silent reflux?

Hi Sarah,

You have my deepest sympathy. The reflux cough was my worst symptom. I used to cough to the poit of blacing out at least once a day, I'd sit up between 2:00 and 4:00 am every night swigging far too much cough suppressant and I'd had my omeprazole increased to 80mg which olny induced hypochlorhydria making me anaemic.

I'd been sent to ENT on numerous occasions but all they ever did was to test my hearing and tell me it was slightly deficient due to scarring from having them syringed too frequently as a boy (for what  I now know was actually caused by reflux). I'd been given asthma inhalers ineffectively, too. And as a teacher, I was talking all day, too.

Extra-oesophageal reflux (also known as LPR or silent reflux) is really only recently being understood.

Go to the book / website www DownWithAcid org uk and scroll down the contents (home) page to find the chapter on extra-oesophageal reflux which explains what is going on and shows 58% or refluxers report the chronic cough.

Unfortunately there's no medicine to reduce relux. The doctors follow guidelines that say for acid reflux, prescribe acid suppressants. It means the reflux is less damaging but it can still persist as "Non Erosive Reflux Disorder".

To reduce reflux, follow th elifestyel rules: lose weight if necessary, eat small protions and more frequently to avoid over-filling your stomach, avoid any exercise or bending after a meal until your stomach has emptied. Leave at least 3 hours between your last meal and going to bed and raise the ehad of your bed by 6 to 8 inches on blocks.

There are many who will try to tell you dietary changes will help or to add certain herbal or "natural" supplements to your diet. Unfortunately none of these is likely to be effective. There may be certain foods you can identify by using a food diary, that exacerbate your condition. Identify these trigger foods to avoid.

There are many devices and techniques coming onto the market that ares upposed to help reduce reflux (You can see them in the Down With Acid book.) but if you cannot manage to reduce your reflux you may decide to opt for reflux reduction surgery - the Laparoscopic Nissen Fundoplication is the gold standard. I had the operation a few years ago and it gave me my life back. From being unable to walk 50 yards from anaemia instigated by induced hypochlorhydria from the years of being on very high dose omeprazole, within a few weeks I was cycling 30 miles a day. The cough had virtually gone entirely along with all the other reflux symptoms (I still occasionally get a minor cough but so does everyone) and I am off all medication.

See if your GP will refer you to a gastroenterologist to discuss this further.

Chris

Hello Sarah, for what it's worth, my throat and voice were affected, and still are to varying degrees, by my gastritis trouble. I coughed a fair bit, to clear my throat, whereas I never used to; and my voice became hoarse crackly. I could even choke sometimes. Adding oats to my diet made it even worse until I dropped them. Also, the PPI I was on, lansoprazole, made my throat and mouth so dry that I weaned of it. So check the side-effects leaflet of your medicine if you happen to find your problem worsens over time. Laryngeal pharyngeal reflux (LPR) can cause your symptoms, and I'm sure a specialist checking your throat would see if that or other relfux issues are the case. Of course using your voice in your job will only add to your difficulty and upset, so getting to the bottom of it is the best thing. Just in case how I deal with my gastritis might be of use to you in some way, the main points are below.

Several medium meals per day (I have seven, one every two hours or bit longer), rather than fewer bigger ones are ideal, so that you don't overfill and stretch/pressure the stomach. Be sat upright for and after meals, not bent or slouching, so you don't squash your tum and press its contents upwards.

We're all different and you might find some foods are ok or bad with you compared to other people, so it's a matter of experimentation and patience, but fried foods, high-fat foods, high-salt foods, carbonated drinks, caffeine and chocolate can all impact on stomach and reflux troubles (a little white chocolate seems ok with me, being free of caffeine and other things that can affect the LES). Spicy and hot foods can also aggravate the trouble for some people. Minty foods relax the lower eosophageal muscle too, so they are bad. I even use a fruity toothpaste.

Stress and excercise that affect the stomach are also to be avoided. Be as calm and stress-free as you can.

Having your last meal a few hours before bed can prevent relfux at night, but you may find, as I did, that waiting to be too empty actually causes hunger discomfort and keeps you awake. Because of this I lie-down (on my right is best for me) about an hour and a half to two hours after last meal, and this is much better.

Another thing which has helped me greatly, is to not burp after about ten or so minutes after eating, as this can bring acid up and cause burn damage that then has to heal, even after a gaviscon. And don't take antacids routinely unless you need to during heartburn periods.

The impact of these types of illnesses on you mentally can be as major as the physical issues, Pain, discomfort and other symptoms can naturally be depressing and hard to cope with, and the sufferer can feel a grief for the life they took for granted and have suddenly lost. Share this with your doctor, family and friends if you need to.

Hi Sarah I know how you feel I had  silent reflux for three years until the doctor put me on lanspazole it helps me and stopped the cough but does take a couple weeks to get in your system. I've been on it three years now 15g a day or when it's really bad 30g. Good luck I hope you feel better soon.