Symptoms

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neptunian808

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Is anyone experiencing these symptoms? hoarseness, throat clearing, acid taste in the mouth but without cough, heartburn or pain? i've been hoarse for 2 months 4 days and counting :/ recently i found out an aunt had the same problem she couldn't talk for over a year she had tests done she took ppi's and nothing worked she said aluminum hidroxide got rid of the hoarseness so that's what im taking now along with omeprazole, my GP changed my pills for nexium (esomeprazole) so im going to the ENT tomorrow to see what i should do next, he seems to know the difference between LPR and GERD so that's why im seeing him. For those who've had a laryngoscopy what did your doctor find? in my case i have a thickening of the posterior commisure which for what i've read it's very common in LPR, also i've noticed the majority of the posts here are about LPR, i'm surprised doctors still don't have a real cure for this disease since it's very common and can ruin your life. If pepsin it's what's causing the damage why dont they just create a med that blocks pepsin.We need to get this part of the forum more active i've noticed before there were much more people posting about LPR i wonder if they found a solution since they don't post anymore.
 
My symptoms these days are no heartburn or indigestion issues, but globus which is the most annoying one, and varies in severity through the day, throat clearing especially after eating, and painful irritating swallowing.

The all began at the same time 2 months ago. I tried ppis and they didn't work at all. Seemed to get a lot worse. I quit smoking and drinking and only ate salaRAB and small meals, drinking only water and it seemed to get much worse. I then started drinking, smoking, and eating whatever I want. For instance, today I ate nutella (chocolate) in the morning, spaghetti and tomato sauce in the afternoon, and drank beer, tea, and ate two donairs (filled with onions) in the evening. I also ceased completely taking ppis, after taking them for about 5 weeks. Ever since I started the new regimin of just doing whatever I want, I've noticed considerable improvement in my mental state, and physically. Though I wouldn't say either are great by any stretch, I don't know what to make of the fact that time seems to just slowly heal it rather than any action at all on my part.

You make a really good point when you said that if this is so common, it is pretty crazy that there is no cure or even a working treatment for it. It's pretty depressing actually. It seems like everyone else in the world has a cure for their problem. I think that the most important thing is simply to supress these symptoms at any cost, since it seems like doctors don't really know or agree if all people with "LPR" actually have the same thing. I think the only real problem is the symptoms, and that should be pretty much 100 percent of doctor's efforts. To treat the symptoms and improve quality of life.
 
Also, if people do get better and then just stop using these boarRAB, it seems pretty socially irresponsible. Maybe they just don't want to ever look back on that time, or jinx their recovery? Or maybe they just get used to the problem.

I do notice too that a lot of people just suddenly drop off the pages after being active for a few months. It's just a big unknowable "x" factor in this whole big mysterious problem.

Definitely if I ever get better, I'll be sure to let people know so they don't just wonder if anyone ever gets a handle on this problem.
 
It does sound like it could be LPR.

My ENT takes a dual prong approach. One is trying to reduce the amount of acid coming up into the throat (consistent lifestyle changes, diet, meRAB) and the other is to help calm the throat.

I think the majority of the people with LPR that is flaring have irritated vocal corRAB upon a scope. That isn't always the case though. I actually had the acid confirmed through pH testing and Modified Barium Swallows.

I've been through the range over the last 8-9 years with this. I've found things that work for a while, but eventually my acid gets bad again. I just move on to the next thing to try. Unfortunately, I've had 3 physicians/ specialists tell me I have the most severe case of acid reflux they've seen in their practices. (Tests show acid in my throat almost 1/2 the day.) It does become frustrating because there really aren't anything strategies (both medical and homeopathic) we haven't tried at this point.
 
I just picked up my lyrica (gabapentin) which an anti-siezure medication.

You wouldn't think that would help "LPR" either, but its like you say: The way we are diagnosed with reflux, and the fact that everyone is diagnosed with reflux with little evidence, makes me believe it could be something else.

