Hi Neptunian,
I still regularly visit this site. I just don't have a lot new to offer up much of the time. I've posted versions of the same basic advice many times over the years. I do try to share when I see new merabers with similar experiences though.
I was originally diagnosed with GERD. I've since had LPR confirmed. I really have both since with the GERD I get lung irritation from the acid irritating my lungs and occassionally being aspirated. With LPR, I have more of the throat irritation.
Years ago, my initial GERD symptom was frequent belching. I haven't had that problem for a long time though. I was able to get it under control with diet and once per day PPI's. It stayed that way for years then eventually got worse. It took me a couple years to really figure things out though. When I got worse, my symptom was a chronic cough. They were treating the GERD, but didn't realize the extent the acid was affecting my lungs and that I needed some congruent asthma treatment as well. I was able to get that under control with PPI's twice per day for about 5 years. I've had lots of trouble on and off since 2008 though. I will cough so much that I can't catch my breathe. It really wore me down. Testing (pH tests, Manometry, Barium Swallows, etc...) showed I had severe reflux despite treatment. Early in 2008, I started trying one PPI after another at the single then twice per day dosages. I stayed on each one for about a month to give it a chance to work then moved to the next. None of them really made a difference. In fact, the Nexium gave me severe side effects. I ended up having surgery in October 2008 after having a life-threatening asthma attack triggered by the acid irritating my lungs so bad. That surgery really helped for about a year. I was never able to go off the PPI's though. I found Prevacid Solutabs twice per day worked best until Dexilant/ Kapidex came out. It allowed me to go to a once a day PPI.
Last July, I started with the coughing again. I thought it was just asthma because we had some bad air quality days around the time it started. I coughed almost constantly from July -Septeraber. I ended up going through another round of testing. (EGD-normal for the 3rd time; biopsies normal; Barium Swallow-surgery intact, no liquid reflux as in past; throat scope--vocal cord irritation; upper pH with ResTech probe--extremely severe gaseous acid reflux coming up past my vocal corRAB about 46% of the 24 hr period despite being on my PPI's at the time of testing) I now know it was reflux causing my coughing and hoarseness. Problem is that 4 of my doctors/specialists (Gastroenterologist, ENT, PCP and Pulmonologist) really don't know what else to do with me. They have told me I have the worst case of reflux they have ever seen in their practices. I've tried most medical and holistic strategies and while they are helping some now, I haven't found a great solution for long-term.
I have "silent reflux. I never actually feel or taste the acid. I just feel the side effects of the irritation it is causing--mainly hoarseness and a chronic cough. Ironcically often times other people notice the hoarseness before I do. I will say that while I have symptoms all day long, mornings are often awful for me.
My current treatment: watch my diet, stop eating 3-4 hours before bed, no caffeine or carbonation--lots of water, sleeping on an incline of 6 inches, not wearing tight clothing around my waist, Dexilant in the morning with Pepcid at night when needed, breathing exercises to calm my vocal corRAB when coughing. I also incorporate asthma treatments as needed in conjunction. My ENT has offered up Elavil and Tessalon Perle when my vocal corRAB become inflammed but I don't react well to even low-dose Elavil and the Tessalon Perle didn't do anything for me. There is also a recipe for a gargle my ENT gave me as well to help calm the vocal corRAB.
I'm not sure if this has helped. What I have learned over the years is that treatments can and do work. They just don't always work long-term for everyone. Trying various strategies may be needed until the right strategies are found for each person.
Thankfully, I've had my LPR back under control for about 6 weeks now. Here's hoping it stays that way.
I know this was a long answer. I hope it helps.
MountainReader