Re: LPR as something else, falsely being treated as acid reflux? Probably...
I had my ENT appt. today and I just want to try and help others who are having this extreme or excessive mucus dilemma. My ENT prescribed a new cortisone/steroid nasal spray for me as the PND and the mucus in the throat, globus feeling were scaring me to death and driving me crazy. I had actually developed a click in my throat on one side when I swallowed because of the excessive mucus and clearing of the throat all day and night. So it is called "Omnaris" and I spray two sprays in each nostril once a day. It is a miracle! I just started it when I got home and have not had to clear my throat for three hours now. The clicking feeling is not as bad and the globus feeling is easier to deal with now, it has become minimal. This is just one day's use guy's and gal's! So mention in to your ENT's if they have not said anything about it previously. For me it is like a miracle, with regard to the excess mucus issue. :-)
Re: LPR as something else, falsely being treated as acid reflux? Probably...
Quote:
Originally Posted by ppiless
How did it go with gabapentin? Did you rough out your side effects and did you see improvements with your symptoms?
Long story.
I ramped up to 1200 mg of Gabapentin a day and 20 mg of amitriptyline. The Gabapentin was drying me out really bad and after 3 weeks into it I started to get a nasal irration sensation as if I was congested. so I was switched to Lyrica 50mg twice a day. That helped the dryness but when I took my 2nd 50mg dose of Lyrica at night around same time as the amitriptyline ,I was getting a jittery feeling and couldnt fall asleep. I then tried 75mg Lyrica in morning once a day amitriptyline 20mg at night and that was better. After a few weeks it really didnt make a difference. My nasal sensation didn’t really get better switching to Lyica and then eventually discontinuing it all together. I went to an allergist and got blood test and all environmental allergies came back negative. Pollen count is so high where I am its possible I am getting irritated but don’t have full blown allergies.
I should mention that amitriptyline has always been very effective for globus or trapped gas in my throat feeling but I get a bad burning in my chest, which gets more intense as I increase the dosage. I am now 5-10 mg of amitriptyline and .5 mgs of Klonopin before bed. It seems to be working, but I still get burning sensation in my chest even at 5-10mg of amitriptyline.
I know that amitriptyline has a strong anticholinergic effect and can loosen the LES but my doctor feels that’s no possible as the dosage is low.
Based on this, I could have sworn it was heartburn as it feels it’s in the center of my chest but I am on a low fat acid diet, I take 15mg of prevacid twice a day and my Doctor preformed an endoscope and my stomach and esophagus looked pristine. I don’t burp any acid nor do I get typical gas or acid chest pains just the damn burning feeling. It was concluded that burning pain is neurogenic and not reflux. I also had a botox injection in my UES 2 months ago, so if acid was refluxing my Vocal folds would be swollen which they aren’t. In fact my throat is completely normal aside from my vocal fold paresis.
I am going to ask my doctor to switch me to nortripyline or despramine as they have fewer side effects and less anticholinergic and see if I can get the globus relief without the chest burning.
This is driving me crazy. It’s been a year now and I just want to feel normal again.
Re: LPR as something else, falsely being treated as acid reflux? Probably...
Amen to your post! I believe you are right on with your assertions regarding treatment for a chronic cough and clearing of the throat. I am new to this diagnosis and have spent a few months researching the issues, causes, treatments, etc. First, my story in a nutshell: Been clearing my throat for over 30 years. Coughing now and again, but pronounced from around January through early May, then it subsides by 85% (never gone). Usually appears after a head cold but a dry hacking cough continues for many many months. Same GP for over 25 years so I have a novel of a file in his office. Tested for Gerd with a Gastro Dr. Nothing but he was convinced it must be Gerd or reflux. Took several different drugs for this but nothing worked and my stomach turned into a knot. Tested for Ashma and taken countless drugs and every inhaler known to man (advent, flovent, seravent, advair, alvesco, etc.) and many nasal sprays as well as prednizone/etc. with no affect at all. Allergy tested (4 times in 4 years) with no allergies present. Pulmonologists - no lung issues. Sinus CT? Clear. Chest CT? Clear.
The only relief is sucking on a menthol cough drop OR using a Vick nasal inhaler (non-prescription) which provides relief for only 5 minutes.
Read many articles on PVVN and finally believe this is the "real" issue. In speaking with several Larynx Drs, they believe (and I do to) that somehow the Vegal Nerve is damaged or compromized in the past (viral? who knows) and the nerve itself becomes hysensitive impacting the throat area. Any foriegn substance or excess moisture triggers the need to clear my throat or cough. I also believe that, because this nerve impacts your heart and gastro area, other symptoms of vegal nerve sensitivity show up as gas, reflux, or IBS and is treated by most drs. with drugs for gas and reflux. They don't work because the real culprit isn't the stomach directly, it's the vegal nerve hypersensitivity.
