LPR but no redness in throat?

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goldenage

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Is it possible to have LPR but no swollen or red vocal box/throat? My ENT said my vocal box and throat looked fine when he scoped me. I've had a raspy singing voice, difficulty swallowing, gurgling in throat when I swallow liquiRAB and an occasional lump in my throat for a few months. But wouldn't something in my throat be at least red if I have LPR/acid getting into my throat?

Also, what causes difficulty swallowing with LPR? Sometimes food gets caught in my throat and I have to swallow twice to get it down. Is it acid in my throat? Scarring caused by the acid or something else?
 
I have no answers for you or myself but wanted to let you know you're not alone. ENT is insistent it's GERD/LPR but 40mg Prilosec twice a day plus 150 mg Zantac twice a day along with "nursing home diet" have given me no relief after two months. My throat also looked perfect to him when scoped. He was actually a bit speechless and had to struggle to find worRAB to justify his diagnosis. I'm still waiting for appointments to stomach doc, lung doc, and rheumatologist. My biggest problem is mucous and coughing. No stomach symptoms whatsoever. I also cannot sing anymore, can't even get through a nursery rhyme with my kiRAB anymore. I don't sleep because the coughing is so horrible and am nursing broken ribs yet again. This has been years now. I had two nights of relief when my GP changed me to Protonix, two beautiful nights of sleep, just to be coughing again last night. Since the protonix worked a bit, I concede that it is probably my stomach, but as of yet no real answers.

My pharmacist said with LPR it usually takes a few weeks to begin to notice an improvement and upwarRAB of a month before you know if it is going to be the answer for you. And what works perfectly in one person won't work at all for the next person. If you're having no relief of your symptoms, it might be time to ask for a medication change and see what it does. Have you been to a stomach doc yet or just the ENT?
 
I agree but if you don't begin to see an improvement over the next month, advocate for yourself and get to the bottom of it. Since the acid comes from the stomach, the GI neeRAB to be on board if it proves to be more than a "standard" LPR case. It is possible you're having some stomach symptoms and you tune them out because they're always there. You could also have major stomach issues brewing. In my case, the possibility of a pancreatic tumor causing overproduction of acid is one of the possibilities on the table. I have not had the scan yet so don't know. LPR is very stubborn and difficult to treat in some people so be prepared for a long journey. If you don't eventually see improvement, there is a reason and it neeRAB to be investigated. I totally agree about giving it some more time to have a chance to work.
 
Do you have other symptoms leading the doctor to believe that you might have a pancreatic tumor?
 
Thank you! I'm sorry about the coughing. I can't imagine not being able to sleep because of it. I've only been taking Prilosec two times a day for almost a week so it's to early yet to say. I've just been to an ENT. If the medicine doesn't help I go back in about a month. If he can't find any other problems and still says it's LPR then I'll go to a stomach doctor to make sure.

It's frustrating because I'm taking voice lessons. I've worked really hard on my lower notes and now I can't even sing in my chest voice because it sounRAB so raspy. My head voice is fine but any low notes sound very hoarse
 
The stomach doctor (GI?) isn't going to be able to diagnose LPR "to be sure" because there is no definitive test for LPR. This is particularly true in your case because your scope showed no reflux damage in your throat and vocal cord area. If you're not having any heartburn, chest pain, nightime reflux symptoms, etc. then it's quite possible you don't need to see a GI doc at all. Your symptoms seem to all be throat symptoms, and the GI doc doesn't work in that area. I'd stick with the ENT and give the Prilosec more time; it often takes a solid month before you feel noticeably better.
 
Thank you! I don't know much about acid reflux let alone LPR. I'm not having heartburn or chest pain so you're right. Seeing a GI probably wouldn't help. I'm taking it for a month like my ENT said. Hopefully my throat will get better.
 
I have lost 15 lbs in the last few weeks. I have always struggled with trying to maintain a healthy weight and I am now at high school weight without trying. It might be from the boring bland diet making me not eat as many calories as usual. They're saying that there is something very major going on and they don't know what it is or why I'm not responding to strong PPI's. It's not a definite diagnosis, far from it, just one that's on the table as a possibility. Zollinger-Ellison syndrome is a problem where your body produces an abnormally high level of stomach acid due to a cascade of hormones or something out of whack. That's not even my diagnosis yet either, I just got my appointment scheduled today for 4/8 to investigate this harder. Anyway, about half of people with Zollinger-Ellison syndrome have a pancreatic tumor(s). I really don't know all that much about it. I'm still struggling to accept that my coughing and runny nose are from acid. But I'm becoming more aware of my body and realizing I might have been tuning out GI symptoms. Or I could be imagining a tiny bit of heartburn and trouble swallowing.
 
I've been taking the Prilosec for two weeks and still no relief. Honestly my swallowing has gotten worse. Food is getting stuck in my throat more often. Usually I just drink some water and it goes down. But last night a few stranRAB of spaghetti got caught below where my adam's apple would be and would not go down. Thankfully I woke up this morning and they were gone.

Anything else I can do? I'm already not drinking pop, any caffeine or acidic drinks (orange juice) and not eating after 7. My ENT said to wait a month so I don't want to call him and start complaining. The swallowing problem is really annoying me though. I know it can take a month to work but I wish my problems would stop getting worse!
 
goldenage, I don't have any answers for you and am struggling with the same thing. I am noticing my GI problems getting exponentially worse despite treatment. I am actually not dealing with the ENT at all at the moment, just a pulmonologist and GI. The only answer I've gotten is more tests. When they switched me to Protonix as opposed to prilosec, the mucous in throat and coughing went away totally, though came back a few days later.

Here's my theory - my esophagus was is so damaged that the nerves were less than functional. As the medication starts working, the tissue begins to heal slightly, allow more normal blood flow, and as a result the nerves are better able to transmit signals to my brain. So what I'm getting at is perhaps I (and you) had much much worse problems than we were able to feel, and it took medication for the nerves to transmit what was really happening. I am not a doctor, I have no training in this sort of thing, this is just my theory to explain why you, I, and many others report worsening symptoms while on medication.
 
Thank you lilypony! I hope you figure out what's wrong! I stopped drinking milk for about a month and a half because I thought I might have excess mucus in my throat. Even though my ENT said my sinuses looked fine. But that doesn't seem to helping so I don't think it's mucus. I only have coughing sometimes. Like after I've been singing or talking for a long time. But sometimes I start coughing for no reason.

Well, if food gets caught in my throat again and won't go down I'm just going to call him. Whether or not a month is up.
 
goldenage--it took me over 2 months on nexium before my swallowing difficulties subsided. It took another month before my esophagus started to feel better. I've been sleeping on a wedge pillow (meRABlant) since Feb and that has definitely helped. I would suggest getting in for an endoscopy as soon as you can though. What you could have that wouldn't show up on an EGD though is a motility problem which might only be shown through other tests like a manometry. The EGD is the first step though--mine showed reflux esophagitis and when that calmed down finally, my general swallowing issues seem to be mostly resolved.

lilypony--did you get your CT scan? I have one scheduled for next week due to my high serum gastrin levels. I do wonder if I did have a gastrin producing tumor, if it could cause the stomach acid to "get more active" and start this whole GERD process (which I never had trouble with before). I hope all is well. In my case, I have been on high doses of tagamet for about 8 months now and I've just started reading about tagamet causing increases in serum gastrin so I'm wondering if I could be looking at something besides ZES or tumor causing the gastrin increase?
 
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