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Old 06-01-2005, 06:11 PM   #1
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Laryngeal pharyngeal reflux (LPR) questions

Hi Everyone,
I am new to this board. My ENT doc thinks I may have laryngeal pharyngeal reflux (LPR). LPR is extraesophageal with reflux going up into the throat and vocal cords, etc. The cartilage above my vocal cords are reddened (arytenoids). I wake up every day with a sore throat. I'm also having weird symptoms such as mouth and back of throat burning, a lump like feeling only when I swallow, and now within the last month bilateral ear pain. I've tried Aciphex which didn't work and now am on Nexium 40 mg twice a day. I'm not totally convinced it's all reflux. Unfortunately the gold standard is to do a 24 hour double probe PH metry but no one in my area offers the dual probe. I've been to 3 ENT docs and am going to see a rheumatologist and a fourth ENT doc next week. Do any one you with LPR get strange tingling/burning sensations behind the tongue/mouth/throat? And how about severe ear pain that comes and goes? I also have an enlarged goiter/hasmimoto's so it may be an autoimmune thing going on. Thanks and if anyone has any info. or experience to share I'd appreciate it.

 
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Old 06-01-2005, 06:38 PM   #2
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Re: Laryngeal pharyngeal reflux (LPR) questions

With me, I think the throat discomfort from the reflux caused some teeth clenching from trying to sleep in odd positions to get relief. SO I got tooth pain, and TMJ can cause ear pain. Its just a thought. Ive been putting this all together for YEARS and Im still not sure Ive solved it all!!

 
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Old 06-01-2005, 08:45 PM   #3
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Re: Laryngeal pharyngeal reflux (LPR) questions

suncat,
I too have an enlarged thyroid but no one knows why. All bloodwork always comes back within normal ranges. But it does change from low to high each time its tested. I also have 3 nodules. I have a horrible lump in my throat for over a year. A bitter taste in my mouth and the feeling of a swollen neck even though it looks normal. And at times swollen lymph nodes in my neck. I've recently been diagnosed with lpr and have been taking nexium 40 2x day for the last 3 weeks. Really doesn't seem any improvement. But I figure it took years of damage to form and it won't go away overnight. So I just keep plugging away and hope to see improvement soon........

Patti

 
Old 06-02-2005, 03:44 AM   #4
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Re: Laryngeal pharyngeal reflux (LPR) questions

Hi all,
ive had a bad time of it also,started with full feeling in my ear and a lump feeling in my throat, then started to get heartburn inside my nose feels like its burning lots of mucus ear pain i was given omeprozol 40mg a day and the heartburns gone but all the other symptoms have stayed do you think its LPR?

Miss L

 
Old 06-02-2005, 03:46 AM   #5
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Re: Laryngeal pharyngeal reflux (LPR) questions

Oh yeah forgot to mention my throat and tonsil area always look red and my tonsil tisue on one side looks like it has been damaged theres holes there i think they call them cripts

 
Old 06-02-2005, 09:55 AM   #6
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Re: Laryngeal pharyngeal reflux (LPR) questions

One thing that helped me is to take xanax to break the anxiety cycle over it all. Not that anxiety was CAUSING my symptoms, but anxiety added to them. Dont let your Dr prescibe xanax and think 'its all in your head', though. It just helps while you are figuring it out. I only take it when the lump in the throat feeling gets too annoying.

patti, I have the bad taste in the mouth, too. Havent quite figured that out yet. Could be hormonal, viral, or part of this LPR thing from what I read.

 
Old 06-02-2005, 07:38 PM   #7
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Re: Laryngeal pharyngeal reflux (LPR) questions

Patti 23 and Miss L,
I was told by my ENT doc that it takes a minimum of 6 months to get LPR under control with proton pump inhibitors such as Nexium, Prevacid, etc. A good indicator that it could be LPR is having a fiberoptic laryngoscopy where the doc runs a tube into your nose down into your pharynx and looks at the vocal cord area which could be red and edematous/swelling, etc. They can do this in the office. The gold standard through is the 24 hr ambulatory double probe PH manometry. They put a tube into your esophagus AND pharynx for 24 hours to measure and record reflux activity. The single probe can yield a false negative result in people with LPR. It's used to diagnose GERD. I'm going to have to go out of town to find a doc that offers the dual proble. It just seems LPR is just now catching on as far as information and research being available. I'm amazed how my internist and endocrinologist didn't even know what it was.

