Silent reflux or something else

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Hello, I have a few health problems and am suffering a lot of pain with osteo arthritis at the moment and am on that forum.  I also suffer from anxiety.

To cut a long story short my gp thinks I have reflux, I also have asthma, well controlled.  My symptoms are continual retching and coughing trying to clear mucus from throat with only short lets up although it never really goes.  Last night a got about 2 hours sleep combination of arthritis pain and the retching.  I have tried everything from saline nose spray, head over bowl of hot water with oil of obus, salt water gargle and using asthma reliever (which I hardly ever have to do).  My gp has given me omeprazole 20mg once a day.  I have taken these in the past but as a stomach protector when taking ibuprofen (can't take these now because of side effects).  The retching and coughing in worse after eating and can go on for hours until it lessens.  I don't have any burning or heartburn just a little burping and sometimes the feeling food is stuck.  These are nothing compared to the continous mucus.  I am so tired this morning as I type this.  Can anyone tell me how long before the omeprazole starts to work 

and is there anything else I can try. I wasstarting to get back on track after a month of pain with knee now all this. Please can anyone offer any help.  Thanks  ps I also have IBS ok at the moment.

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  • Posted

    Please take omeprazole half an hour before food. It will help to reduce stomach acid secretion. Also please avoid spicy, fatty and fried food; carbonated beverages; tea and coffee; alcohol; chocolate and citrus fruits.
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    • Posted

      Hello Pat , Thanks for your reply.  My doctor has told me to take it 1/2 hour before evening meal.  Only one day at the moment.  I know about avoiding alcohol chocolate and citrus fruits, spicy and fatty food but not tea.  Do you know how long does the omeprazole start to work.  I sing in a choir and start back Monday I will be so sad if I can't go. I have to pay for a term ahead.  Thanks
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    • Posted

      Once a day omeprazole is sufficient as it inhibit the stomach acid secretion for around 72 hours and it start to work within half an hour after oral administration. Hopefully your symptoms will reduce soon. Please try to avoid tea as well, as it can trigger gastric acid secretion.
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    • Posted

      Hi I see you say avoid various things.  I don't drink coffee or carbonated drinks and only odd glass of wine so easy to avoid.  I have cut out chocolate,citrus fruit,tomatoes,and juice.  I do love my tea though, I have it so very strong with skimmed milk.  What else can I drink just plain water, not too good when it's cold.  Any ideas please.

      thanks.

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    • Posted

      If it is not possible to avoid completely, please limit the consumption of tea. It will definitely help you to recover from acid reflux. Instead of citrus fruit you can eat fruits like apple, bananas, peaches and pears. Also you can try a variety of green vegetables; broiled, grilled or roasted skinless chicken, meat or seafood; but avoid spicy fried food.
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    • Posted

      Thank you.  I am trying to cut down tea and am going to try camomile when I go shopping this week.  I eat apples,pears peaches,bananas also nectarines not sure about them might not buy them this week.  I eat most green,veg and root veg.  I am trying to eat more chicken and only small amount of lean beef.  I hate seafood so that's not an option for me. I don't usually fry anything.  I try to avoid spicy and greasy anyway because of my IBS.  What about cheese I have heard feta is ok.  Salad is great minus tomatoes.  I am finding this quite hard to do and am not really enjoying my food due to bad taste in mouth and the mucous.  What do you find is best for breakfast.  I used to have porridge with skimmed milk most days, sometimes toast and the odd boiled egg or bacon sarnie  Assume the bacon is out now.  Any suggestions are helpful.  I have read up on line but advice seems to vary.  I am also eating natural yogurt with the good bacteria.  I miss my chocolate and slice of cake at the weekend.

      Thanks

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    • Posted

      Please keep a track of food that increases your symptoms and avoid it. Even after 10 days of omeprazole, if there is no improvement, you may need to change the treatment. Please continue taking suggested diet.

