Laryngopharyngeal (LPR)/silent reflux SOB has me confused and hopeless

@baguette That is like me I exercise a lot and I consume a lot of water during the day and my issue is that I have to separate any intake of liquid for about 5 hours before I can eat any food or else the phlegm builds up and the forced feeling to want to burp happens. This is really rough.

You can get a lot of good, free information here: https://jamiekoufman.com/

If I were you I would stick to the low acid, whole food diet for a few months. Dr. Koufman and Dr. Aviv have versions of the diet. Pick one. There is a FB group with lots of recipes based on Aviv's version: https://www.facebook.com/groups/199013402360712.

I would also keep a food diary and see if any food triggers an attack (the attack doesn't have to happen immediately, which makes the diary more important so you can track .

Other things you can do is sleep with your head elevated; if you are a side sleeper, do it only on your left side to decrease the odds of an acid/pepsin attack. Eat three meals with snacks in between, with the meals being smaller than you may be used to. Try an alginate to create a plug in your stomach to keep acid in place; good to use before bedtime. Other people have found that manukah honey and aloe vera helps them. There are some videos online touting breathing exercises for mitigating GERD. Some people buy OTC h2 blockers like Pepcid to help them (short-term). And follow the adage of chew your food very well. Digestion begins in the mouth.

In short, you have a lot of tools at your disposal that you can experiment with on your own and track what works for you. Don't expect immediate results. It took time for the condition to develop to its current state and it will take time to heal. And yes, some people have to stick with these changes for the rest of their life.

If you go to a doctor, you will probably be prescribed medications for GERD. These are higher doses than the OTC versions. You have to decide whether you want to go that route. Sometimes it's good to do meds short-term to quiet down the GI tract. Be aware that some doctors will tell you to stay on the drugs forever. My neighbor has been doing that for 15 years no problem. I did that for 4 years and developed kidney disease and daily diarrhea and B12 deficiency. If you opt for long-term meds, my two cents is to make sure your doctor regularly monitors you for side effects via blood tests. And care for your bones, because there are some studies suggesting an increase in bone fractures with long-term use.

They may also prescribe a drug for your stress. You are correct that anxiety can worsen reflux.

This is a difficult condition to manage. It is overwhelming and a PITA that GERD/LPR is split between two specialties. I find eating the more frequent, smaller meals difficult because I am exercising sometimes two or three times a day, and exercise can spur an attack. The type of food and timing becomes a puzzle those days that I am slowly putting together. I chew sugarless gum a lot to manage exercise reflux, or take an alginate before exercising.

One more thing: Holistic doctors will tell you to drink filtered water. I have finally switched to that and found that it does help. Be aware that some filtering systems leave the water acidic, in which case you have to add a pH balancer. Or you can buy a system that both filters and makes the water alkaline. It is the only water I drink.

Be kind to yourself. Literally take a deep breath. Lots of people have this condition and are confused and overwhelmed until they find their footing. I wish you well.

@baguette What type of water filter machine do you think are best? I have seen Alka Viva or Tynet but those are like $4000. I even tried a product called reflux gourmet that has alginate did nothing for me. I think the tricyclics are the best to modulate the human brain. Deep breathing is fantastic but I have not learned how to breath properly yet( ie Diaphragmatic like a singer). At the end of the day the Vagus nerve controls 80% of our system that is what needs to be repaired. I Hope everyone on here suffering from LPR can get healthy really soon. I feel everyone's pain this is no way to live

@boodine44 I didn't do a deep dive into water filters. My friend a nutritionist said get something like a Brita and that alone will be an improvement. I got a slightly pricier pitcher with filter from Zero Water, which is now part of Culligan's. With my pitcher, and perhaps a lot of others, it boosted the acidity. I have to use pH drops to make the water alkaline. Dr. Koufman talked of a pitcher she uses that produces alkaline water without the drops. Have you ever heard of the Iqoro device? It's not available in the US, it's a European product. You can google and see the claims about how it strengthens your diaphragm. People in the US have bought mouthguards with straps to mimic the Iqoro. The guards are cheap, you may want to buy one and follow the Iqoro directions. It's not a quick fix, expect to do it for months before seeing progress. As for alginates, I use Gaviscon Advance, which is the UK version with more alginate and no aluminum. It has helped me a lot, especially with chest pains. Have no idea why, maybe it's a vagus nerve thing. Anyway, I don't use it that much anymore because I am eating mostly whole and minimally processed foods that are low acid. It's pricey, you'll have to decide whether it's worth experimenting with. The UK version is commonly considered the premier alginate with more of the active ingredient. The US version I wouldn't bother with. The UK version does not taste as good as Reflux Gourmet, and if your throat is sore from acid the GA will sting at first. I knew I was improving when that sting went away (alginates are rich in sodium). Good luck everyone!

@baguette You know what happened to me?? I felt like I was choking and food was getting stuck for 2 months. I was so scared I could not swallow the medication. I even tried the liquid form and on the 4th day gave up because that as well felt like it was "dragging" like peanut butter. Now I can eat anything so I might start Nortriptyline soon. Thank you. By the way I love "baquettes" great name since I am French I thought I would say that!!