Does surgery work for Laryngopharyngeal Reflux (LPR)?

Posted by Bpositive @bpositive, Jun 13, 2017

Since December 13, 2016. My symptoms started with a soar throat, soar inflamed taste buds on the tip of my tongue and inflamed salivary glands on my soft palate. My tongue, throat and soft palate had a painful burning sensation that was on and off. My General practitioner referred me to an Ear Nose throat specialist who referred me to an oral surgeon who referred me to an oral pathologist for burning mouth syndrome. After wasting 3 months of running around with these Dr's and being tested for oral thrush, hsv tests, vitamin deficiency tests, auto immune deficiency tests, cultural bacteria tests all which came back normal. I decided to go for a second opinion with another E.N.T. specialist who performed a camera scope and diagnosed me with acid in my throat. I was put on Dexilant and noticed the pain dissipate almost immediately only problem was I couldn't tolerate the medication. I was then put on Tecta and referred to a G. I. My general Practitioner did some blood work for h pylori and I tested positive. I started to develop tinitus in my left ear. I had a gastroscopy where they found a 2 cm Hiatel Hernial and my lower sphincter was weak. Thats when I was told I have a mild case of gerd, but I don't suffer from any heart burn. I was put on triple dose of antibiotics for h pylori and continued with the Tecta, domperadone and sucrolafate. I'm getting a little relief from the PPI and meds but I still suffer from bitter reflux taste and burning pain in my throat, soft Palate, the tip of my tongue and dry mouth that comes and goes. I'm in the process of having a 24 hr ph level test done. The G. I. I was seeing says my esophagus biopsy tested clean and he doesn't believe what is happening in my oral cavity is related to my gut. He stated in order for acid to travel to the throat it has to travel through the esophagus and the esophagus tested clean. Thus he can't help me anymore. I'm so confused my ENT says I have acid in my throat and the G.I. doesn't agree.

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jdecks | @jdecks | Feb 17, 2023

In reply to @jsfr99 "What does your diet consist of? What do you usually eat?" + (show)

I think what I don't eat now made the biggest difference. I have always had a sugar addiction. Some of the most extreme at an early age involved me with a spoon and a sugar cannister. It wasn't raw sugar anymore when I hit my teens but no less harmful. Did not help that I was tall and always thin so I didn't see any reason to slow it down. Fast forward to age 59. I had not had any real health issues until then so I was lucky. The LPR felt like it came out of nowhere but looking back I probably had it for years. With the testing came a lipid panel and my triglycerides were nearly 400 - So I found this part out first.

As mentioned I read a lot and knew sugar had to go, I concentrated on no other food elimination except the sugar at first because it was the worst. After the LPR I started removing more foods. The mints and ACV is what I think made the biggest difference. Concentrating on my diet I then removed meat and dairy. I'm not a huge veggie fan but still drink smoothies so I put in there what I don't like mixed with fruits. I also loved stir fried veggies over rice with Tamari and spices. I stopped eating most processed foods. I have more time to cook from scratch now because since Covid I have been working from home. The only citrus fruit that I eat is lime because citrus is bad for LPR. It's not easy and I do not preach my diet to anyone else. I feel great eating mostly healthy. Olive oil occasionally. I don't follow any rules other than my own as far as carbs. I do eat tortillas, pancakes, pasta and white rice. I use oat flour over white flour if I'm baking. My sweet tooth is still with me but I use maple syrup and fruit now. Seriously, applesauce and raisins help. Mild salsa over spicy and soups are great. I don't think there is any one answer to controlling LPR for different people.

jsfr99 | @jsfr99 | Feb 18, 2023

In reply to @jdecks "I think what I don't eat now made the biggest difference. I have always had a..." + (show)

I was diagnosed with LPR a few months ago. Thank you very much for sharing what has helped you. What medications are you taking right now? How long did it take to work? I'm taking omeprazole and trying to follow the diet, but I don't see results yet. What symptoms did you have? Thank you very much again and I hope you can help us

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jerrysgirl3 | @jerrysgirl3 | Feb 19, 2023

In reply to @jdecks "I was finally diagnosed in 2019 after so many tests. My GP was on Medical leave..." + (show)

@jdecks

I was finally diagnosed in 2019 after so many tests. My GP was on Medical leave so another doctor in the practice ordered all the lung tests. I had shortness of breath, extreme excess phlegm, a feeling of something stuck in my throat, small bits of food getting stuck and chest pressure. The chest x-ray, cat scan and breathing tests made me relieved but did not solve any problem. I was prescribed Prednisone and that did partially clear my throat and relieve the chest pressure but my main symptoms persisted. I tried a few home remedies which did make me feel better temporarily. Next, I made an appointment with a Cardiologist. After EKG, Echocardiogram and a nuclear stress test found nothing I did not know where to turn to.