 
Old 06-03-2005, 04:14 PM   #8
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Re: Laryngeal pharyngeal reflux (LPR) questions

suncat,
The 1st ent I went to thought I had a thyroid problem. But when my bloodwork was within normal ranges, he dismissed that. He ordered a barium swallow test because he wasn't sure what to do next when I complained of the lump in my throat. I never went for that (wish I had) but he seemed like he was fishing for answers. The 2nd ent I went to scoped me first thing and told me she couldn't believe the swelling and redness of my larynx. She's the one that gave me nexium and zantac. But after seeing my gp for something unrelated, he increased my nexium to 2x a day. I go back to him next week for a bp followup and he said we'll talk then. He did suggest I see a gastro in the future and did say maybe nexium is not the right drug for me. We all know that ppi's are hit and miss with everyone. But this darn lump is always there. But its only been 3 weeks of double dose. So lets see, I only have 5 months and a week before maybe I feel better. That's nothing compared to the 1-1/2 years, I've felt like this and nobody would listen to me............


Patti

 
Old 06-10-2005, 09:38 AM   #9
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Re: Laryngeal pharyngeal reflux (LPR) questions

patti23 and Miss L

I can't believe I have the same exact symptoms! My ENT says there is no damge at all to throat or vocal cords so I am completly mystified! He does not believe my lump in throat, fuzzy tongue feeling has anything to do with reflux. However, I do have a hiatal hernia and some inflammation around my lower esophageal sphincter. Can he be wrong after looking at me 5 times now?

tschuller

 
Old 06-10-2005, 11:11 AM   #10
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Re: Laryngeal pharyngeal reflux (LPR) questions

Hi everybody on this thread! I too suffer from LPR. There is a really good thread called "LPR info.-went to specialist" on the gerd board. It's a ways down the list so you may have to hunt for it a bit over several pages. I have looked for the original posted of this thread, "neverenoughslee", but haven't heard from them in a while. I am hoping they will post again to let us know how they are doing. Anyway-look around on the gerd board-there's lots and lots of very good information about LPR. At least we know we are not alone! It does seem that LPR is just getting the recognition it deserves in the medical world. Though it is not a serious life threatening illness, it sure can be miserable and a real "quality of life" issue.

I have been on PPI's for a little over 7 months an do seem to be making progress, albeit slow going. I injured my shoulder a little while ago and am also seeing a sports medicine chiropractor to help work out the shoulder problems. She advised me to try digestive enzymes to help with the reflux. I just started taking them a few days ago, but will keep you posted if they work. Can't hurt to try!

Last edited by Red Maple; 06-12-2005 at 10:28 AM.

 
Old 06-11-2005, 09:45 AM   #11
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Re: Laryngeal pharyngeal reflux (LPR) questions

hi -
I was interested in the LPR after reading these posts. I was DXed with GERD a couple years ago (no scope, just based on my symptoms) and I am wondering though if it is more involved than the doctors thought. I experience the same throat pain as mentioned above, and also when I wake I always have a sore throat. If I press the center of my thoat, in the collar area, (very very lightly) I start coughing uncontrollably. My uvula is very odd looking as well, and I have been recently having some odd pains in my chest, like a stabbing sensation.
I am 28, active and in good health otherwise! Very frustrating!

