LPR (Laryngopharyngeal Reflux) support forum?

[Grosser]

Hello,
I was diagnosed by LPR (Laryngopharyngeal Reflux). I would love to discuss managing of my LPR with other LPR sufferers. However, I can't find any active support group, forum etc. Do you know about anything? Could you send me a link?

Thank you.

G.

[selmaS]

Hi and welcome to the GERD forum.

We have many here in the GERD forum with Silent Reflux or Larygopharyngeal   Reflux.

Symptoms of Laryngopharyngeal Reflux are:

Continual throat clearing
Chronic throat irritation
Chronic cough
Hoarseness
Excessive phlegm the throat
Dysphagia (difficulty swallowing)
Constant sensation of something in the throat
Swallowed food comes back up
Post nasal drainage
Weak voice
Cracking voice
Blockage of the breathing passage
Spasm of the larynx (voice box)
Wheezing
Heartburn( not all experience this )
This condition is a result of both UES and LES not working correctly.
And it is possible not to have typical gerd/acid reflux  symptoms

So u can chat with people right here, or u can start ur own (grouphttp://www.medhelp.org/user_groups/list) if u want if we do not have a group for this, but we have many forums devoted to GI issues and I know we have had several members mention they had this dx.

How can we help u?

[Red_Star]

Yes my mother had severe GERD and LPR for 5 years. Her worst symptom of LPR was when burning stomach acid poured into her mouth walking around shopping. It was terrible to watch. Today she is free of GERD and LPR. She takes NO acid blockers (after 25 years of being told she had high acid!) and takes digestive enzyme supplements to help with digestion and betaine HCI with pepsin to increase stomach acid. She even has a hiatus hernia so these supplements are gold. Also when she is stressed she needs magnesium and probiotics to prevent any upsets.

[Ladybut1973]

This is very helpful information. I constantly have a sore throat and was told it was LPR and put on a PPI almost a year ago. it really has not helped much. I am 61 and have heard stomach acid decreases with age but have been afraid to try increasing it.

[Flycaster305]

There are several of us who have experienced this condition and have  experienced a reversal of conditions.  Links and research could be helpful, but first-hand testimonials from those of us who have been there and done that and experienced relief might give you some insight.  We aren't health professionals, but have experienced what you have and can give some insight.  
Keep us informed.

[Grosser]

Thank you for your replies very much. It is awesome that there are sites like this one.
I am not from the english speaking country. Therefore my english isn't perfect. Sorry for that.

I will briefly describe my case:

Last year, I was an exchange student. I experienced a lot of stress. It was probably the main trigger of my problems. I ate very healthy and even so I started to have severe problems with indigestion (flatulence and bloating). A few stomach spasms probably occured (EG. I drunk a cup of coffee one hour after lunch and my belly started to gurgle a lot. For following 1-2 days my digestion was very bad and I experienced strong flatulence after every meal). I had these problems for a few months and it was getting worse and worse. It led to malnutrition (I lost a lot of weight, started to have problems with rashes, experienced hand-shaking, nocturia etc.)  However, I did not experience any GERD symptoms! Unfortunately, one day, I got badly overeaten and something with my LES happened and I started to experience GERD symtoms.
A few days later, during endoscopy, doctors found inflamed esophagus and stomach they diagnosed me by GERD. However, I have never experienced anything like heartburn. In this time, I am back at home. Frankly speaking, I am relieved from stress and I do not suffer by indigestion anymore. Nevertheless, I still have GERD (LPR) problems.


My most common symptoms are:
feeling of a lump in my throat
weird tastes in my mouth
belching
irritated throat
burnt tongue (probably by stomach acid)
belching

A few times, my throat got irritated after singing two songs with my friends or drinking two beers. ENT diagnosed me by chronic laryngitis and found my vocal chords slightly damaged by something. Allergy doctor found out that I have an deficiency of T-lymphocytes ( I think it was caused by that long-term malnutrition).

I have a bunch of questions:

1/ Nobody officially diagnosed me by the LPR yet. But I think, according to my symptoms, it is the LPR. What is your opinion?

2/ Very often, I wake up with runny nose. I thought it is an allergy. However, anti-histaminics do not help me. Can some stomach acid/ bile irritate my nose during the nights?

3/ I follow a classic GERD diet. However, I feel my symptoms most of day (mainly at evenings) and I have a very hard time to determine what kind of food causes my problems. I do not see any connection between my irritated throat symptoms and food. It is not so obvious like having or no-having heartburn. Only thing which I reliably found out is that overeating and very fatty foods make my symptoms worse (mainly belching and stronger feeling of a lump). Do you have any piece of advice how to find any triggers? I am kinda desperate about that.