I was thinking Allergist and decided an ENT doctor would be better first. Well he knew pretty quick what it was. Trying to make a now sceptic patient believe it could be so simple as diet related took some convincing. He put the tube through my nose to my throat and prescribed Prilosec. I scoured the Internet for LPR which I did not know existed. At that time I did not have a great diet but consumed a lot of healthy food and drank lots of water. Every morning I made smoothies for myself and my kids. Like a lot of other people Apple Cider Vinegar was a regular part of my life. If you look even now you will still see that people swear by ACV to help with their acid problems. I stopped using ACV / water mix and kept it out of my smoothies at the same time I was taking the medication. Because I read a lot online I learned my other culprits as well. My afternoon espresso and the mint candies. I didn't seem to have a problem with tomatoes as long as they weren't mixed with spicy peppers. Not every LPR sufferer will have the same triggers. My life was saved by just food changes and 8 months of Prilosec. I will say that due to this issue and also high triglycerides I completely changed my diet. I don't think you need to go to extremes but I'm now Vegan - WFPB. ACV - even the smell makes me sick and causes my throat to burn. I actually do vomit if it's in anything I eat. I don't believe I'll ever be cured but it's very rare that I have symptoms now. I really do think ACV is so bad with anyone with LPR.

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I see now that my thyroid nodes that didn't respond to leukemia meds was probably (and still is to a lesser extent now that I'm aware of reflux) due to the reflux and not due to medicine not working.....at least I think!

navia | @navia | Feb 20, 2023

In reply to @jerrysgirl3 "I see now that my thyroid nodes that didn't respond to leukemia meds was probably (and..." + (show)

Our bodies are so complicated that sometimes we can figure things out more than the Drs because we know ourselves better than they do. What a lucky day it was when you saw the young intern. Sometimes a fresh pair of eyes is needed. Also, remember that some Drs passed their exams in the bottom half of the class!

avamaeve | @avamaeve | Feb 21, 2023

In reply to @cmdw2600 "Has anyone been diagnosed with silent reflux or LPR? This is a condition where there is..." + (show)

Yes, I had silent reflux a few years ago. It was a horrible, miserable experience and it took me a long time to finally get the correct diagnosis after going to many different specialists. I had a chronic cough, very sore throat, and had nasal irritation and a continuous nasal drip. Actually, I was diagnosed with acid reflux, not silent reflux, and was told to take OTC medications and a few foods to avoid - that did not work for me at all. My gastroenterologist prescribed the drug named Dexilant. It was very expensive, totally worth it, and I only took it for about 3 months. In addition, I totally eliminated foods that could possibly contribute to the reflux. I highly recommend that you get the book by Dr. Jamie A. Koufman named The Chronic Cough Enigma: How to Recognize Neurogenic and Reflux Related Cough. She provides recommended foods to avoid and a lot of other good information. I believe that she still has a practice in New York City. I hope this info is helpful to you.

jsfr99 | @jsfr99 | Feb 22, 2023

In reply to @avamaeve "Yes, I had silent reflux a few years ago. It was a horrible, miserable experience and..." + (show)

¿What do you usually eat? Did you take the medication on an empty stomach?

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avamaeve | @avamaeve | Feb 22, 2023

In reply to @cmdw2600 "Has anyone been diagnosed with silent reflux or LPR? This is a condition where there is..." + (show)

I followed the guidance that was in Dr. Koufman's book. You can find a lot of valuable info on her webpage under the blog section. One of them is this article:
https://jamiekoufman.com/is-a-vegan-or-vegetarian-diet-good-for-acid-reflux/
As far as the medication, I don't remember if I had to take it on an empty stomach or not. Dexilant is a drug that you need to wean yourself off of. Fortunately, it was very effective for me.

I hope this is helpful.

eileenb1022 | @eileenb1022 | Feb 25, 2023

In reply to @cmdw2600 "Has anyone been diagnosed with silent reflux or LPR? This is a condition where there is..." + (show)

Hi, I think most likely i have sient reflux/ LPR. i see a ENT this coming week. i have had the symptoms for about a year. symptoms started shortly after my galbladder surgery. i did have the 24 hour monterty ph test. which was very unpleasant but it came back negetive. i never thought i had gerd my GI at the time did cause i was overweight. but i did see a ent last summer but he was awful. at the time i was hoping my symptoms were just worsening allergies. ( i later found out it wasnt. ) but this ent said i had silent reflux but he did no kind of testing, just put that string up my nose that gives you a picture and then he started talking about surgery, etc i just looked at him strangely. i did not have a good feeling about him then basicly he gave me a script for astylin which is a very strong alergy nasal spray. his words to me was to use the astylin for 4-6 weeks. if it works its allergies if it doesnt its silent refux and basicly that was it so i never went back to him. i am hoping this new ENT i will be seeing is much better. i do have a routine i do at home just to give me temp relief. but i am hoping this new ent wil be able to let me know for sure and give me ideas better ones for me to do.