 
Old 06-12-2005, 02:01 AM   #12
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Re: Laryngeal pharyngeal reflux (LPR) questions

Note to tschuller

Interested to note your symptom of fuzzy tongue. By this do you mean a semi-permanent white coating ? I to have had this along with the lump in throat sensation. I also have other LPR symptoms such as throat clearing, PND / mucous, burning mouth. I had an endoscopy which highlighted a sliding hiatus hernia. A hernia and damaged sphincter are the main causes of reflux including LPR. It could be that any damage being done to your pharynx and larynx has not shown up as yet however the lump in throat is usually one of the first identifiable physical signs that LPR is taking place. Many others including myself have noted periods of coughing fits as the real pre-cursor to further trouble and for many remains a problem. This has gone away for me.

I would be interested to hear if you have noticed any dental problems such as enamel erosion, gum or cavity problems as well as the tongue coating. It is felt that continual exposure to even low levels of acid can damage this area as well as the delicate microbial balance of the mouth which can result in tongue coating and bad breath. Does your mouth and throat feel acidic ? My saliva is 6.25 an unhealthy PH.

Thanks

Last edited by ginger65; 06-12-2005 at 02:03 AM.

 
Old 07-09-2006, 06:50 AM   #13
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Lightbulb Re: Laryngeal pharyngeal reflux (LPR) questions

I have very similar symptoms. I have Hashimoto's Thyroiditis too. My doc just recently upped my Levothyroxin to 75, from 50 because he likes for my TSH to stay around 0.2 and it had just creeped to 4.5. My thyroid tests are within what most consider 'normal' range, but I have a goiter, hair breakage, and dry patches of skin, etc.

I am being treated for an ear infection and have been having ear pain for the past week or so. A couple of days ago, I woke with what felt like a big lump in my throat. At first I thought maybe it had something to do with my thyroid, or possibly even my ear infection? However, the feeling is more down at the bottom of my neck in the collar area. I also have GERD, undiagnosed, that I take a couple of Pepcid every now and then when I need to. I haven't taken it all that serious, um, until now. I've also been under a LOT of stress lately, so it could be that as well. I found a site about that too -- [url]http://www.nexiumresearch.com/globus_hystericus.html[/url]

So, I guess it could be any number of things?! At any rate, I feel better reading the posts because I immediately thought it was cancer and although I haven't ruled that out, I see that this lumpy feeling could be something else. Especially since it just 'flared' all at once.

 
Old 07-09-2006, 12:33 PM   #14
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Re: Laryngeal pharyngeal reflux (LPR) questions

I also have diagnosed myself with LPR, my doctor just calls it GERD.
My symptoms are mainly burping, coughing, waking with a DRY MOUTH (does anyone else have that??) and EAR PROBLEMS, constant clicking in my ear when I yawn or swallow, and last night had a full blown ear ache. I also at times have the throat burning and mouth/tongue burning..
I don't have medical insurance right now so am trying the natural route, but have tried several ppi's and don't really have all that much faith in them for me; plus I don't like the side effects. I've been on prevacid, zantac, and another one that's OTC.
This is just no fun..

 
Old 07-09-2006, 08:15 PM   #15
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Re: Laryngeal pharyngeal reflux (LPR) questions

Quote:
Originally Posted by backslide05
I also have diagnosed myself with LPR, my doctor just calls it GERD.
My symptoms are mainly burping, coughing, waking with a DRY MOUTH (does anyone else have that??) and EAR PROBLEMS, constant clicking in my ear when I yawn or swallow, and last night had a full blown ear ache. I also at times have the throat burning and mouth/tongue burning..
I don't have medical insurance right now so am trying the natural route, but have tried several ppi's and don't really have all that much faith in them for me; plus I don't like the side effects. I've been on prevacid, zantac, and another one that's OTC.
This is just no fun..
What natural route are you trying. I went to a Nature store and they told me to stop taking all these toxic ppi's and try the probiotic stuff at the store. Also bought some digestive enzymes although my domperidone will probably do the trick.
I get that tingling, spasm feel in my throat below the adams apple somewhere, very irritating. Also feels like throat or airway has narrowed.
Not encouraging to read that it takes min. 6 months to see any improvements to larynx area. Especially the cost of pantoloc here.

 
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