Hi, if anyone can't already tell, I am starting to worry a lot. One thing that I have been learning from these posts and this board is that it is best to be aggressive with LPR right out of the gate. Today my stupid ENT prescribed Protonix only once daily, so I had to call back and leave a message that I did not want to take a "wait and see approach", I'd like to do it twice per day to get better coverage.

What I need to know most from you all is when to expect this lump to show up.

So far I have had burning in voice box--comes and goes--coughing--remarkably better--none of the mucous people are describing. I just want to prepare myself. Any input would be greatly appreciated, thanks! I wish I could relax.

Hi Vintagegirl,

Double dose full strength PPI should be used for LPR. I tried it for 3 months (standard in UK) with no success. Hope you fair better. Bit confused by waiting for lump to show. If by this you mean the globus sensation of something sticking in your throat it is usually one of the first physical symptoms of LPR although the reflux could have been present for some time (silent reflux). If you do not have it yet it sounds like you have caught the reflux in time. What I experience is an annoying feeling of something that you cannot clear. It is usually a semi-permanent feature of established LPR. I believe the cause is inflammation of the pharnygeal / laryngeal tissue from the reflux although the mucous / PND could be an aggevating factor.

Hope helps

Thanks for replying, Ginger. My first symptom was loss of voice on and off and then a dry, spastic cough. That is gone now...I never had a sensation of mucous or a lump...but am just really terrified that I will develop that if this PPI therapy skips a beat in any way. Come to think of it, the ENT's first question to me was, "Do you feel as though you have something stuck in your throat?" I said no, but the cough was embarrassing because I could hardly get through a sentence without it sneaking up on me before I could cover my mouth, and I did not want to put people off. He said my vocal cords looked a little red. Then yesterday, I was feeling really good until I had one cup of coffee, burped a few times, then I went on a coughing jag. Not sure what to make of that. I really am rooting for all of you on here, my heartfelt best wishes to you......

Hi Vintage girl,

Thanks for your kind words. Coughing is noted as a symptom but I have always ignored it as I do not get it just now. However, thinking back a couple of years I did used to have coughing fits regularly especially with alcohol. I suppose these must have been the very early stages of the reflux as I only got the mucous and globus last year.

For info the process I have gone through was to firstly see an ENT who diagnosed mild nocturnal GERD to which I was sceptical as I never experience heartburn. Had 3 months pantaprozole (PPI) , no alcohol, lost weight. Still experienced the acidic taste,bad breath,burning mouth, PND, mucous and globus. On follow up ENT said there was clear evidence of LPR on larynx and that given failure to respond to meds etc best option would be fundoplication surgery. Next stage was an Endoscopy and 24 hr PH monitoring prior to any surgery consideration. Endoscopy last week showed no damage to esophaegus but no surprise there as no heartburn, evidence of reflux further up, sliding hiatus hernia and the H.Pylori bacteria (cause of peptic ulcers). Unfortunately whilst the endoscopy helps in identifying possible cause of reflux it does not really detect the severity and regularity of LPR. Having PH study next month and possible Barium X-ray too check for sphincter malfunctioning. Depending upon these findings surgery next step.

You can use this continueum to see where you are at although I hope the PPI's do the trick.

Best wishes

Hi Vintagegirl. Know it sounds basic, but my sisterinlaw had a dry hacking cough for 6 months and they couldn't figure out what the problems was. Finally ... post nasal drip. The muscas was going down her throat and making her cough. With my lpr, I do have a cough, but I also have a burn in the throat, like someone is cutting it with a razor blade and a 'thick' feeling in the throat - like it is partially closed off (except when I eat). Also, I lose my voice easily. However, if the ppi is helping you, it probably is lpr. Just thought you might want to check the other in case.

Vintage girl--Regular coffee is one of the worst things I can do to my LPR. I have switched to coffee substitues, or low acid forms of coffee. I use a cold brewing method called a "toddy". You can find information on the toddy coffee maker on the internet. I also use a product called "coffee tamer" that I get a health food store--also can be found on-line but it's easier for me to pick it up locally. Also caffeine is very bad for reflux, so I use only decaffinated coffees when I do have some. However, I feel best by cutting out the coffee completely. Coffee is highly acidic, when you reflux stomach acid along with coffee acid, you are getting a "double dose" of acid in your throat.

