LPR with no relief

  • Thread starter Thread starter neptunian808
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the problems being mentioned on this thread are the very problems I have in believing the diagnosis of LPR is accurate in most cases.

It's an easy way for a confused ENT to get a patient out of his office though...

If it were diet related, it would be impacted by diet.
If it were reflux related, surely signs in the esophagus would correlate with reflux (which they don't in most cases)
If ppis were an effective treatment in any way for this "reflux", the effects would have to be basically as quick as they are for the treatment of GERD.

However, since the throat is sensitive, any kind of issue in the area will cause basically these symptoms. That means, you could have any of a nuraber of problems in the throat, and probably hard to detect ones.

I would favour the idea that people with these symptoms have nerve issues, a cyst, some sort of infection, a vitamin deficiency, a thyroid issue, way before I'd believe that everyone with hard to resolve throat issues has LPR. Especially after the great and infallable ppi treatment inevitably fails to resolve the issue.

If you can pinpoint exactly the area where the issue is coming from, the best thing might be to actually ask for electrical testing of the different areas of the throat. They might detect full or partial paralysis or a cyst of some kind. In the field of ENT, it seems the doctors need direction from the patient :( Otherwise, one must be content with the nexium and its probably harmful effects on the (previously untroubled) digestive tract. This is the state of medicine in the 21st century I guess.
 
Hi,

I'm a 49 year old female, suffering in the past 3 months from the following symptoms: feeling of something stuck in throat, mucus in throat, coughing mucus, constantly clearing of throat. After seeing 3 ENTs, they all put a tube down my throat and said my issues were acid related. I then went to see a gastroenterologist who performed an endoscopy and concluded there was nothing wrong with my stomach which made things even more confusing.
After doing some research I was convinced the ENTs may be right since most of my symptoms do fit with LPR. However, I do not suffer from heartburn nor do I get any feeling of acidity in my throat. The ENT put me on 40mg Nexium twice a day and I've been taking it for almost a month with no relief. The strange thing is some days are better and some days are worse and it doesn't seem to be related to my diet at all. I would also expect to see gradual relief if the medicine was working. I am now beginning to doubt that I have LPR and I've lost hope.
Has anyone had similar experience?? What could be the cause of my symptoms??
 
hi Rachel i've been to 3 ENTs who've said my problem is caused by reflux (only one said LPR) i've been on omeprazole (prilosec) for a month with no relief, ENT's send me to speech therapy i went to a speech therapist and when he saw my laryngoscopy pictures said "you have really bad reflux" (no sh**), according to one ENT a speech therapist would help me phonate even with the inflamation present..yeah right. Now im seeing a GI doctor who will perform all the tests he seems understanding but i don't know if he is familiar with LPR yet. My symptoms are not exactly like yours though i have: hoarseness, feeling of something stuck in my throat after i eat, EXCESSIVE belching, bloating and fullness in my right ear but idk if that's due to reflux, my advice to you is go to a GI doctor and push until you can get a Multichannel intraluminal impedance (MII)
this is the ONLY exam that will detect if you have LPR as it measures acid, non-acid, gaseous and liquid reflux, really get that test to at least rule out reflux as a cause, im on it now i have to get a barium swallow tomorrow morning and then probably an upper endoscopy and finally a MII, for us LPR sufferers upper endoscopies and other exams come up with normal results so get the MII i would post links with info on the exam but this forum doesn't allow it, keep us updated on how everything goes and good luck.
 
Thank you! I'm not sure it's related to reflux since my symptoms are not affefted by when/what I eat. I was hoping to find the corrilation so I could at least confirm it's somehow related but I just couldn't...
 
i think that happens in EVERY field, my throat looks pretty much like this
r_edema_5.jpg
the typical "reflux finding"
 
There are videos on "the internet" made by an ENT doctor recently. Unfortunately I forget his name because it's really boring sounding, like John Wood, or Michael Smith or something.

But you could just seach well known video sites on the net, and check ENT doctors and LPR.

Anyway, in his video he clearly says that he has never had one case in his whole career that he would ever attribute to acid reflux.

Then he goes on to explain: this person has a swollen back of the pharynx. often this gets called LPR, but what it actually was, was....

and then he goes on to explain how he properly treated it.

I have to tell you, I would way rather have an ENT who doesn't believe in LPR than one who does. Just my opinion, but I think you have a way better chance of getting healed that way.
 
From what I have read, folks with LPR suffer pretty much all day from their symptoms - not just after eating. In fact I have read some post that say that when they eat they feel better (not sure I understand how that works though).

A couple of your symptoms - hoarseness, mucus after eating - are also symptoms of post nasal drip due to rhinitis; however, if it is due to rhinitis you would also have nasal congestion and a runny nose.

From what I have read a diagnosis of LPR is sometimes difficult to make but the symptoms are (1) hoarseness, (2) chronic cough, (3) chronic throat clearing, (4) copious amounts of mucus, (5) constant globus (sensation of something in throat and (6) chronic sore throat. Granted you may not have all of these but the ones you have are pretty much constant during the day.

I found a ENT website where the doctor said that (1) hoarseness, (2) globus feeling and (3) chronic clearing of the throat were the three most common symptoms of LPR. I think to have a diagnosis of LPR you would need several of the symptoms for an extended period of time.

One thing you could try is to start taking some antihistamines to see if they help.

Good luck on getting to the bottom of your problem. I think sometimes doctors make a diagnoses of LPR and get peeple started on double dosages of PPIs. For some folks it helps but for others it doesn't which make me wonder if maybe they jump to the wrong conclusion.
 
yeah i've seen his videos specially that one i think his name is james thomas or something, he says interarytenoid pachydermia or reflux won't cause hoarseness but all the cases he talks about in the videos have other factors that can contribute to hoarseness, i only have the interarytenoid (back of the larynx) thickening, his video doesn't really prove or disprove anything, wish it did though, i sent him a msg but he never replied...
 
I have dealt with this for several years now. I have been treated by a specialist and must still take medication off and on. Sometimes I must clear my throat often.
 
[/I]Hi Rachel
I'm currently having similar symptoms but only for about the last month. I went to my doctor with a feeling of a lump or something stuck in my throat. I had also had an increase in burping symptoms but no acid/burning. It became increasing more uncomfy as the more I tried not to swallow the more I seemed to need to swallow! My doctor diagnosed me with globus and put me on omeprazole 20mg which I took with a little relief. I went back after 2 weeks and the dose was increase to 40 mg per day. After two days my symptoms had gone and I was over the moon, however since yesterday they have come back. I have not been reffered to an ENT doctor but I'm sure I would feel happier being checked out mainly because I'm finding it difficult to understand why something like LPR can cause such troublesome symptoms.
I have noticed the same as you, the symptoms are variable on a daily basis, some days I can wake up and throat feels fine but by later on it's back! I'm also getting a little hoarse/croaky on occasions.

Anyway, I hope that you symptoms have improved and it has been useful reading your post and I was starting to think I was the only person with such symptoms.
 
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