4/ I want to try to consume one tbs of vinegar before meals. Does it have to be apple vinegar? I do not have this kind of vinegar at home.

5/ Do you have other tips/recommendations?


Extra INFO: My mom suffers by heartburn a lot. When I was very young, I was slightly experiencing an asthma. A few weeks ago, during the breath tests, doctors found lactose intolerance and very slight fructose maloabsorption.


Thank you.

G.

[selmaS]

  Hi...not sure that ur stomach may be causing ur runny nose, but could be the other way round...u may have PND(post nasal drip)  and that may have increased to a noticeable  amount of drainage, that can cause GERD issues....

U may have an allergy, which u can develop at any stage in ur life.....

There r diff thoughts on the vinegar....adding more acid to a stomach already filled with acids....not always a good idea...if the GERD issues were due to low acid levels then I would agree it may help...but, not if u have high acid levels....have u had a PH test?

Have u tried keeping a journal on ur foods and other factors like stress etc....u may have a better chance of finding ur trigger...plus the elimination diet...just pick something eliminate it and then reintroduce it...see what happens.

[Smiley2000]

Hi there Grosser,

We are glad that you have found our Community Forum :)  Just remember that we are not Medical Professionals and the advice we give is on personal experience or general knowledge and because we care and like to help others.

From my personal experience I would really recommend that you get further tests done by an Ear- Nose and Throat (ENT) Specialist to confirm that you indeed have LPR.

In my opinion, you would only accept the diagnoses as "LPR" once you've seen an ENT.  He can do a Larynxscope that would look at your throat/nasal area and see if their are LPR damage/signs and then take it from there.

I have had a horrible 7 years with GERD.  I had a lot of ENT symptoms - similar to yours.  I had all kinds of tests done (24hr Impedance study, Manomatric studies, Barium swallows) and also seen an ENT and after extensive testing, I agreed to the Nissen Fundoplication Surgery - anti-reflux surgery - and I am now 3 months + post-operative and actually doing great!  

I am still seeing an ENT/Otolaryncologist who discovered that my Cricopharengeal muscle goes into spasm and the muscle is thickened due to GERD damage.  That could maybe explain your "lump in the throat" feeling.

Please let us know if we can help with further info and keep us updated.

[Carumba]

My LPR situation is one that I am still trying to get a handle on... One part of it I think is due to food intolerance leading to the stomach attempting to reject its contents.  A reason I say this is when I had a stomach infection once, my stomach definitely closed up its lower sphincter, raised stomach acid levels and tries to kill the infection.  I think that is similar in GERD/LPR where the stomach senses a problem (allergic response to food) and then tries to reject or neutralise the contents.

Mine started after a viral infection and food poisoning, which I think has buggered up some nerves (Vagal nerve neuropathy seems likely but not confirmed).  Also a major food poisoning event before has left me with a weakened LES as confirmed by an endoscopy.  All this may have caused me asthma also.

I have tried many things, and found that whereas PPIs offer some relief they are not a consistent solution.  Digestive enzymes help, and anti-histamines can provide some control.  Also a prokinetic drug can be prescribed and seems to help when the stomach won't empty (eg. Domperidone, but not available in USA).  I am trying that now to try and get the stomach clear before lying down at night.

Soon I will try Zantac again, as it is essentially an anti-histamine, so may solve two problems in one.  I am also interested in trying D3 supplementation.

Problem is that every day brings a different level of problem, and it is hard to get a handle on the cause, or get any accurate measure of improvement when it can take a long time.  I am still trying, and it is very upsetting not being able to sing, and trying to not let the stress caused get to you.

Good luck to all...

[selmaS]

  Hi and welcome to the GERD forum.

Thanks for sharing ur GERD journey with us and what is working and not working for u.

Vit D3 is something we all seem to be low on and I do not mean just those with GERD, I mean people in general today....all the sun block, albeit good to prevent skin damage it is also blocking out the necessary rays we need.

Also I found if u do not have enuff magnesium u will not absorb the vit D, so have a full blood panal done.....GERD meds can strip us of naturally occurring vitamins and minerals....so do check and make sure u r working with ur Dr to get the right ones and the right dosage for u !!

[Pmac21]

Symptoms

History of food sensitivities, allergies, and drainage problems. Also anxiety and self noticed arrhythmia.  Rare atrial palpitations found on 24 hr halter test two years ago. Heartrate at bed time usually 47-51 bpm, sitting during day 80-90 bpm. Take 24 hr zyrtec and multivitamin. 

