yes, that's my pattern exactly. i also have LPR. thankfully, I don't cough at night, and can sleep usually --
my coughing is anytime during the day--it can strike when I least expect it and usually when I least want it to.
The drugs didn't stop my cough that much but did help the burning.
I don't have LPR, just hiatal hernia with GERD. But I've never had problems at night, in fact lying down seems much more comfortable. It starts in the morning, and rages on until after dinner, then quiets down when I'm sprawled on the couch or in bed. Was wondering if propping my bed up and not eating before bed would help my daytime symptoms, as it doesn't keep me up at night.
Yes, my problem is never at "night" - or rather, specifically, lying down. Read my "burping" reply for some extra.
But yes, I don't have horizontal problems (at least, not with acid reflux! ), although I often feel very warm in my throat when I 1st awake, as if maybe something was welling up there and burning it. Don't know. Could be just a weird sensation.
But my burping stops when I completey "relax" - I mean, near horizontal, and I am completely rested against something not supporting myself. Even if I prop on an elbow near horizontal, I can burp. But if I relax on the bed/couch - nothing. So, my sleep is not interrupted by LPRD/GERD - only my husband and my dog!
Last edited by Ol'Line Rebel; 07-28-2006 at 10:37 AM.
Your LPR has the same symptoms as mine. I've found that taking the Nexium together in the morning helps me a lot more than 1 at night and 1 in the morning. I'd say that some symptoms come back when I separate them. Since the Nexium wears off after 12-15 hours, if I'm having any breakthrough symptoms before bed I take a Zegrid. But if I'm doing OK at the end of the day, I don't take anything else, because once I lie down all symptoms of reflux stop.
Some people here take Ranitidine before bed (up to 300 mg) instead of Zegrid provided that they are doing the double dose of a PPI in the morning.
I'm basically 100% on this regimen and feeling very good.
I will try taking my two doses in the AM. How long do you wait after you've taken them until you eat or drink? I have to admit I've been taking my one dose and then pretty much immediately drinking a cup of decaffeinated coffee (I gave up caffeine and alcohol for this, and it's killing me).
I also have an asthmatic-like feeling of tightness in my chest, nasal congestion, and the feeling of mucus in my throat. You guys have this too?
Have you found anything that helps with this particular pattern?
Have same symptoms for months now. plus very bad throat irritation and feeling of being choked. My ent looked down my throat, said he saw no obstruction, no throat infection, and no indication of any acid damage. He said he doesn't know whats causing it. Great. Now what.
Everbody blames it on LPR and acid reflux but are you just taking the docs word for it or has tests been performed, like 24 hr ph, etc. My family doc had a catch-all for patients who seem hard to diagnose. "you have allergies to environmental factors".
I usually wait 15-30 minutes after taking my 2 Nexiums before I have breakfast. I admit that I drink coffee in the morning as well, although I've gotten it down to 1 cup. The coffee always makes me cough a little bit, but not enough to make me stop. Then the coughing goes away after about an hour. If I didn't drink the coffee, I wouldn't be coughing. On occasions when I skip the coffee, I don't have any problems eating my standard breakfast of oat bran flakes with fresh blueberries and skim milk, probably because it's a low-fat, high carb breakfast.
This AM I took two my two doses of Nexium and waited about half an hour before having lowfat yogurt for breakfast. I have to admit that I do feel better today. I am having some symptoms (mostly the asthmatic feeling and a small amount of coughing) but--I think it's better than yesterday.
Do you find that fat is a major trigger for you? Are you able to drink any alcohol at all (since you're having a little bit of coffee)?
What I can't figure out is--what happens during the day, that isn't happening at night, to cause symptoms?
Don't worry about why the coughing doesn't happen at night - it's a phenomenon associated specifically with LPR. It probably has something to do with the path of the acid, or where the spinchter is tighter/less tighter. But you're not the only one who experiences this. Usually people with heartburn GERD get wicked back symptoms of the heartburn at night. But most people with LPR feel much much better lying down. There is some thought that we reflux less, but reflux higher.
Before I was diagnosed with LPR and but on Nexium 2x/day, I was sick for 6 months. By the 3rd month, it was clear to me that lying down was the only way I felt better - and I had to lie down on my right side only. (The left side wasn't any good). I quit my job and spent 3 months in bed, being harrassed by my family for having a "mental cough" while I called doctor after doctor from my room. I can't tell you how many times they said "Well, you'll just have to live with it", with my response being "I KNOW something is really wrong and it's not asthma, it's not allergies, and it's not sinsutits." LPR is devastating when it's not being properly treated, so I know exactly how you feel. The day I started on 2 PPIs a day, it was like getting the gift of life back.
