the night and in the morning until the breakfast I have almost no symptoms; no hoarseness, no throat mucus and clearing and caughing.
Can I ask what symptoms you had and what were you diagnosed with?
Thank you so much!!
mcson
Posted
I have read the paper you suggested. I think it is very useful.
It suggests that '' The concept that reflux may also be an aerosol has only recently emerged, at this stage more plausible (albeit persuasive) than proven''.
I believe this should be more researched. Because people like me who do not have typical symptoms of Reflux (heartburn, stomach contect refluxing in my mouth etc.) and who suffer PNd, caughing after eating, soar throat etc. are diagnosed with LPR in most of the cases. However if it is the case that aerosol of reflux is not proven yet, how would those know that they are really LPR while they have no symptoms of GERD.
I know there is pH metry test but in the paper this is also criticised in diagnosys of LPR.
Thus, what is left for me to use Peptest to find out if I really have a LPR or pepsin in my larynx/pharynx?
I am just trying to figure out how could I be diagnosed with LPR when I have no typical symptoms of GERD.
As I stated earlier on the forum; my symptoms are PND and caughing after eating which causes vocal problems and soar throat sometimes. My ENT, having checked my nose-sinus and throat, stated that I have sinusitis, my throat is red and vocal cords are irritated, which MAY BE due to LPR!
Thank you so much for your help !!!
All the best!!
JPT
Posted
Just to clarify
GERD/GORD
Symptoms
Persistent Heartburn
Oesophagitis
Nausea
Hoarseness in the morning
Difficulty Swallowing (Oesophageal Stricture))
Regurgitation
LPR/Airway Reflux
Symptoms
Sore Throat
Chronic Cough
Feeling of Lump in the Throat (Globus)
Post Nasal Drip
Persistent Throat Clearing
Voice changes
Difficulty Swallowing (Dysphasia)
Hoarseness
Asthma – Reflux is the cause of 40% of adult onset Asthma
Essentially Any stomach content that exits the stomach in the wrong direction is reflux.
Travel below the Uppper Esophageal Sphincter is LPR and below it is GERD.
Most LPR Airway Refuxers are 'Vertical refluxers and do not experience heartburn or supine reflux.
GERD refluxers experience reflux symptoms when the lie down or sleep also.
Transient lower Esophageal Sphincter Relaxations (TLSER's) are responsible for opening the LES above the stomach. These occur in most people few times a day but in refluxers much more often.
Pepsin is the most aggresive reflux agent although the 'industry' continues to only mention acid.
No Pepsin in saliva = no reflux. Although it depends on whether there were and TLESR events during testing.
Just a bit of background to add to our discussions.
Best Regards JPT
mcson
Posted
I appreciate your detailed messages.
It appears that you have had an extensive experinece in this subject.
However there is still something which I cannot figure out. You mentioned that;
''Travel below the Uppper Esophageal Sphincter is LPR and below it is GERD.''
So what you are saying is that; travel of stomach contect below the upper esophageral spincher causes LPR and below causes GERD. So here comes the question; how the stomach content travels to the upper esophageal spinchers without causing any symptoms of GERD? In other words; if this content travels up in the esophagus to affect larynx and pharynx, why dould not this stomach contect affect the lower part and cause GERD also. This ispuzzling for me.
My father who is a very experienced surgeon stated the same.
Your kind comments would be very appreciated.
Best Regards
thomas83
Posted
mcson
Posted
Thank you for the clarification. However I still do not understand why the stomach content (acid,pepsin etc.) travelling up to the larynx and pharynx and causing LPR symptoms would not casue GERD symptoms also?
Thank you in advance
thomas83
Posted
Oh it often does. But often the esophagus is tough enough to withstand it, as I explained briefly above.
JPT
Posted
Thomas has covered your question. you got it a little wrong and maybe I didnt explain well enough
''So what you are saying is that; travel of stomach content below the upper esophageral spincher causes LPR and below causes GERD''
What I'm saying is ...Stomach content that travels below the UES is GERD. Above it is LPR.
The geographic point is important because below the UES the Oesophagus naturally produces its own bicarbonate which neutralises acids. Above the UES laryangeal tissue has no natural defence.
Alkaline water gives it that defence by denaturing Pepsin and neutralising acid on contact.
You can track the severity of LPR reflux sinply by tracking Pepsin
Best Regards JPT
JPT
Posted
Sorry I forgot to answer your other question.
It is now believed that a lot of LPR is caused by an aerosol effect of refuxate, whereas conventional GERD is the refluxate washing up into the Oesophagus causing heartburn and Barretts.
Best Regards JPT
mcson
Posted
Thank you very much for your response.
I understand that very clearly. The point whihc I was trying to make was that; stomach content that travels above the UES is LPR., I am fine with that and I totally understand. However this stomach contect which travels above UES obviously passes through the below part of UES. Right? So like you have mentioned; geopraphical point is very important as you have stated ''below the UES the Oesophagus naturally produces its own bicarbonate which neutralises acids. Above the UES laryangeal tissue has no natural defence''.
As such, how the stomach content which travels below the UES to cause GERD in some people, would not cause the same symptoms when it travels further above to above the UES?
This does not really make sense to me.
It is like simple physics to me; imagine a water pipe in which 2 levels are defined for water to be pumped. It is obvious that water cannot travel to the higher level without passing through the lower level. It seems that we have as similar sytem and stomach content while travelling upwards can cause GERD, LPR etc. but how is that possible that someone without any symptoms of GERD can have symptoms of LPR while the same stomach contect passes through below the UES!
I would understand if it has already been proven that it is the aerosol effect of refuxate which causes LPR. However as far as I understand the article I have read upon your suggestion stated that this is still under research and not proven yet. Despite that I have such a feeling that this has to be the case otherwise it does not make sense to me that someone without any symptoms of GERD can have symptoms of LPR.
Thank you for your kind support.
all the best,
mcson
Posted
I also forgot to ask you a couple of things with respect to alkaline water.
Do you use alkaline water yourself as well? Is this how you have got rid off your suffering?
Also what pH level do you prefer? I can easily find here in Turkey alkaline water at pH leve 8.22 sold in supermarkets, for a higher pH there are water machines and some sort of equipments which can be purchased from the manufacturers. These are costly machines but claim to provide pH above 9!
What pH level you personally prefer? Do you think pH 8.22 will be sufficient to deactivate Pepsin? And how often should I drink such water?
Thank you so much for your kind support.
All the best!!!
mcson
Posted
Thank you for the clarification. I think I should research more on ths subject.
And I have read in the article suggested by JPT that gaviscon advance is quite effective to clear out pepsin.
I am already on gaviscon advance for 2 weeks, I will see how it goes.
All the best!!