Trying to find a qualified Dr. in this field to help me start a regiment of drugs designed to help the Vegal nerve such as amitripylene, Elavil, Gabapentin, or Lyrica. I started taking several of these via my GP but he is clueless how to take them (he prescribed both Amit and Gab together 3 times a day! I fell asleep by 1pm in the afternoon!.
I know of dozens of people suffering from the same symptoms and go through the same idiotic tests/drugs with Dr.s who are simply guessing. I have found that to a Pulmonlogist - everything is a lung problem. To a Gastro guy, everything can be traced to a stomach problem. An Alergist - it's simply an allergic reaction. All lead to taking drugs like a pin cushion and test animal where my side affects and personal life take a massive hit.
One critical assertion I can make here: I do believe I have some small issues with allergins or stomach issues. However, these issues for most normal humans goes unnoticed but with a Hypersensitive Vegal Nerve, I react by clearing my throat and coughing non-stop. I have lost my voice multiple times from coughing and gotten to the point of throwing up (which stops the cough by the way!!).
I have tried all of the normal teas, gingseng, vicks vapo-rub on my feet at night, etc. All baloney and only temporary relief if at all.
Would love your opinion and what type of drug protocol (type and dosage) anyone has taken with success. I feel I am on my own and swinging wildly at the medical community now. No more mister nice guy!
thanks for listening
Re: LPR as something else, falsely being treated as acid reflux? Probably...
it never made sense to me why I could get postnasal drip so severely and exasperated so much after I ate all without really feeling anything come up my esophagus.
Re: LPR as something else, falsely being treated as acid reflux? Probably...
Did some research on Baclofen and found it is accepted in the medical community but not widely understood and not well known for LPR relief. Also interesting to me in some studies done that a number of individuals admitted to the studies suffered from LPR soon after being intubated for surgery. That is exactly when my LPR started after sinus surgery last year.
Since PPI's have given me little relief but not eliminated the issue and Clonezepam did for short periods a few months ago while taking it then there may well be more to the idea this may be nerve damage somehow related to my intubation. I had mentioned this to the GI once before he wondered about the nerve being involved and he thought there might be something to it.
Of course if he does give me a script for it then there is the side effects as with any drug. I work out all the time, would be a bummer if it impacted that. Hopefully it would not be a drug that I would have to take forever. Any information as to the duration folks need to be on this?
Last edited by Administrator; 11-02-2012 at 01:51 PM.
Re: LPR as something else, falsely being treated as acid reflux? Probably...
An addendum to my last post. Talked to my family doc and he wouldn't prescribe Baclofen, say it was off label for reflux and he had some concerns about using that drug even as a muscle relaxer. Guess I will have to wait for my GI guy.
Re: LPR as something else, falsely being treated as acid reflux? Probably...
I have always had a issue with sugar and itching but I suspect it might be also tied to the Dexilant this time. Just started in August and the itchiness started within a month. Sugar makes it worse, also think I get some seasonal allergies in the Sept time frame so lots of variables. Started Clariten in Sept to offset the itchiness. I am going of Dexilant as of today and back to Losec which also worked for me and see if the itching goes away. Try it for a week or so. I see Dexilant like a lot of drugs has feeling itchy as a side effect.
So many variables in food, drugs etc as you go thru this it drives you nuts trying to understand what it might be.
Last edited by Administrator; 11-02-2012 at 01:51 PM.
Re: LPR as something else, falsely being treated as acid reflux? Probably...
My Gastro doc has prescribed me Baclofen. Trouble is we were planning on spending a few days in Florida , flying out on Thursday so I hate to try a new drug while traveling and visiting folks so I am going to start it next week once back home. I will post what my experience is with it once I get rolling.
If anyone else out there has some experience with Baclofen or similar Gaba-B type drugs please post and share those with us.
If our friendly allergist is back on could you let me know what dose you find is usually working for your patients, what might I expect once I start with this. I hate side effects but know there usually is some, always some price to pay it seems. Think the only drug I ever took that didn't seem to have any side effect was Pepcid/Famotidine.
Re: LPR as something else, falsely being treated as acid reflux? Probably...
I know I have issues with high histamine foods and alcohol , especially wines and beers which are high in histamine. Don't drink much for that reason, can't eat chocolate, strawberries, aged cheese. Have had hives from red wine, migraines were always an issue. Reflux is just this last year for me but had stomach issues for years, taking Pepcid for the last 15. Taken me this long to figure out most of the triggers for my migraines and so have really reduced that aspect but now trying to understand this reflux issue.
On a side note I had two sticks of gum yesterday with the sweetener Sorbitol in them, first time I had ever had it wow, within a 1/2 hour big time stomach pains. Today it was like I had taken a laxative instead of chewing a couple of pieces of gum. Now I know to avoid that stuff as well. Oh well cleaned me out
Re: LPR as something else, falsely being treated as acid reflux? Probably... 
