Relationship between reflux / LPR and anxiety....?

Posted , 6 users are following.

Hi

A bit of background for context, sorry if it is long winded.....

I'm a 58 years old male and have some chronic health issues. Due to those comes the need to use pain relief medication at times. Primarily it can be my back problems which can trigger that need. That situation is somewhat manageable and it is what it is following several back operations many years ago.

But around 1.5 years ago I started to experience some reflux issues. I felt the reflux come up into my mouth on a few occasions.

What I didn't feel was the silent type of reflux, the type that might accompany a burp and travel up to your larynx and vocal cords.

After seeing two different ENT specialists who diagnosed LPR I tried PPI's for around 5 months in total, two different types. I do not think that they helped.

Saw a Gastroenterologist and after endoscopy and other tests he didn't feel that LPR suited the diagnosis but instead preferred to use the words of functional reflux. He even used the expression NERD, non erosive reflux disease. He suggested to use Nortriptyline.

So at the present I'm left with modifications to my diet and eating habits as well as using Nortriptyline and the advanced Gaviscon.

My voice can be hoarse at times and both the back of my throat and ears can also be painful.

The above is difficult to resolve as there seems to be no one solution but a series of things to do to manage it as best as possible.

It is the relationship between reflux and anxiety which concerns me.

I have always a suffered from both anxiety and depression over my life. I have had medical support which had included trying medication as well as CBT and Mindfulness counselling. For those of you who are also suffering from either or both of those conditions you will appreciate that it can be the matter of management rather than then being cured or resolved. Sometimes it can be overwhelming.

But I'm feeling that there can be times when my symptoms of reflux seem to be better than other times and yet anxiety can then make them much worse.

Does anyone else feel that their control of reflux can be affected in that way..?

Having recently accepted that there could be a link it is a little tenuous at the moment. But that doesn't mean that it isn't real.

I'm trying to concentrate more on gut health and digestion, along with lifestyle changes etc to help with this reflux and LPR.

As mentioned PPI's didn't seem to be that effective, if the reflux is more of stomach contents rather than that of excess acid.

Thanks for any advice regrading the possible link of anxiety to reflux. Whilst not perhaps being the single cause I do think that it is a big factor in being able to control it.

Best wishes.

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  • Posted

    There seem to be many that are dealing with LPR also have mental health issues, particularly anxiety/depression. It's very hard to say that there is a correlation.

    I have LPR and I also see a psychiatrist and take medication for GAD and depression but the LPR is relatively new and the anxiety disorder has bothered me for decades.

    I have tried PPI's and H2 blocker meds for the LPR and have had no luck with them. Lifestlye changes are probably the best method but I find it difficult to stick with that. I exercise every day and try to do everything in moderation. Routine screening is my choice of care.

    Wish there was a simpler fix.

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    • Posted

      Thanks for your reply James.

      It was the Gastroenterologist who gave me the idea of a possible relationship between LPR and anxiety. That is why he placed me on Nortriptyline.

      As mentioned anxiety and depression has been a big part of my life for decades and, like yourself, this LPR is relatively new.

      I do not suggest that anxiety is a cause, I doubt that there is any single cause or solution to this condition, but I am curious about once you have this condition then anxiety could be a very real hindrance to a sustained recovery.

      I hesitate to try and demonstrate a relationship but a few weeks ago my LPR seemed pretty good and responding well to my changes in lifestyle and diet. However mentally I started to spiral into not a good place. Everything else remained a constant. My LPR over the following few days became troublesome.

      I can understand that seeing and forming relationships does not make them right, but it did make me curious.

      Lifestyle and pretty strict dietary changes could be a possible way forward to reducing or resolving this LPR condition. But like you mention it is not easy to be fully committed to those. For me struggling with mental health issues isn't helpful in that respect.

      Take care.

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    • Posted

      Only OTC standard antacid products like "Tums" and usually after the evening meal.

      The symptoms of LPR are everpresent no matter what I do.

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    • Posted

      I can relate with that.

      After going through PPI's etc and finding them to be ineffective I have not held much hope that OTC antacids would be the answer. However they might offer some help, my evening meal needs to become lighter and I'll need to spread those calories out with my other meals.

      Ensuring that a few hours have passed since my evening meal and then bed, on a raised wedge, is fairly typical.

      I do also sip now and then some water with a small amount of sodium bicarbonate mixed in.

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  • Posted

    I have very similar symptoms and have been on amytripline among others and it seems to help. Only problem is that the drug lowers my blood pressure and heart rate too badly at times. Functional Reflux is as slippery in definition as in management. There are times when I am amazingly healthy without any apparent explanation even taking such forbidden fatty meals while the PPIs and diet may sometimes not stop or ameliorate the reflux which could trigger very painful episodes of esophagus spasm. I have a suspicion that it would resolve effectively over time subject to consistent management and improved lifestyle habits.

    I became more of a recluse after a number of life changing events and I have been trying to adjust to my old sociable self. I found an obvious correlation between that and the attacks.

    Cheers.

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    • Posted

      I seem to tolerate nortriptyline, with fewer side effects, over that of amitriptyline. I feel that the dosage that I'm taking has helped with my mental well being and also might have a positive effect on the reflux condition.

      I completely agree with your thoughts on functional reflux.

      When I first experienced this the ENT started me on PPI's and I decided to see a Gastro specialist. After an endoscopy, bravo chip fitted in the oesophagus and then a restek probe fitted in the larynx, as well as a bunch of other tests I'm left with the diagnosis of "functional" reflux. After that I'm left with the management and care of that condition.

      Rather than focusing on excess acid as being a primary cause I'm looking more towards digestion, gut health and lifestyle choices as being more of a long term solution to this situation. You have to think long term as well due to the nature of the condition and ambiguity to its treatment.

      I do use certain antacids which contain sodium alginate.

      My mental disposition also seems to contribute to this reflux condition and sometimes finding a way to manage that can be as elusive as dealing with LPR.

      Best wishes.

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