Laryngopharyngeal reflux (LPR)

Posted by sanchopanza @sanchopanza, Jul 7, 2019

Hi. My problem started about a month ago when I started chugging down a glass of water and suddenly I had a spasm in the area of my pharynx. It scared me, and took several minutes to abate, but no other symptoms. Soon, I found that I could no longer drink orange juice without the same problem, and then ice cream gave me very thick saliva that was difficult to spit out as well as the tightness in my throat. I had had problems with normal heartburn in the past, but a few days of ranitidine (Zantac) and I was OK. I think this was because of my taking ibuprofen on an empty stomach. If the Zantac didn't help, which was seldom, I took Prilosec for 3 days and it was gone. Now, after the spasms, I began burping and having hiccups frequently, which was new to me, so I started on Prilosec 20mg once a day. I also changed my diet to conform with the diet for GERD and I think I'm beginning to get better, but it's taken a lot out of me because I've been on the same diet for a long time and all of a sudden I'm missing crucial nutrients that I ordinarily get. By the way, I"m 69 and have been healthy and disease free for at least 20 years. I want to discontinue the Prilosec because I've only been taking it for a little more than two weeks. I'm wondering if I could switch back to the Zantac 150mg twice a day without experiencing rebound symptoms because I've been on the Prilosec for such a short time. I can see that there are many people here with digestive health problems and I'm hoping someone can steer me in the right direction. My doctor is very good at giving labs and writing prescriptions, but he doesn't seem to do much doctoring, but that was OK, because I haven't had any serious health issues. He just told me " You know you have to see a gastroenterologist". Because of the holiday I haven't been able to schedule an appt. yet and now, with some of the symptoms lessening, I'm hoping there's a chance that I can switch to Zantac, or preferably cimetidine (Tagament) which helped me greatly when I developed an ulcer many years ago, and solve this problem without any intervention. The reason I want to stop taking it is because of the side effects. I've had diarrhea a few times and lots of headaches.I"m also worried about the things that can happen when you have so little stomach acid. I"d appreciate any comments from people who have had experience weaning off Prilosec after short term use, or anyone who has suffered with LPR or laryngopharangeal reflux, or anyone at all. Thanks for listening!!

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@kbro2010

No, I do not have a hiatal hernia. They would have found it during the esophagram or EDG. I am not currently taking ppis. I was on omeprazole twice a day for a month with no help. Then pantoprazole twice a day for two months with no help. The side effects were awful so I stop taking them. I’m not a fan of tight clothing. And with the weigh loss all of my clothes are huge.

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Are you avoiding trigger foods - coffee, chocolate, mint, thick red tomato sauce, wine. Sometimes a person needs to eat 5 small meals instead of 3. Chew slowly. Also it could take about a month to two before you see improvement. Hopefully the test in January will give doctor more info. Have you had a esophageal manometry test? I found out that I have that in addition to a HH. There's a new drug that was recently approved that's different than PPIs. It's originally from Japan. Vonoprazan is the name.

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@jackielb

Are you avoiding trigger foods - coffee, chocolate, mint, thick red tomato sauce, wine. Sometimes a person needs to eat 5 small meals instead of 3. Chew slowly. Also it could take about a month to two before you see improvement. Hopefully the test in January will give doctor more info. Have you had a esophageal manometry test? I found out that I have that in addition to a HH. There's a new drug that was recently approved that's different than PPIs. It's originally from Japan. Vonoprazan is the name.

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I have avoided trigger foods since August 3rd when I found I had LPR. Im not a drinker. I would have the occasional soda that’s all. I’m on a low fat, low acid diet. And I’ve lost 30lbs 🙁 I’m now 105. I have always been a slow eater. That eats small meals. I have recently started to had a small snack between lunch and supper. I eat supper before 5pm to give it time to digest before bed. I have not had the manometry test. That was one of the test my GI doctor suggested after the Bravo. Thank you for replying

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@lhabada

I'm and 82 Y.O. male who was able to eat and drink most things during my life, but I did have a lot of stomach acid and I ate a lot of tums for years. Age has a funny way to sneak up and show your health problems you didn't know you had. About 114 days ago, 5 of my buddies and I were playing our weekly card game. Of course, we drank some beer during the game as usual. After the game, I ordered a pizza to take home. After eating just two fairly small pieces of Pizza I developed a severe stomachache. My wife drove me up to the local ER and after many tests determined I needed immediate surgery. My stomach had grown up thru a hole in my hiatel hernia into my upper chest cavity between my lungs and rib cage. The surgeon pulled the stomach back thru the hole back where it belongs and used part of the stomach to do a 360 degree wrap to close the hole in the hernia. The reason given by the surgeon for the 360d wrap, was so that I wouldn't have GERD after healing from the surgery. The surgeon went on to tell me that had the stomach burst, I probably would not have made it. (Nice news, right?) For 5 days following the surgery I was in considerable pain and couldn't eat or drink anything, so they went back in to cut the two Sucher's holding the wrap, but inflammation didn't allow them to get to the wrap, so they inserted a feeding tube into my stomach which I've had since. During the second surgery they determined the wrap had slipped down a little but there was nothing they could do about it because of the inflammation from the original surgery. As of today, I'm still taking Jevity 1.5 twice a day and just recently starting to experiment with soft foods and juices. The message here, is DO NOT wait to see a GI doctor if you are experiencing any issues with acid reflux. Had I done so, they could have corrected the hiatel hernia issue and I would probably be completely healed, which I am not yet. The surgeon said we will just have to have patience to see how it heals. My quality of life has changed for the worse because I was too stubborn to see a gastrologist. Suggest you take heed if you are experiencing any stomach issues.

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Adding to my history above is the following. Today's date is 12/21/2023 and I am now a young 84-year-old male. I had the G-Tube removed after eating and drinking everything to sustain life 131 days later. I am still not able to eat hardly any normal meal because while undergoing a gall bladder surgery, the surgeon observed I still have a hernia in my esophagus and still unable to eat a normal meal and still experiencing acid reflux. I'm seriously considering applying to the Rochester, MN Mayo Clinic to see if they would take my case to rectify the condition.

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My gastro doc advised me against a nissen fundoplication because esophageal manometry showed i had presbyesophagus that causes motility/swallowing issues. He put me on 30 mg of amitriptyline but 20 mg keeps my spasms under control. There's a surgeon in Austin Tx - Dr. Francis Buckley - conducting a clinical trial for a new GERD/Hiatal Hernia procedure. There's also a new acid reflux med that's been available in other countries for some time now that is different than a PPI. It's called vonoprazan.

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