Started with a lump sensation in my throat. Voice was weak and hoarse Dr. Tested for strep, diagnosed as laryngitis.

A week later developed small red sores in back of mouth on soft palate in front of tonsils. Went to ER said probably reflux. Did soft tissue throat X-rays found nothing sent me on my way. 

Went to primary care dr. They said probably thrush due to some white heads on a few sores. Started nystatin swish and swallow. They tested strep, bacteria and fungal culture, blood tests for thyroid, autoimmune screen, std screen, HIV, general blood screening, and etc. only thing was low good cholesterol. 

In the meantime I lost 10 lbs from start of symtoms to now due to lack of eating I didn't like how I felt from the lump sensation.  Lost 35 lbs since January due to anal fissure an diet change resulting. Treated with .3 nifedipine Compound ointment applied to affected area just prior to these issues starting and overlapping. Used it 3 times daily pea sized amount for 5+ weeks.  Fissure healed upon last visit 2 weeks ago but sometimes bleeding still occurs. Had colonoscopy done in feb and found nothing else.

The sores burned excruciatingly and I started taking tums and Prilosec upon suspicion of reflux.

One developed into a large aphthous ulcer that was larger than the eraser of a pencil. 

Eventually this went away about two weeks later. Saw ENT who diagnosed me with just an aphthous ulcer. Looked in my throat with a mirror apparatus since I gagged out the scope in your nose.

Symptoms improved with the sores about a week, I continued the prilosec and propping up my head and back when sleeping pretty substantially.

Constant bitter taste in back of mouth. Throughout waking up in middle of night with dry sour mouth . Would take tums and go to bed. 

Symptoms recurred and constant strangling sensation and dry difficult sometimes painful swallowing of saliva and liquids. No problem swallowing foods whatsoever.

Went to my gastro, had endoscopy done to my duodenum. Found nothing. Ate, went home, slept an hour woke up and felt fluttering in my throat with rapid heart race. Felt like a moth was literally stuck in my larynx.  Not sure I it was palpitations, cricopharyngeal spasm, but I panicked. Called gastro said to go to the ER, didn't, it went away in about a minute. Called my family dr to come in. They tested me for food allergies via blood RAST test. Came back normal. Said I had anxiety and prescribed me celexa 20mg.  I was on this medication about a year for general anxiety but have been off it for a year with no major relapse.  Of course I'm anxious due to not being able to find out what's wrong but I believe this is secondary to my symptoms. Looked up crico pharyngeal spasms and laryngopharyngeal reflux. Both of which I find my symptoms adequately match, however I've been in Prilosec and Prevacid for over a month and increased up to 40mg a day with little relief. Now my stomach hurts an feels like I'm not digesting foods properly. A lot of gas, bloating, sharp pains in lower abdomen and feeling of food not going down when I eat. I am still eating, but things are getting to where I might stop again. Thinking it may be from the PPI but afraid to stop taking it.  No heartburn ever throughout all of this. Very very frustrated. As you can tell ive become pretty obsessed with my Internet research because I'm sooo freaking miserable. Can you help me?

[Sharing_is_caring]

Greetings to all. I recently had symptoms of LPR and GERD and have been a frequent reviewer of these forums to try glean any insight from fellow sufferers. On the advice of my doctor, I was advised that a recent 10 pound gain in weight that I put on in my stomach area might be contributing to the problem. How so?

The doctor suggesting that while I may have expanded my waist size, my clothes nevertheless remain the same and thus, wearing these clothes (including underwear) causes a greater restriction from the expanded waistline. I started to wear looser-fitting clothing and my symptoms improved noticeably.

Google Tight Pants Syndrome. Belching, distension and heartburn, amongst other manifestations, are common under this premise. Think about how logical this is since motility of the bowel is adversely affected by tight waistbands.

Hope this may help some.

[Shon1234]

I just visited an ENT about two weeks ago or so.  He said that I probably have LPR after performing the usual exam.  Over many years (not quite sure how many), I have often had a lump feeling in my throat.  As I get older, it seems to get worse, along with a terrible post nasal drip.  Sometimes, it would go away for a couple of years then come back.  Not sure if stress triggers it back or what. He put me on prilosec OT.  I took for three days and noticed no results.  Went back to regular eating lifestyle.  Got smarter, and went back to taking the Prilosec and being patient.  Changed eating style while reading Dropping Acid....and I must say that I am feeling a little better.  Less anxious, throat doesn't lump up as much after I eat (smaller meals now), still have nasal drip, but remaining positive.  