I'm glad that the double dose in the morning helped you. Keep doing that, and if you want, get a 2nd prescription for Zegrid at night. Zegrid is just a reformulated picture of prescription-grade Prilosec mixed with the antacid ingredient in Tums.
I have serious problems with eating fat - glad you asked. The absolute worst trigger is anything deep-fried, followed by any meats that are tough with a lot of saturated fat (like many cuts of beef). Eggs also make me cough (and I love eggs). Even sauteeing a veal cutlet in oil can set me off.
Strangely, I've found that the opposite extream (baked plain chicken breasts wrapped in foil) will also make me cough as the meat gets dry and tough.
I've had the most success eating moist meats that are either done in the slow-cooker with the fat skimmed off, or chicken breasts/thighs, baked in the oven under the natural layer of fat, with the fat removed before eating. I don't have any problems with fish. But a potato chip or spring roll will immediately make me cough. I also love love love ice cream, and can handle a small amount (1 scoop) without triggering the syptoms.
salad dressing doesn't bother me - perhaps because I use good quality olive oil. Who knows? I also have an Italian grandmother who taught me how to cook, so I'm partial to lots and lots of garlic and onions - I just cook them extensively. Only the raw or less-cooked garlic/onions causes problems.
My symptoms seem to become better at night. Does anyone have difficulty swallowing? No one seems to complain about that symtpom. It seems everyone has coughing. I don't have that?
If my sytmptoms are different, should I be treating the LPR differently?
I will try taking my two doses in the AM. How long do you wait after you've taken them until you eat or drink? I have to admit I've been taking my one dose and then pretty much immediately drinking a cup of decaffeinated coffee (I gave up caffeine and alcohol for this, and it's killing me).
Jane, let me know if the two in the morning work for you. I have been debating trying this. The doc put me on 300 mg of zantac at night now and I'm not sure how I should be taking my pills anymore.
I''ll try cutting back on fat and see what happens. I took 150 mg of rantidine last night as well as my two doses of Nexium in the morning. I just can't stand this; when I get so symptommatic my tendency is to eat as little as possible.
My gastroenterologist thinks I have low motility. I think the motility problem is in the esophagus as well as in the stomach. I had an endoscopy and will shortly have a swallowing test...I wonder if the problem with fat is that it takes longer to digest so is a bad match for someone with low motility? Also, any chance the acid is produced not only in the stomach, but in the esophagus/pharynx as well? I thought Aswander said there is some evidence of this?
Last edited by Jane Craig; 07-30-2006 at 08:26 AM.
Well - I know it's a fact that fat slows the stomach emptying process. If you have a reflux condition, having any food in the stomach means there is a higher probablility that you will reflux the acid that's digesting the food. In practice, I find this is true every morning when I eat my non-fat breakfast of cereal, skim milk and fresh fruit. I don't feel any reflux. But whenever I have any fat, I can always reflux, and the amount of reflux depends on how much I eat and how much fat is the food, as well as what type of fat I am consuming.
But motility is a real problem for some people, and I'm not very familiar with how it's treated. I suppose that a low-fat diet may help it in emptying the stomach contents faster, but I honestly haven't looked into it and am in no position to make any suggestions about how to improve it.
Regarding acid in the larynx - there was a study (done on cadavers) (and the citation is available at the U.S. Gov's NCBI's Pubmed database) on proton expression in the larynx. Apparently they found patches of acid-producing tissue at the top of the esophogous? I didn't have a subscription to the periodical, so I was only able to read the citation.
But then I read somewhere else about patches of acid-producing tissue in the lower esophogous that cause reflux-like symptoms. They are called "inlet patches", or "oesophageal inlet patches" or "esophogeal inlet patches".
Apparently, these patches are sensitive to PPIs in the same way that the proton-producing stomach is, and respond to PPI therapy. However, there is some experimental surgery going on that targets the inlet patches in people with sore throat symptoms.
I start having symptoms when I get up and start to walk around. Yes I do sleep with the wedge. I also feel weak when I wake up and takes me awhile to feel some energy. Anyone else feel this way?
), although I often feel very warm in my throat when I 1st awake, as if maybe something was welling up there and burning it. Don't know. Could be just a weird sensation.