You are one of the lucky ones if you do not have a "lump in your throat"! It may never show up at all. I have found that eventhough there are similarities and definate symptoms that those of us with LPR share, each case is different and needs to be treated with therapy differently. I am fortunate in that I have a terrific ENT, who usually listens and considers my input in my treatment. As a result I am far more willing to also listen to his advise when our opinions differ. He does treat most things aggresively. (He also has helped me thyroid problems. Again the treatment was aggressive but ended up exactly what I needed). I usually bow to his experience, and so far he has handled my treatment very well. Maybe my case of LPR is more mild than others, but after 6 months I AM getting better so maybe there's hope for all of you out there! I hope my progress is lasting.

I also hope you can find a medical professional whom you can develop a good relationship with. I cannot emplasize enough the importance of good communication with your doctors. If you are not receiving the care you feel you need, look around for another doctor. Talk to everybody you know for references and find someone you can relate to. Call your local hospitals and find out who they recommend. Talk to any nurses you know or can find for references. They work with many docs and can give you good info on who they prefer and why they feel a particular doc is good. Unfortunately "silent reflux" usually takes a long time for the symptoms of the acid damage to develop; the treatment to reverse the damage therefore also takes a long time. The best course of action is to decide with your doctor how you want this problem treated, then stick with the treatment long enough to allow it to work. The down side of that obviously, is that if the treatment is not working you won't know for a long time either. :confused:

Hang in there, and keep us informed to any info you get, or any progress you hopefully are making. Thanks for posting. I appreciate any info I can get from anyone. At least we are not alone and have someone to talk to who understands from a first hand point of view!

Hi all,

I'm a newly (self diagnosed) LPRer myself. On March 4 I went to the ER with hot fire in my lungs. After a complete cardiac work up (5 days in the hospital including a cardiac cath to investigate what turned out to be a shadow of my breast tissue), a visit to a pulmonologist (and treatment for pleurisy including steroids which really did a number on my stomach), a GI (who treated me for GERD with Nexuim and Zantac) an ENT (who sent me back to the GI), and back to my family doc I decided to get on the internet and figure out what the heck is going on. As soon as I saw the first LPR post I knew what I had.

I called my family doc and got on Nexuim 40 mg twice a day. That was 3 weeks ago and already it's MUCH better. I had to fight my insurance company to get them to cover it, but they did.

I've been fighting this for two months now and so I have learned a few tricks.

Some things that have really helped me:

1. The Nexium 40 mg twice a day - the only way to go. The others aren't as good. I will need to take this for 6 months before I even consider tapering back down.

2. Sleep with a warm mist humidifier right by your head.

3. Drink at least 5 big glasses of water per day.

4. Rest your voice. Write notes - especially in the evening.

5. Eat a GERD-friendly diet. No it's not what we have, but the principles of food choice are similar. You want to eat only low acid and low fat.

6. Try standing up or walking around after you eat. The exercise seems to help me keep stuff in my stomach and out of my throat.

7. .25 mg of Xanax helped me when my throat was really tight and constricted. Yes, it has been shown to lower LES pressure, but it works for the strangling feeling.

8. There was a stud in Belgium regarding the use of Baclofen for increasing LES pressure. My doc prescribed it (cause I asked for it) but I only tried it once and refluxed it onto my already raw vocal chords so I didn't try again.

9. NO CARBONATED SODA. It really acts on the throat thing.

10. Should be #1 - PRAY. God has really been active in helping me through this. I am a better person and much stronger in my faith.

Hang in there and if your doctor isn't listening (or has no idea waht you are talking about) find another one. I've never been a doctor hopper before, but this is a tough illness with few experts (except us patients ;) )

God Bless!

Just curious...does the use of Xanax lower your LES pressure for GOOD? I was on it right before all of this crap started. Since I've switched to a nicer job, I have not been using it. You guys are awesome, thanks! :wave:

No, just while you're on it, as best as I can tell from what I've read, although my GP and my GI both said that it's benefits outweighed the concern over that. Some doctors even think that is a myth, so it just depends on who you ask. I do know it helped me through the worst "throat" times. There were days I wanted to cry but I wouldn't let myself because I didn't think there was room for any more constricture in my throat.

I feel soooo much better now. I wish everyone else did, too.

Cherbo....I have pretty much found those very things help me a lot , too. I agree on the xanax, emphatically, and im not one to take drugs. In fact I have not yet done the Nexium as I am trying Acid Ease from the healthfood stores, slippery elm, and aloe juice...