Sometimes, medicine will work if we are patient, but when you are uncomfortable, you like a quick fix.  I really think the food change is helping.  I do not eat fried food, spicy food, chocolate, etc.. The Dropping Acid book offers tons of foods to eat and not to eat.  Hopefully, I won't drop too much weight because when trying to eat the proper foods, they contain very little (heavy-make-you-full) fattening foods.

My doctor told me to make sure and take it for a while because it takes time for the medicine to actually work.  So far, no side effects and my throat has a slight tickle throb-soothing feeling going (way better than before) and I even feel more better each day.

[Roberthart66]

I am not sure if this is helpful, but I was taking high dosage (80 mg.) omeprazole (prilosec) and it was having no effect.  I recently switched to Nexium and I am experiencing a significant improvement.  I take 40 mg. Nexium at night and 20 mg. omeprazole before breakfast.

[marlene2013]

I have been coughing non stop to the point of throwing up for 3 months now. This all started after a bout with bronchitis.  I am miserable and cannot work as I must spit every minute or two. I also have post nasal drip and after being diagnosed with GERD I feel like it is LPR. I have no reflux in my throat and when I lie down I actually feel better.  Should I see an EMT?  The doctor I am now seeing has put me on 40 mg of Protonix twice a day.  I feel after 2 weeks I am only maybe 20% better and still not able to be out in public or back at work.  I am getting very depressed.

[Puplet]

How are you doing now Maureen? I've had this same LPR issue (diagnosed by ENT last year.) It went away for 6 months, but now it's back with a vengeance. The coughing is just awful. Nothing seems to help it: cough syrup, PPIs, irrigation, steam, elevated bed. I can't get a full night's sleep.

[selmaS]

  Hi and welcome to the GERD forum.

2 weeks is not enuff time to critique how well u r doing on this med...it can take another week or 2 provided u have modified ur diet and lifestyle too.

Since u have PND, going to an ENT may be a good idea, but it may be as easy as taking an antihistamine, I started with one b4 bed and it not only helps me sleep but has cut down on the PND and in turn my reflux.

So do u have a lump in ur throat?What symptoms do u have other then   the vomiting that u feel it is LPR?

[noanannuck]

I too have LPR as well as Barrett's Esphagus Disease and MTD (Muscle Tension in my neck and throat). I am on my 2nd Voice Therapy lesson this week. I also have already had the Laproscopic Nissen Fundoplacation surgery in Jan 2012 and ended up with a 1 in a million leak and 7cm bacterial mass near the wrap that landed me in ICU. I've had 1 EGD with Dilation this Jan 2013 and was Diagnosed with LPR in Feb (Last month). I'm new with all this and I'm not even 40 yet so any tips etc you get I'd love to have and visa versa. I have other things too (Hashimotos Autoimmune Disorder) High lipids, cholesterol, Ostepenia at age 30 and the Reflux disease in 3 areas. If anyone lives in GA maybe we can help each other.
Nat

[Red_Star]

I hope they tested your pH levels. Hypothyroidism is one of the well noted causes of low stomach acid as metabolism slows down the stomach acid production.  Low stomach is by far more common that high stomach acid but both can cause heartburn, reflux, GERD, LPR (LPR is one of the causes of muscle tension dysphonia).  

Low stomach acid is a risk factor for osteopenia as you need good levels of stomach acid to absorb nutrients.  Vitamin D and calcium deficiency are both risk factors for osteopenia.

The top three nutrient deficiencies found with hypothyroidism (in most cases in developed countries hypothyroidism is due to Hashimoto's thyroiditis), are vitamin D, iron, and vitamin B12. Vitamin D is essential for calcium absorption. Magnesium is the boss of vitamin D and calcium so if taking supplements for vitamin D and calcium magnesium needs to be in good supply as well.

After a poor diet, hypothyroidism is the second most common cause of high cholesterol. It is common to be undertreated with hypothyroidism. I can't tell you how many comments, websites and books are on this subject but it's numerous! This can be anything from doctors using the TSH to determine thyroid dosage to poor conversion of T4 to T3 to cellular resistance issues.

[noanannuck]

I've had 2 Bravo 48 PH tests and plans are to do one down my nose in May 24hours PH test to my throat/LPR

I've been having a ton of Hashimotos coomplications lately. If I even look at any form of Diet pill that has Niacin or anything familiar I turn Bright red, hot to touch, ears, face, neck chest flush etc.

With having so many Diagnosis's, it's been really hard on me.

[Rob_Dee]

Nice forum you have here.

