hey im vinny, i have been hearing clicking noises when i swallow, and i dont know if its anxiety thats making me think im having trouble swallowing because im focusing on swalling alot now.... i also have a white coated tongue. i also have only one white "tonsil stone" on my right tonsil, and i just went to the ent, you think he would have said something about that but no....i also hack up alot of phlegm. he siad it might be GERD.....if you know what i have/or you have same symptoms as me i would love to hear from you

=) vinny

Vinny-you probably have LPR or laryngopharyngeal reflux, rather than typical GERD. LPR is where the acids make it all the way up to the larynx (voice box) and pharynx (the upper part of your throat). These tissues are much more sensitive to the stomach acids than the esphogus and thus just a very small amount of acids can do a lot of damage. Often there are no symptoms of typical GERD such as heartburn etc. It is frequently called "silent reflux" because the patient often does not know they have it until the larynx is swollen and damaged. The tonsil problem you mention may also be caused by the stomach acid reaching your throat. Many of us who have this form of reflux have a lot of phlegm and a feeling of a "lump in the throat". The best way to find out more about this is to do a general web search on Laryngopharyngeal reflux. Many sites will come up, and you can get a lot of information about this disease. The usual treatment is PPI medication like nexium or prilosec, 2x a day for at least 6 months, and often longer. I have had it for about a year now, at first it was really miserable, but now I seem to be managing it pretty well with medication and diet changes. Good luck and keep us posted to your progress!

Dr. Norm- I am very interested in your research into the link between carbs and reflux disease. As I mentioned in my post I was diagnosed with LPR last fall. This past June I cut out all junk food carbs, but increased carbs in whole grains, bran, and fruits. Since then I have felt MUCH better. For me it seems to help to keep the digestion moving with the fiber in the grains and fruits but both contain carbs. I also take digestive enzymes and probiotics to aid in digestion.

I took PPI's for about 9 months and they helped, but was never completely symptom free of the LPR. Since changing my diet to include lots of fiber, digestive enzymes, and probiotics, I gave up the Nexuim in mid-July and have been pretty much symptom free since then. Maybe I just got lucky, but I'm very interested in your research. Does your theory apply to all carbs including natural fruits and fibers, or just the junk food type? Thanks for the info!

lisman, i have been wanting to talk to you about your LPR recovery i just couldn't find you on an active board. I am taking Nexium 2X day, Reglan 4X a day, and pepcid before bed. I have been doing this for almost 4 months now for a chronic cough, and recently i have gotten a lump in my throat. Did you continue to notice symptom improvement after 4 months of meds? I'm just looking to see if i still have hope. I went for my 3 month follow up at the ENT a few weeks ago and he said that my throat looked like it was getting better but wasn't normal yet. He also said that it would continue to improve and that my symptoms would eventually go away. He did say however that i would have to take meds the rest of my life or get surgery because if i ever came off of them my symptoms would come back. please tell me that im going to continue to get better!

umanac-how I wish I could tell you that you are going to get better! However I can only share my experiences which may be very different from yours eventhough we both have been diagnosed with LPR. Mine started last August with a feeling of a "hair" in my throat, it progressed to where I felt like a cat with a "hairball" stuck in my throat. My throat felt like it was coated with peach fuzz. I made an appointment with my ENT and while waiting for the appointment date it progressed to a lump in my throat, and then further to feeling like I had a grapefruit lodged in my throat. The doc did a scope down my nose and diagnosed me with LPR. At first he put me on Prevacid 2x a day and told me that it would be at least 60 days before I had symptom relief. Boy was I naive, I thought it would be GONE in 60 days, in fact I was rather annoyed that it would take that long. I expected a magic pill to "cure" me right away. I did feel some relief after the initial 60 days but nothing really significant. I continued on the Prevacid until March when my insurance company dropped it from the list of "preferred" drugs. (one must ask--preferred by who? the insurance company, the doc, or the patient...) I was switched to Nexium in April as the insurance company would cover that, however I was able to only get Nexium at 1x a day. Additional dosage needed to be "pre-approved" from the insurance company or they would not cover it. I took the one a day dosage for two months, and did not feel like I was making any progress at all with that dosage. I called the doc and insisted that they get me "pre-approved" for the 2x a day dosage. It was such a hassel with the docs office and the insurance company. It was now June and I had HAD it with the insurance hassels, the docs, etc. I also had a shoulder injury and saw a sports medicine professional to help with that. She is also a nutritional expert, when I told her about the LPR, she suggested I try to support the digestive system with digestive enzymes. She has a full line of supplements at her office and since the enzymes were only $20 for a bottle of 100 I decided to give it a try. I took one pill with each meal, maybe two if I was having a particularly large meal. My meals are usually small, so the dosage of 1 with a meal was plenty. After about a week/10 days, I noticed a difference in the way my throat felt and it seemed like I was improving. However at the time I didn't know if I was improving because I was back on the 2x a day of Nexium or because of the enzymes. I was just so happy to be feeling better that I continued to do both the nexuim and the enzymes. In July the sports meds. doc suggested I also add probiotics, the "good" bacteria that helps your digestive system. I added them to my regime, taking one morning and one before bed. I also added LOTS of fiber to my diet, to keep the digestive track moving. In mid-July I felt really good and stopped taking the nexuim as an experiment. Just using the enzymes and the probiotics did just fine for me! I have avoid all junk food, eat lots of fresh fruits and veggies (not a sacrifice for me, I love them) and lots of whole grains and bran for fiber. I have a fresh fruit smoothy for breakfast everyday-including orange juice- and mix a "greens" food supplement in the smoothie for vitamins and minerals. I also exercise at the gym regualarly and swim. I have also done a colon cleanse to flush my digestive system (no pun intended...) That also seems to have been successful. For me, it has been a long process and one that has not been easy. Patience is not my strong point, sometimes I just wanted to have "the surgery" and be done with it.

I wish I could tell you that I had the secret to this miserable problem of LPR, but I really don't know what has given me the desired result. Maybe the nexium finally healed the larynx and the reflux just went away-I don't know. Maybe an improved diet was the trick. Maybe I'm just lucky. I am just enjoying feeling back to normal for now, and symptom free most of the time. I fully intend to continue the life style changes, I would like to think that with diet, exercise, and healthy living I will find the improvement lasting. However, I have learned over the past year that with LPR you really have to take every "good" day as a blessing, and live one day at a time.

Best of luck to you in your quest for answers. Keep us posted to your progress.

thanks for the help