In my case, my symptoms began suddenly during a virus that was so bad, I would cough up blood. That was the first time I ever did that, so it just shows you that the virus did quite a bit of damage to my throat. So then this globus and throat clearing started up, and I, and the doctors here, are going to act on the idea that it might be nerve damage in the throat. That causes symptoms that are a lot like allergies or lpr.

elavil I was suggesting actually for mountain reader, because her ENT suggested it. It is a pretty strong anti-depressant but it produces other effects too. I just don't think the doctor would recommend something that strong, unless he thought it had a good chance of helping the situation.

As for you neptunian, have you tried nyastin or whatever, the nose spray? Also, ppis, according to the article "back to the diagnosis of silent gerd" have some kind of anti-inflammatory effect, so they might, ironically, help with your throat clearing.

I just really don't like ppis though, because I think they cause heartburn and digestion problems, while not really doing much for LPR symptoms. It seems like a really poor trade off.
 
hey mountain it's good to see you here again, i've read a lot of your posts but didn't think you still posted here, do you have only LPR or GERD too? cause you mention acid coming into your throat, do you feel it or do you only see it on tests results? i don't feel anything except for acid saliva after i eat and early in the morning and the hoarseness of course :/ also what are all your symptoms and are you on any treatment at the time?
 
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
 
yeah i agree, i mean if you can solve the problem why not share it with those who suffer the same, indeed it is irresponsable but we really don't know what happened to those people :confused:

i have throat clearing after eating too it's so f***** annoying :mad:
have you experienced any alterations in your voice? cause throat clearing and voice quality kinda go hand in hand, my mom has really bad throat clearing and her voice sounRAB kinda shaky at times, same problem i have but mine is 24/7 :/
 
hey mountain, thanks for sharing your story is not a long post at all , it's extremely interesting i feel like the same is going to happen to me, i haven't had any gastric tests yet but im sure there wont be too long before i do need them, 6 weeks under control is excelent are you still hoarse? can you please share the recipe your ENT gave you, i've been doing gargles with salt, baking soda but they dont make much or any difference, it surprises me that gargles can do anything though since the liquid doesn't even reach the vocal chorRAB, you mention vocal chord irritation what was the exact finding? my vocal chorRAB are 100% healthy according to the ENT,the thickening of the posterior commissure it's what's causing the hoarseness. I wonder why don't PPI's work not even in higher doses according to logic they should work, if there's no acid then pepsinogen can't be transformed into pepsin then there wouldn't be any damaging agent, i wonder if this is really pepsin, if it was we should respond to ppi's at least a tad bit. I do the same things you do, eat healthy, stop eating 3-4 hours before bed, lifted the headboard etc but still nothing, i havent been on double dose ppi's for more than 20 days though so maybe i should give it more time but after seeing all the studies that say ppi's don't work im like pfft why bother. I have the belching problem too, but i've had it since i was like 14 way before LPR so i don't know how related they are..
 
You might want to try a gaba B like baclofen at least temporarily.

They supposedly cause a major reduction in les relaxations. Totally different from pregabalin (which I'm picking up today, if they have it at the military hospital. the prescription is in my pocket as we speak.)

Anyway, that is tough, your mother had the same thing right? How did she cope with it?
 
Just to be clear, I've had the twice per day PPI's work well for me for pretty good perioRAB of time. I just haven't found any one that works more than a few years. As I said though, my acid problem is more extreme for me than typical according to several specialists I've been to. Even the Dexilant I'm currently on does make a difference, it just doesn't take care of all my symptoms.

I'm not sure what you are asking with regarRAB to the "findings" of my throat irritation. They scope showed my vocal corRAB were inflammed. I had the pH test after that that confirmed that the gaseous acid was causing the inflammation. (I've had multiple EGD's w/ biopsies that have come back normal.) I reflux constantly year-round, but don't always have the constant irritation. I'll usually do OK for several months, then "flare" for about 3-4 months. I can't always identify a trigger for the "flare" though it is usually tied to asthma issues as well. Ironically, the coughing from reflux causes acid to irritate my lungs/throat. It also squeezes the stomach making the refluxing worse. If I cough from asthma, it has the same cycle with the acid as well.