For 5 months I've been waking with a very dry throat and mouth and lots of mucus in my throat.  I finally went to an ENT specialist who put a  camera up my nose and down my throat and straight away said my problem was "Laryngopharyngeal Reflux (LPR)".

Ive known for year I had a large hiatus hernia, but now my problem is apparently stomach acid etc getting into my throat and mouth and this causes mucus in the throat and a very dry mouth & throat when I mouth-breath at night (which I often cant help).

Funnily enough this dry mouth/mucus problem seemed to start around the time I started the process of moving house, which as everyone knows can be a very stressful time. So I'm hopeful that once the house move is finally out of the way I'll again be free of LPR symptoms - as I have been for years since being diagnosed with a large H.Hernia around three years ago.

Anyway, my strategy for coping is to try and keep to a low acid diet, i.e.  no fruit juice (especially not orange juice), no coffee or tea. No yogurt (very acid), no chocolate (damn!).  I'm also now taking Organic Aloe Vera juice (100% daily). Its a very good healer and anti acid. I got it on Amazon. Its not cheap but you dont need a lot. Before swallowing it I gargle a bit with it to help heal my acid throat. I'm also thinking about buying 100% cocunut water to drink ...again an excellent cooling anti-acid.

I dont take meds but prefer to take herbal anti acid tablets (called Amlant),

I''m very aware these days of how tight my jeans are and how I really need to wear loose fitting clothes to ensure that I'm not pushing my stomach acid up into my throat (after a meal, especially if I bend down).

While searching the web tonight I came across a video by an ENT guy called "The Dreaded Diagnosis of Laryngopharyngeal Reflux Disease".
Scary title but interesting info (and maybe worth a Google).

All for now,

Rob

[marlene2013]

Thank you for your reply.  I have not been on here and just now saw your note.  I am still coughing and spitting up phlegm constantly.  After being on Protonix for 6 weeks  I am a bit better during the morning but after lunch my cough gets worse and after dinner I cough constantly until I fall asleep. I no longer throw up but the cough is severe.  I think the Protonix may be causing insomnia as I can't fall asleep until 2 or 3am. I had a cat scan 2 days ago and will get the results next Thursday. (a week's wait!)  I guess if the scan is clear then other tests may be ordered.  It is hard to think that I have to live my life like this. I have been coughing since Dec 15th, 2012.  

[dirk4111]

Having been diagnosed with LPR, I know how you feel. My suggestion - check out this site (http://amzn.to/11C3RDp) to get plenty of useful info about LPR. It will help you to become a better advocate for yourself with your health care provider. Best of luck.

[sisterrenee733]

hello, please know that you can get a NON flushing Niacin! B6, via the company called:

Standard Process inc.  i get mine from my Chiropractor, but you can on the website and get info from them about it.


i have LPR and Gerd, take a PPI and another drug to tighten my LES, was doing fairly well until allergy season, my postnasal drip has me back living in misery again with the throat thing, most of all, i find the sensation of choking twenty four seven, the hardest to deal with, anxiety rules when you feel like you are being choked to death every second, anybody relate?
i am new to this forum, would love some advise on how to breathe and swallow again,     God Bless you all,  Sister Renee'

[lecrbc]

I started having symptoms of LPR in Dec 2012.  I started having a lot of burping in the evening especially. I never have heartburn but have the phlegm and the throat irritation with lump sensation as well.  This is very annoying and I am not sure the extra Nexium is going to do anything for me.  I have been taking it now for about 6 weeks.   I had been taking Nexium for many years (40 mg in am).  I had the Bravo test and it did not show real high acid levels associated with the burping.  My Gastro increased my Nexium to another 40 mg before dinner.  I have a hiatal hernia which I was born with.  I am contemplating going on the Medifast Diet plan to both lose weight and also eat smaller portions of food.  I do not think that any one thing  or another causes me more symptoms.  I don't know whether to take digestive enzymes either.  Have PPIs helped you at all?

[selmaS]

  I too have a hiatal hernia....and it does seem like meds do not work when in a flare....but avoiding certain foods is helpful as is making so lifestyle changes...ie- elevating the head of the bed, .....

Keep in mind changes in weight be it a gain or loss can also trigger more GERD symptoms.

Eating more meals, but smaller meals in a day may be helpful to u and just eating healthy...exercise .....

I no longer take PPI's as they stopped working for me, I now use the H2inhibitors....they work for me along with modifying my diet and lifestyle.

See tips in the Health Pages.

And do talk to ur Dr in regards to med changes/concerns and diet changes.

[lobsterguy]

Have you ever heard of irritable larynx syndrome?   It causes a chronic cough and is treated with amitriptyline