       

      Reflux disease may be caused due to conditions like ‘Hiatal hernia; Zollinger-Ellison syndrome (in which there is increased gastric acid secretion); H pylori infection’. You need to do investigations to identify the reason. Please let me know if you have done gastroscopy. If it is not performed, please consult your GP for it. This is a very useful diagnostic procedure and it helps to identify the underlying cause.

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    • Posted

      Hi What is gastroscopy?  It is the same as endoscopy?  No I have not had any tests done.  I am due to go back to GP on Monday.  She did say last time she might refer me for a barium swallow as my mum had a hiatus hernia and was on a low fat diet.  I was tested HP infection 2/3 years ago when my Ibs was bad and my anxiety too.  It was negative.  Do you know anything about oral thrush?  I have had it several times over the last 3/4 years due to asthma inhalers and probably anxiety.  I still wonder if this is part of the problem.
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    • Posted

      Gastroscopy is an endoscopic investigation of the stomach. If we do it for examination of the oesophagus, stomach and the first part of the intestine it is called as ‘Oesophagogastroduodenoscopy’.

      In addition to performing a visual examination of the upper gastrointestinal tract with the endoscope, the doctor can insert instruments through the endoscope to obtain tissue samples for a biopsy, remove foreign objects, stop bleeding, or perform endoscopic surgery, laser therapy. So this is a better procedure than barium swallow. It will help to identify if you have a hiatus hernia.

      Oral thrush is an infection of the mouth caused by the Candida fungus. It may be caused by certain medicines such as corticosteroids. Corticosteroids are used to treat asthma. That might be a reason of your frequent oral thrush.

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    • Posted

      Thank you for your reply.  I still think that oral thrush may be something to do with all this.  I am aware that the use of asthma inhalers increases the risk of oral thrush.  I have to go to the orthopaedic consultant next week for arthritis knees ( also in spine and neck).  I will also see my GP next week and will see what she suggests in the way of tests. 
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    • Posted

      Hi, Wanted to ask you when you say please keep track of food that increases your symptoms.  Did you mean in terms of mucous.

      I don't have heartburn just ocassional belching and feeling like food has not gone down properly.  Why I ask this is that although on the diet I notice that the moment I stop eating I then start producing loads more throat mucous and start retching and hacking to try and get it up sometimes this will go on for around 2 hours after eating.  In between it is better but still there.  Anyway one day this week after having a egg and cress sandwich, salad and a peach I was ok afterwards.  The next day after eating a chicken salad sandwich and peach the mucous started again.  So apart from the obvious like spicy, greasy or citrus.

      I don't quite know what affects it, also why does it act so fast. The only good thing about all this is that I have lost 1/2 stone (I need to lose a lot more).  Do you think it might be something else added to the silent reflux.  I am going to ask gp about swapping BP tablets as I know the ones I am on do have a side effect although rare of rhinitis and I do have trouble with nose congestion

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    • Posted

      Hi libralady,

      Trying to respond to your questions is difficult because  for one thing..you have many things going on, some most likely overlaping, some could be a cascade being initiated by one condition.

      You have Reflux....when food you've eaten comes up...thats a refluxation. So you could have GERD,

      GE, and LPR without heartburn and or Gastritis.

      Generally two conditions affect a reponse to food...

      1. food

      2. stomach condition

      1. Some food may immediately cause an immune response..an example...high acidic food or liquidwith a high PH touches inflammed tissues, the immune response is mucus, stomach contractions

      and reflux .

      2. Food left behind from a previous meal or snack is yet in the stomach....could be in chime process,and when "any" new food is introduced and mixes......the response is...bloating, pain, and reflux.

      Taking your example of foods...what I see identical is peach...the other two can be quite different in PH.

      And of course...perhaps with egg, the stomach was empty...perhaps  not so with the chicken.

      (you didn't mentioned pre meal medications, therefore assume whatever, the same would have been

      for both meals).