As for the Elavil, they use it as an anti-depressant at much higher dosages. To help with muscle spasms, they prescribe at very low dosages. I took it at 10mg for a several nights last winter. Even the very low dosage completely knocked me out for about 14 hours each time. Nothing would wake me. Even 12 hours later, I slept through two alarms. One very loud and one that vibrates my bed (I always have a backup because of hearing loss). I'm one of the small percentage of people who experience reactions this intense as a side effect. Granted, I was taking it because of muscle spasms that were really causing me some pain and I wasn't feeling the pain when knocked out. I won't take it again unless I absolutely have to and I'm not working. I just couldn't function well the days I took it.

The Tessalon Perle they recommended I've tried about 10 times over the years. It just doesn't do anything for me at all. Theoretically, it should help "nurab/calm" the vocal corRAB a bit to help them heal.

My ENT gave me a handout from the Texas Voice Center that had a gargle recipe for dry irritated throats:

1/2 tsp. salt
1/2 tsp baking soda
1/2 tsp clear corn syrup
6 oz. warmed distilled water

You gargle gently for two "long, boring" minutes then spit. He recommended not rinsing after.

He also recommended avoiding coffee, tea and soft drinks...not hard if you are already following the anti-reflux diet anyway. Using a humidifier at night if you are in a dry environment, drinking tons of water and doing a vocal exercise.
 
I really think even those who have reflux as a major cause behind chronic cough still do benefit from things that calm the vocal chorRAB. You might want to give the elavil a month or so at 10 mg-25 mg per night.

It's not like we don't give ppis all the time in the world to do their magic. Doesn't elavil deserve at least a few weeks? I mean, the ENT is trying to get you to take it, and the side effects of these things wear off quite often after the initial shock.

Do you have occassional laryngospasm/pvcm, or are the choking issues related solely to asthma attacks?
 
what about the posterior part of your larynx (arytenoiRAB, interarytenoid area) was that normal or inflammed as well?. I wanna get that ph test done as soon as possible, did you had this test done? "Multichannel Intraluminal Impedance and pH Monitoring" i read that's the one that can detect non-acid reflux i have no idea if it's available in my country so i gotta find out to at least rule out acid. The ppi doesn't seem to be doing much i had a laryngoscopy the other day and my larynx it's worse than before treatment the funny thing is my voice feels a bit better not at 100% but it's easier to produce speech now, i used to communicate through text everyone thought i was loosing it :/ until they saw my exams.
 
"Elavil (amitriptyline) is a tricyclic antidepressant used for treating depression." what does Elavil do to help LPR? im curious how can an antidep. help with damage in the larynx. "Do you have occassional laryngospasm/pvcm, or are the choking issues related solely to asthma attacks? " i don't i guess i was "lucky" in that department, i have hoarseness and throat clearing only and i have allergy symptoms at times but i don't now if it's LPR related cause i've always been allergic, specially in spring which is the current season here now. I'm going to the ENT in a few hours and im gonna tell him to explain why does this happen, if there's a cure, if he has had any patients with LPR that have responded to any treatment etc to see what he has to say, i hope he doesn't just sent me to a GI doctor like the previous ENT, the previous one didn't explained s*** he just said "you have "reflux laryngitis" do you have reflux? go to a GI and i asked what if that doesn't work then he said then "go to a speech therapist". yeah right like a speech therapist is going to stop the pepsin from reaching my throat :mad: my mom has the throat clearing symptom and sometimes alterations in her voice but it's mild, she's never hoarse, she has complained of pain before, i wanted her to go an ENT to cause maybe this is heredetary but we can't afford it, before this happened i was going to take singing lessons again (i did the past year) and now this happens...
 
I did not have the Multichannel Intraluminal Impedance and pH Monitoring. It isn't something my doctors discussed with me. Results might be interesting though.

I have had regular 24 hr pH tests w/ Manometries and an upper 24 hr pH test using the ResTech system. The lower ones showed the severity of my reflux originally. The upper ResTech system has only been out since 2008. That is the test I had a couple months ago. It was what confirmed I had gaseous acid coming up past my vocal corRAB a majority of the day.

I will say that my EGD's have shown no esophageal damage despite confirmation by pH tests of severe reflux.

My throat irritation comes and goes even though the reflux is constant. One scope really doesn't tell the full story in my opinion.
 
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