I came across a new study about LPR. In my own words, a few of the things I found of interest:
People can have up to 50 GERD reflux episodes without developing any esophageal damage. People with LPR can have as few as 1 or 2 incidents of reflux acid exposure in the throat and can have some serious damage and LPR symptoms. I would imagine that is why it is so challenging in treating LPR and why we are so miserable much of the time.
Chewing gum is recommended after meals. They especially recommended bicarbonate gum. That is something I'm not familiar with, but will be keeping an eye out for.
LPR tends to be a chronic-intermittent disease that can be horrible for periods, better for times and return with no specific time frames.
Testing for LPR is different than GERD. The lower probes measure liquid reflux and bile. The probes above the UES need to be able to measure the reflux in its gaseous state.
Thanks for any and all updates on LPR. I truly believe every statement you stated!
I have seen the gum mentioned in an old pharmacy and it did work better than regular gum but I haven't seen any around in a long time. I believe there is a place to order on the internet and need to check it out. If you hear of any place let me know!
Do you know what the test for LPR is called? I had the typical GERD test via my GI doc-- the 24 hr Ph monitor, with probes near the LES and then about 3/4 of the way up the esophagus. But when I saw an ENT, the only test she did was put a then probe through my nose into my throat and look for about 1 minute. She did not mention any other testing.
It seems to me that Mountainreader has good knowledge on LPR. I am very interested in what you mentioned "probes above the UES need to be able to measure the reflux in its gaseous state".
My hoars voice box and the lump sansation in the throat are caused by sort of "GASEOUS STATE" things, because it occurs only about 1-2 hours after a formal meal, nothing to happen at night. I wonder it is due to HIGH stomach acid or LOW stomach acid. Who could give more information about this?
Thanks for the compliment. With regards to the LPR, I think we all learn through necessity when we are faced with the problems. It is extremely frustrating at times and can have some significant impacts on quality of life at times. I really believe in doing all the research I can when faced with an issue. The more knowledge we have, the more we can advocate for ourselves.
You can have 24 hr pH testing with dual probes or a single UES or LES probe.
The single LES probe is the most common. My ENT does the dual or UES probe regularly. My GI doc doesn't really see the need for the upper probes though. It really is one of those things that depends on the experience and education of the doctor. Might take some calling around to find someone to assist if you need the testing.
The thing about the 24 hr pH testing is that it measures for the full 24 hour period. They can tell how frequently you have reflux incidents and the duration of each incident with the dual probes, they can tell how often you have reflux incidents and if they reach the UES area. The single UES probe only measures incidents that come up into the throat area.
The testing isn't really comfortable, but it isn't that bad either. I think the single UES probe would be the easiest because basically it goes from your nose to just above the UES where the other probe goes all the way down your esophagus to above the LES.
They typically do a Manometry before placing the pH probes. The Manometry measures the functioning of the LES and helps them know where to place the pH probe.
I think many people struggle trying to figure out if they have low or high stomach acid. In my case, I have such an excess that even after a Nissen Fundoplication I have stayed on the 60 mg Kapidex daily.
I think many people on this board who are diagnosed with the low stomach acid have gone to Naturopathic doctors. You might try doing some more research in that direction.
Belching is a classic sign of GERD and does not necessarily indicate any LPR. It can be made worse by movements such as sitting and bending over or wearing tight waistbands that squish the stomach. Typical GERD treatments and lifestyle changes such as diet and elevating your headboard should help.
Mountainreader provided helpful information for the PH test. I wonder if the PH test last 24 hours, can the person being tested eat and sleep. It is said that LPR can be caused by either high acid or low acid. Does this test tell us the stomach secrets too much or too little acid?
Mountainreader, I have been doing studies on GERD and LPR too. Would you like me to exchange information with you over emails?
Last edited by River99999; 12-23-2009 at 04:52 PM.
Hi- I have only had LPR symptoms for about 5 months, but I have checked out a lot of info in that time. In general I am a big believer that a lot of folks can handle this without meds, and that elimination diets can relieve the majority of cases. I certainly have never seen evidence that strict diets do not effect the disorder. And while low carb diets have the anecdotal reputation for having the most success doctors and other official sources continue to list fatty and spicy foods as the main culprits.
As to River9's question about too little versus too much acid, you can really spend some time on that question. Doctors here seem basically unwilling to either test or admit that too little stomach acid might be a problem, and some will argue that it does not even matter since the treatment of LPR must be too reduce acid no matter whether the stomach is operating in an high or low acidic state. A large scale screening on American menopausual women indicated that too little stomach acid was present in a significant amount of the population over 50. Anecdotaly a lot of folks have reported improving their LPR/GERD symptoms with Betaine and digestive enzymes which are designed to augment the stomachs digestive capability and go on the assumption of treating too little acid
Mountain Reader I too have seen the papers which suggest that one or two upper reflux episodes a day may be enough to cause LPR symptoms, but I would suggest there is little evidence for such conclusions. In fact the whole idea that LPR occurs when reflux moves above a dysfunctional UES seems unproven to me. I think you guys were discussing the vapor hypothesis which is being explored in a large study whose results will be out next year. and yes Jamie Koufman is a proponent of that theory. Also there is a school of thought that LPR sufferers who also have heartburn type symtoms are the only type of LPR patients who can be treated by PPI's and surgery. In fact this school suggests the aproximately half of LPR sufferers who do not respond to PPI therapy may have a condition not directly related to reflux. What I have never seen is it in fact the case that it is the same LPR sufferers who have heartburn symptoms the same ones who respond to PPI therapy. Seems like a simple obvious question which should have been answered by now, but I have not seen it.
This disorder is a mess of confusion and dangerous diagnosis in my opinoin. Luckily for me things seem to have gotten better without having to do too much. Even so I am embarking on a no grain, no dairy, no concentrated sugar diet in the next couple of weeks I expect it to be hell and almost wish I had worse symtoms to help inspire me. But I want to see for myself what validity the claims thatthis type of diet can be life changing have merit
I am interested in the info provided by Mattnapa. My symptoms are lump sensation and hoarse voice. It occurs only 1-2 hours after meals. No any problems at night. Dr's prescription of PPI worsened my conditions. I stopped the PPI and switched to acidophilus and enzymes, and changed my life style. The symptoms are being improved.
I support the theory of Vapor Hypothesis. That the symptoms occur after meals only and nothing at night implies they are caused by undigested food and the devil is not liquid but gas generated by the undigested food. The question is what kind of gas??? I hope researchers or anybody interested in the issue provide proving information.
Last edited by River99999; 12-28-2009 at 09:35 PM.