      Because you have the responses that you do plus a nasal conditon, I'd suggest quickly a referral to a skilled ENT.  If you've already seen one, without results, get a 2nd opinion...

      While the stomach is Gastroentrology  the throat and nose is ENT...google Dr. Ja Kaufman, she's the ENT doc that coined "silent reflux"..she is referenced in many medical abstracts dealing with reflux, acid, pepsin, bile, bacteria, and other stuff's.

      I mentioned to Ines that I have a copy in pdf format of the "international symposium" held in the UK back in 2010 that

      pretty much clarifies "almost" all of your conditions. It's really lengthy and has technicals but you can manage...

      "Review article: reflux and its consequences – the laryngeal,

      pulmonary and oesophageal manifestations

      Conference held in conjunction with the 9th International Symposium

      on Human Pepsin (ISHP) Kingston-upon-Hull, UK, 21–23 April 2010"

      claudio

      Trying to respond to your questions is difficult because  for one thing..you have many things going

      on, some most likely overlaping, some could be a cascade being initiated by one condition.

      You have Reflux....when food you've eaten comes up...thats a refluxation. So you could have GERD,

      GE, and LPR without heartburn and or Gastritis.

      Generally two conditions affect a reponse to food...

      1. food

      2. stomach condition

      1. Some food may immediately cause an immunte response..an example...high acidic food or liquid

      with a high PH touches inflammed tissues, the immune response is mucus, stomach contractions

      and reflux .

      2. Food left behind from a previous meal or snack is yet in the stomach....could be in chime process,

      and when "any" new food is introduced and mixes......the response is...bloating, pain, and reflux.

      Taking your example of foods...what I see identical is peach...the other two can be quite different in PH.

      And of course...perhaps with egg, the stomach was empty...perhaps  not so with the chicken.

      (you didn't mentioned pre meal medications, therefore assume whatever, the same would have been

      for both meals).

      Because you have the responses that you do plus a nasal conditon, I'd suggest quickly a referral to a

      skilled ENT.  If you've already seen one, without results, get a 2nd opinion...

      While the stomach is Gastroentrologist, the throat and nose is ENT...google Dr. Ja

      Kaufman, she's the ENT doc that coined "silent reflux"..she is referenced in many medical abstracts dealing

      with reflux, acid, pepsin, bile, bacteria, and other stuff's.

      I mentioned to Ines that I have a copy in pdf format of the "international symposium" held in the UK back in 2010 that

      pretty much clarifies "almost" all of your conditions. It's really lengthy and has technicals but you can manage...

      "Review article: reflux and its consequences – the laryngeal,

      pulmonary and oesophageal manifestations

      Conference held in conjunction with the 9th International Symposium

      on Human Pepsin (ISHP) Kingston-upon-Hull, UK, 21–23 April 2010"

      claudio

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    • Posted

      Hello Claudio, Thank you taking the trouble to reply.  I am finding this condition or what ever it is I  have, quite anxiety provoking, which of course does not help.  Reading all the different posts it seems there are opinions as to what you should and shouldn't eat/drink, medicines you should try and tests you might need.  From what I read it seems that many think GP's know little about this condition and I am frightened that mine will not address my symptoms correctly not because they are not helpful but because they simply don't know enough about it.  Also all this talk of cancer frightens me as well.  I am going to see my gp on Monday and will try and explain my symptoms and what I have learnt from the forum.  I think I my take a break from the forum as I am getting bogged down with all the information  Thanks once again for taking

      the trouble to reply, and thanks to everyone else who has also posted on this subject. 

      Carol

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    • Posted

      Understand. Many try to help but its tough for them, and for me knowing little about specifics. I would urge you to read the symposium review before you meet with your GP. Again its lengthy but not over technical..it will NOT frighten  you but provide you with the amo you need to get on the recovery road......You may want to "print" some of the information, for your GP meeting..so be prepared........wish you the best...donclaudio
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    • Posted

      Hi, Common symptoms associated with gastro-oesophageal reflux disease are heartburn and regurgitation. Sometime the patient may have pain with swallowing, increased salivation, chest pain, nausea and coughing. Please try to avoid food that causing these symptoms.

      Throat mucus is not common in gastro-oesophageal reflux disease, but it may be seen in another condition ‘Laryngopharyngeal reflux’. In this condition, there is a retrograde flow of gastric contents to the upper aero-digestive tract. The patient may have hoarseness of voice, indigestion, cough, postnasal drip, sore throat, and asthma.

      As you have felt like food has not gone down properly, there may be a possibility of hiatus hernia. Gastroscopy will help to confirm the diagnosis. For Laryngopharyngeal reflux’ laryngoscopy is useful. Please consult a GP for these investigations. Proper diagnosis will help you to take the right treatment.

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    • Posted

      Hello,  I don't have heartburn, and very occasional regurgitation. Sometimes chewing and swallowing seems hard but not all the time.  I think I have LPR or silent reflux from what I have read.  The worst symptom is the throat mucous which has me retching sometimes all day.  It is worse on waking and after eating.  I have cut out all foods associated with reflux but it is not making it much better.  I saw the doctor yesterday and she increased the omeprazole to 20mg twice a day.  She just calls it reflux and from what I have read gps don't seem to know much about it.  She has not suggested any tests at this point.  I did say I was worried about damage to throat and vocal chords etc.  I believe for silent reflux you need to go to ENT for testing not the gastro dept.  I am supposed to be going out for a belated birthday meal with my daughter son in law and grandaughters we usully go to an italian so is there anything I can actually eat or drink. I am fed up and have been having crying spells unusual for me even though I suffer from Anxiety.  I know it does not help my LPR but my doctor I believe thinks it is all anxiety related.  I was also supposed to see the consultant about my arthritis, but this morning it was cancelled as they say that had booked me under the wrong consultant clinic.  Will have to wait again for another appointment.  I also sing in a rock and pop choir something I love and good for anxiety.  Have not been for 2 weeks and as I have to pay each term  not sure about going back a waste of money If keep missing it.  I am angry about this the one thing I love doing.

      Ishould have said that she also gave me beconase nasal spray, but it seems to make the throat mucus worse.  Last night after I took it was 2 hours before I could go to bed and be able to lie down.  I am glad that I found this forum because I have been given advice and support, but sometimes wish I hadn't because there does not seem to be a cure for this condition.  Tried camomile and redbush tea but found them horrible will stick with apple and pear green tea and one cup of ordinary each day plus water.  I think I mentioned I have lost 1/2 stone which is great as I need to but not the way I wanted to diet.  My mum had an hiatus hernia so maybe I have one as well.  Sorry to moan on and flit from one thing to another but I am not coping very well with all this.

       

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    • Posted

      I also meut ant to say when you say what foods upset you I don't know I get the throat mucous the moment I take my last bite regardless of what it is.

      I did have something similar to this around 7 years ago.  It started funnily enough around the same time of year with tight chest and horrible sore mouth antibiotics made not difference was ill for weeks. Was just retiring from work at the time.  It left me with some mucous but quite manageable I put it down to blood pressure medication.  I had thought about changing it but at the moment have left it as have all this to contend.  This started one Saturday night when I went to make a cup of tea and whilst in the kitchen ate just 2 square of fruit and nut chocolate.  Chocolate had neve bothered me before it was instant and I swallowed the chocolate the mucous started.  

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    • Posted

      Hi, Your symptoms suggests that you have a 'Laryngopharyngeal reflux' or 'silent reflux'; But you need to confirm it by diagnostic investigations. I have already suggested laryngoscopy and gastroscopy to you. These are very useful investigations. Please request your GP for these investigations. There is also a possibility of hiatus hernia, but you need to do investigations for it. Until final diagnosis, please continue to take given treatment, as gastric pH balance is very important in silent reflux.
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